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Dermatology and Wound Healing
Published on
January 25, 2026

Alayat M.S. et al. - Photobiomodulation after episiotomy: a meta-analysis on pain and wound healing

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This meta-analysis, published in 2026, found no significant benefit of photobiomodulation for perineal pain or for wound healing following an episiotomy. The overall level of evidence was deemed very low, and the authors call for better-standardized randomized trials before any clinical recommendations are made.

What this study measured

This is a systematic review with a meta-analysis, not a single clinical trial. The authors searched several electronic databases to identify randomized controlled trials and non-randomized studies that evaluated photobiomodulation following an episiotomy. Two outcomes were assessed: perineal pain and wound healing.

The risk of bias was assessed using the RoB 2 tool for randomized trials and ROBINS-I for non-randomized studies. The certainty of the evidence was rated according to the GRADE approach. Quantitative syntheses used random-effects models.

Key Findings

Eight studies were included in the systematic review and six in the meta-analysis. The pooled results show no significant difference between photobiomodulation and the comparison interventions.

  • Pain: standardized mean difference of 0.04 (95% CI -0.60 to 0.68; p = 0.89)
  • Heterogeneity in pain: I² = 91%
  • Wound healing: mean difference of 0.94 (95% CI -0.69 to 2.56; p = 0.26)
  • Heterogeneity in wound healing: I² = 94%
  • Risk of Bias (RoB) 2: 1 low-risk trial, 2 trials with reservations, 3 high-risk trials
  • ROBINS-I: Serious Risk for the Two Non-Randomized Studies
  • GRADE level of evidence: very low for both criteria

How photobiomodulation works for this indication

The mechanisms proposed in the literature remain hypothetical. Red or near-infrared light is thought to be absorbed by mitochondrial cytochrome c oxidase, which could increase ATP production in exposed cells. When applied to a wound, this could support fibroblast activity, collagen synthesis, and local angiogenesis. Modulation of the inflammatory response has also been suggested as a possible explanation for any effect on pain. These hypotheses are not supported by the results of this meta-analysis.

Limits You Should Know

The main finding is negative: no statistically significant benefit was observed, either in terms of pain or wound healing. The number of included studies is small, there is considerable heterogeneity among them, and the GRADE certainty is very low for both outcomes. The authors state that they were unable to conduct either sensitivity analyses or subgroup analyses, which prevents the identification of a potential patient profile or treatment protocol associated with a response. The radiation parameters used in the primary studies are not detailed in the abstract.

What This Means in Practice

As it stands, these data do not support recommending routine photobiomodulation following an episiotomy. A recent scar, a perineal wound, and, more broadly, postpartum care should be monitored by a midwife or physician. No light therapy should be administered to a recent scar without prior medical consultation. The authors conclude that high-quality randomized trials with standardized protocols are needed before any clinical recommendations can be made.

Frequently Asked Questions

Does photobiomodulation relieve pain after an episiotomy?

This meta-analysis does not show this. The difference between the treatment groups and the comparison groups is close to zero and not statistically significant. Since the level of evidence is considered very low, we can neither confirm a benefit nor definitively rule out an effect under certain conditions.

Can a light therapy device be used on a recent perineal scar?

A recent scar is a sensitive area, and the postpartum period requires medical monitoring. Any application to a wound or recent scar should be done only after consulting a doctor. Talk to the midwife or doctor who is providing your care before considering any course of action.

Why do the results vary so much from one study to another?

The reported heterogeneity is considerable, with an I² of 91% for pain and 94% for wound healing. This means that the studies do not measure the same thing in the same way. The study protocols, the scales used, and the time points for assessment differ, making the synthesis difficult to interpret.

Reference

Alayat MS, Sroge RA, Alshiakh FM, Abd El-Kafy EM, Fadil A, Awali A, Subahi MS, Almutairi AA. The Effectiveness of Photobiomodulation Therapy on Perineal Pain and Wound Healing After Episiotomy—A Systematic Review and Meta-Analysis. J Clin Med, 2026;15(3):964. PMID 41682644. DOI 10.3390/jcm15030964. https://doi.org/10.3390/jcm15030964

This summary is provided for informational purposes only and does not constitute medical advice. Photobiomodulation is not a substitute for prescribed treatment. Consult a healthcare professional.