Dr. Bishan Mahadevia's - Latest Tips and Resources

Saturday, January 16, 2010

Hair Loss and Laser Therapy/ cold Laser/ LLLT

Laser Therapy

Low-Level Laser Therapy (LLLT) or Cold Laser in hair restoration utilizes cool lasers to stimulate hair growth and reduce shedding of hair. LLLT is based on the scientific principle of photo-biotherapy. Photo-biotherapy occurs when laser light is absorbed by cells and stimulates cell metabolism and protein synthesis. Although the exact mechanism by which laser light promotes hair growth is still unknown, it appears to stimulate the follicles on the scalp by increasing energy production and by reversing miniaturization (the process leading to thicker hair shafts and a fuller look).

Laser light is in the visible red light spectrum and is generated in a laser diode. The energy level is far below that of laser beams that cut or burn tissue. The low-level red laser light has a very low absorption rate in human tissue making it safe for use in the treatment of hair loss. The Revage laser emits 670nm of visible red light.

Low energy lasers have been used for over thirty years to accelerate healing after wounds or burns and to reduce pain. In 1992, Pontinen published the first paper discussing its possible use in promoting hair growth. Since then there has been much progress is defining the exact parameters necessary to accomplish this, In 2007, the FDA cleared for marketing the use of low-level lasers for the treatment of androgenetic hair loss in men. This clearance was based on the device’s safety, and not on its effectiveness in treating hair loss.

The HairMax LaserComb, cleared by the FDA as a Class II medical device in January 2007, is a compact version of the larger laser therapy units used by hair clinics in other countries to stimulate hair to increase in thickness and make the hair appear fuller. This home product has teeth that part the hair to potentially enable the laser light to reach the scalp in areas of existing hair.

The Revage Laser System, from Apira Science, utilizes Rotational PhotoTherapy (RPT). The Revage 670 is a Class IIIA diode laser approved by the FDA for cosmetic use. It is a low-level laser system that contains 30 laser diodes that rotate 180 degrees around the scalp. This dynamic process increases the contact of the laser energy with the hair follicles and is potentially more effective than a static system in delivering the laser energy to the scalp. It also eliminates human error and variability in self administration. A potential limitation is the fact that existing hair may interfere with the laser beam effectively reaching the scalp.

The unit may prove to be useful for hair loss in women where the thinning tends to be diffuse or those experiencing telogen effluvium. LLLT can be used safely in conjunction with other medications including Propecia and Rogaine and there are no contraindications which would interfere with hair transplant surgery.

While these cool laser treatments have been approved for use, their long-term effectiveness has yet to be determined. A 12 month program can require treatments from 3x per week tapering to one treatment per month and the results and satisfaction from patients thus far have been sporadic.

How Effective is Hair Loss Treatment with Laser Comb?

It is difficult to tell since there are no long-term studies using the LaserComb.From the data we have available, it seems to be about as effective as Rogaine (Minoxidil). As most who have used Minoxidil know, it only works in areas where there is a fair amount of miniaturized hair and over time loses its effectiveness. The HairMax LaserComb is not as effective as Finasteride and, of course, is not a substitute for surgical hair restoration.

Which Laser Comb Works Best ?

I have been trying to find some evaluation of which laser combs work best for “hair restoration”. I have seen some dermatologists speak about the Hair Max laser comb and its effectiveness (considering patient compliance, the amount of time the patient has been losing hair, the amount of total hair loss at time of treatment, etc.). I have also seen reference to the Sunetic laser comb which claims to have a superior technology to the Hair Max and offers a changeable head to allow treatment of the skin for healing, wrinkles, etc. A company in Michigan also offers a laser comb called the Hair Rejuvenator which it claims is superior to either of the other combs but I have not heard of any dermatologist who recommends this comb. A firm in Australia also offers a laser comb (Aculas) which it claims is the most effective; however, the makers of the Hair Rejuvenator comb say it is too powerful and dangerous and could cause blindness. Amidst all these claims, the consumer (patient) is left wondering which best option is and which is merely hype or fraud.

There are no comparative studies thus far. For a hand-held device, I would stick with the Laser comb for now since it is the only one that has cleared the FDA.Some others may work as well (and are less expensive) but we just don’t know at this time – and how useful any of them are long-term is also still not known.

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