Over the past few years, we have seen remarkable clinical benefit with LLLT. Low-level laser technology is not new. It is the portability of the equipment and the ease of compliance that gave us a new and better perspective on the effectiveness of LLLT. In 1967, when Hungarian scientists were evaluating the denuded area of a mouse to see whether visible red light would influence cancer incidence (which it did not), they found that the hair regrew much faster in the treated area. Low-level laser therapy works by photostimulation of the hair follicle by cold laser light in the visible red spectrum using wavelengths between 630 and 670 nm with low power (wattage). The photobiological reaction involves stimulation of intracellular cytochrome c, which in turn sends signals throughout the cells of the hair follicle so as to stimulate its activity, decrease cell death, and promote other changes that enhance cell activity and survival. In January of 2007, a handheld laser therapy device was cleared by the FDA as a treatment for AGA. Since then, several other laser-therapy devices were cleared by the FDA.
For years, LLLT was offered only as an in-office treatment that required the patient to travel to a clinic for treatment several times a week, which made patient compliance difficult. The trend now has been to move from in-office units to portable home units that offer similar results without the hassle. Home units come in various strengths (containing anywhere from 10 to 272 laser diodes and various shapes such as comb, brush, standalone dome, helmet, and hat). Recently, randomized, sham device-controlled, double-blind clinical trials were conducted at multiple institutional and private practices to evaluate the efficacy of LLLT. A total of 128 males and 141 females participated in the study. Their whole scalp was treated three times a week for 26 weeks and showed that using a handheld comb device 10 minutes three times weekly over 6 months in both men and women regardless of their age demonstrated a statistically significant increase in hair counts. In addition, there was a higher percentage of patients who reported overall improvement in their hair loss as compared with sham-device users. In the United States, the general consensus is that three times weekly for about 15–30 minutes is not only sufficient to stimulate hair growth but that daily usage may actually overstimulate the follicles and thereby be detrimental. Unfortunately, we do not have a firm grasp on what are the ideal wavelength, wattage, duration, and frequency to use the product, or even the ideal design of the product. Further investigations must be undertaken to refine our current understanding of this technology.
Clinically, the laser therapy can be used in combination with other medical and surgical solutions for hair loss or in isolation. It can also be used to prepare patients for surgery to minimize postoperative telogen effluvium, and post hair-transplant procedure to promote healing and to help with growth of the transplanted hairs.
Medical Suite Building,
Arwyp Hospital, 22 Pine Avenue,
Kempton Park, Johannesburg.
Behind La Coline Commercial Centre,
Candos (close to hospital) Quatre Bornes