Use of the pulsed infrared diode laser (904 nm) in the treatment of
MAKRAM WAIZ1, ANMAR Z. SALEH2, RAAFA HAYANI1& SAMAR O. JUBORY1
1Department of Dermatology and Venereology, Baghdad Teaching Hospital, Baghdad, Iraq, and2Department of Medical
Physics, College of Medicine, University of Baghdad, Baghdad, Iraq
Background. Alopecia areata is a rapid and complete loss of hair in one or several patches, usually on the scalp, affecting both
males and females equally. It is thought to be an autoimmune disease which is treated with different modalities with variable
success. Laser treatment of different wavelengths has been used in the management of this problem.
Objective. To study the effect of the pulsed infrared diode laser (904 nm) in the treatment of alopecia areata.
Methods. Sixteen patients with 34 resistant patches that had not responded to different treatment modalities for alopecia
areata were enrolled in this study. In patients with multiple patches, one patch was left as a control for comparison. Patients
were treated on a four-session basis, once a week, with a pulsed diode laser (904 nm) at a pulse rate of 40/s. A photograph
was taken of each patient before and after treatment.
Results. The treated patients were 11 males (68.75%) and five females (31.25%). Their ages ranged between 4 and 50 years
with a mean of 26.6¡SD of ¡13.8, and the durations of their disease were between 12 months and 6 years with a mean of
13.43¡SD of ¡18.34. Regrowth of hair was observed in 32 patches (94%), while only two patches (6%) failed to show any
response. No regrowth of hair was observed in the control patches. The regrowth of hair appeared as terminal hair with its
original color in 29 patches (90.6%), while three patches (9.4%) appeared as a white villous hair. In patients who showed
response, the response was detected as early as 1 week after the first session in 24 patches (75%), while eight patients (25%)
started to show response from the second session.
Conclusion. The pulsed infrared diode laser is an effective mode of therapy with a high success rate for resistant patches of
Key words: Alopecia areata, laser
Alopecia areata (AA) is a common a symptomatic
skin disease characterized by a rapid onset of non-
scarring hair loss in a sharply defined area. Any hair-
bearing surface may be affected, especially the scalp
(1). It affects 1% of the population and can occur at
any age, most commonly in children. Although it is
not life-threatening, the hair loss can be psycholo-
gically harmful (2,3).
The cause of AA is thought to be mainly
attributed to an autoimmune process, which may
be modified by genetic factors and aggravated by
emotional stress (1). Many studies have documented
an abnormal cell-mediated immune reaction in AA.
There is an increased suppressor T-cell function in
patients experiencing hair regrowth. Antibodies to
pigmented hair follicles were detected by Western
blotting in the sera of 100% of the AA patients
examined compared with only 44% of normal
The treatment of AA depends on the severity and
extent of the disease. These include a topical irritant,
and topical and intralesional steroids in mild cases.
However, more aggressive therapy is used for severe
cases such as systemic corticosteroids, immunosup-
pressive drugs and immune modulators (1).
The laser (light amplification by stimulated emis-
sion of radiation) has been used in the treatment of
different skin diseases. The laser beam differs from
the ordinary light by being coherent, monochromatic
and polarized. It concentrates its beam in a defined
position. These properties allow low-energy laser
light to penetrate the surface without damage of the
Correspondence: Professor Makram Al-Waiz, Department of Dermatology and Venereology, College of Medicine, University of Baghdad, PO Box 61269,
Medical Collection Post Office, Postal Code 12114, Bab Almua’dham, Baghdad, Iraq. E-mail: email@example.com
(Received 17 November 2005; accepted 18 January 2006)
Journal of Cosmetic and Laser Therapy. 2006; 8: 27–30
ISSN 1476-4172 print/ISSN 1476-4180 online # 2006 Taylor & Francis