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Background: The purpose of this study was to elucidate why some potentially damaging and beneficial effects were obtained following blue light exposures on skin., Materials and Methods: Light-emitting diode (LED) devices containing 415 and 470 nm bulbs were used on normal human keratinocytes, skin biopsies and subjects with acne. Reactive oxygen species (ROS) evaluation was performed after a course of blue LED light exposures. A comparison between very small bandwidth centered at 415 nm and a combination of (415 + 470 nm) wavelengths was also carried out regarding the effects on ROS production. The effects on other targets such as opsin1 short wavelength (OPN1 SW) photoreceptor, fibrillin-1 dermal component, LL37 antimicrobial peptide and interleukin-8 (IL-8) proinflammatory cytokine were then explored. Finally, clinical pictures of acne signs were also investigated after blue LED exposures., Results: Dose dependent increases of ROS production were obtained on keratinocytes exposed to increasing 415 nm LED exposures. However, a ROS decreasing first phase was observed on keratinocytes exposed to 415 + 470 nm LED exposures. Moreover, comparing the same doses of 415 nm wavelength and (415 + 470 nm) wavelength combination, 415 nm alone is more damaging than the 415 + 470 nm exposures. In case of increase in ROS, decrease in OPN1 SW photoreceptor and fragmentation of fibrillin-1 dermal fiber were observed. When conditions of ROS decrease were experienced, an increase in LL37 antimicrobial peptide and a modulation of IL-8 inflammatory response were noted, suggesting improvement in acne signs. Clinical results confirmed the benefits on inflammatory lesions on subjects with acne., Conclusion: Blue lights can induce beneficial and adverse effects, depending on the dose and on the spectrum width of the exposure., (Copyright © 2020 The Authors. Published by Elsevier B.V. All rights reserved.)