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Hair Regrowth and Increased Hair Tensile Strength Using the HairMax LaserComb for Low-Level Laser Therapy
Abstract
The authors wished to confirm the efficacy of low level laser therapy (LLLT) using a Hair- Max LaserComb for the stimulation of hair growth and also to determine what effect LLLT with this device had on the tensile strength of hair. Thirty-five patients, 28 males and 7 fe- males, with androgenetic alopecia (AGA) underwent treatment for a six-month period. Both the hair counts and tensile strength of the hair were affected very beneficially in both sexes in the temporal and vertex regions, with the males and vertex areas showing the most im- provement.
... Increase in hair density on both the vertex (145.1 vs. 137.3/cm 2 pre-treatment, P < 0.005) and occiput (163.3 vs. 153.3/cm 2 , P < 0.005) as well as anagen/telogen ratio (vertex: 84.7 vs. 79.7 pre-treatment and occiput: 91.9 vs. 89.6 pre-treatment) was observed, and 83% of the patients reported to be satisfied with the treatment. [44] Satino and Markou [45] tested the efficacy of LLLT on hair growth and tensile strength on 28 male and 7 female AGA patients. Each patient was given a HairMaxLaserComb ® 655 nm, to use at home for 6 months for 5-10 min every other day. ...
... In terms of hair tensile strength, the results revealed greater improvement in the vertex area for males and temporal area for females; however, both sexes benefited in all areas significantly. [45] In terms of hair count, both sexes and all areas had substantial improvement (for temporal area: 55% in women, 74% in men, in vertex area: 65% in women, 120% in men) with vertex area in males having the best outcome. [45] Leavitt et al. [46] used the Hairmax ® comb in a doubleblind, sham device-controlled, multicenter, 26-week trial randomized study among 110 male AGA patients. ...
... [45] In terms of hair count, both sexes and all areas had substantial improvement (for temporal area: 55% in women, 74% in men, in vertex area: 65% in women, 120% in men) with vertex area in males having the best outcome. [45] Leavitt et al. [46] used the Hairmax ® comb in a doubleblind, sham device-controlled, multicenter, 26-week trial randomized study among 110 male AGA patients. Patients used the device three times a week for 15 min for a total of 26 weeks. ...
Androgenetic alopecia (AGA) is the commonest type of alopecia affecting over half of men and women. Only two drugs have been approved so far (minoxidil and finasteride), and hair transplant is the other treatment alternative. Low-level laser therapy (LLLT) has been claimed to be a new safe devise-based modality for stimulating hair growth in men and women in AGA. Searches of PubMed and Google Scholar were carried out using keywords alopecia, hair loss, and LLLT. Fifteen studies were found to be strongly relevant and were analyzed. Studies have shown that LLLT stimulated hair growth in both men and women. Studies with largest randomized controlled trials demonstrated statistically significant hair regrowth by terminal hair count in both males and females. One study also showed that LLLT and minoxidil had similar efficacy in hair growth and that combination therapy was even more effective. LLLT represents a non-invasive, safe, and potentially effective treatment option for patients with AGA who do not respond or are not tolerant to standard treatment of AGA. Moreover, combining LLLT with topical minoxidil solution and oral finasteride may act synergistic to enhance hair regrowth. However, the level of evidence of the studies is still low and hence more controlled large studies are needed.
... Satino et al. conducted an early clinical study in 2003 looking at LLLT to treat AGA [20]. Thirty-five patients, 7 females, and 28 males were treated at home with the HairMax Lasercomb® 655 nm for 5-10 min every other day for 6 months [20]. ...
... Satino et al. conducted an early clinical study in 2003 looking at LLLT to treat AGA [20]. Thirty-five patients, 7 females, and 28 males were treated at home with the HairMax Lasercomb® 655 nm for 5-10 min every other day for 6 months [20]. This study was not randomized or controlled, but compared hair strength and count to each patient's pretreatment level. ...
... This study was not randomized or controlled, but compared hair strength and count to each patient's pretreatment level. The results showed overall improvement in hair count, with an increase of 93.5% compared to baseline [20]. Hair tensile strength increased 78.9% overall compared to baseline [20]. ...
There are many new low-level laser technologies that have been released commercially that claim to support hair regrowth. In this paper, we will examine the clinical trials to determine whether the body of evidence supports the use of low-level laser therapy (LLLT) to treat androgenic alopecia (AGA). A literature search was conducted through Pubmed, Embase, and Clinicaltrials.gov for clinical trials using LLLT to treat AGA. Thirteen clinical trials were assessed. Review articles were not included. Ten of 11 trials demonstrated significant improvement of androgenic alopecia in comparison to baseline or controls when treated with LLLT. In the remaining study, improvement in hair counts and hair diameter was recorded, but did not reach statistical significance. Two trials did not include statistical analysis, but showed marked improvement by hair count or by photographic evidence. Two trials showed efficacy for LLLT in combination with topical minoxidil. One trial showed efficacy when accompanying finasteride treatment. LLLT appears to be a safe, alternative treatment for patients with androgenic alopecia. Clinical trials have indicated efficacy for androgenic alopecia in both men and women. It may be used independently or as an adjuvant of minoxidil or finasteride. More research needs to be undertaken to determine the optimal power and wavelength to use in LLLT as well as LLLT’s mechanism of action.
... P hotobiomodulation, also referred to as low-level laser therapy (LLLT), has been studied and used for the treatment of a variety of clinical indications, including the promotion of hair regrowth. [22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38] Each of these applications is based on the biological effects of photobiomodulation in living organisms. The potential application of photobiomodulation to stimulate hair growth can be traced to Endre Mester, a physician practicing in Budapest, Hungary. ...
... [24][25][26] These observations led to laboratory and clinical investigations on the effects and applications of LLLT in male and female pattern hair loss. [27][28][29][30][31][32][33][34][35][36] In January, 2007, the Food and Drug Administration granted the first clearance for a device indicated for use in treating males diagnosed with androgenic alopecia (AGA) and with Fitzpatrick I to IV skin types. 32,35 In 2010, the category was expanded to treat females diagnosed with genetic hair loss based on the results of a randomized clinical trial. ...
... [27][28][29][30][31][32][33][34][35][36] In January, 2007, the Food and Drug Administration granted the first clearance for a device indicated for use in treating males diagnosed with androgenic alopecia (AGA) and with Fitzpatrick I to IV skin types. 32,35 In 2010, the category was expanded to treat females diagnosed with genetic hair loss based on the results of a randomized clinical trial. 37 A clinical study was developed to define the safety and physiologic effects that occur when the human hair follicle and surrounding tissue structures are exposed to laser light using a novel device that is fitted with an array of laser diode sources operating at 650 nm and placed inside a sports cap to promote discretion while in use. ...
Background:
Photobiomodulation, also referred to as low-level laser therapy (LLLT), has been studied and used for (among other diseases) the promotion of hair regrowth.
Objective/materials and methods/results:
A clinical study was developed to define the physiologic effects that occur when the human hair follicle and surrounding tissue structures are exposed to laser light using a novel device that is fitted with an array of laser diode sources operating at 650 nm and placed inside a sports cap to promote discretion while in use. The study demonstrates that low-level laser treatment of the scalp every other day for 17 weeks using the HANDI-DOME LASER device is a safe and effective treatment for androgenetic alopecia in healthy females between the ages of 18 to 60 with Fitzpatrick skin Types I to IV and Ludwig-Savin Baldness Scale I-2 to II-2 baldness patterns. Subjects receiving LLLT at 650 nm achieved a 51% increase in hair counts as compared with sham-treated control patients in this multicenter randomized controlled trial.
Conclusion:
These results suggest that the emerging technology of low-level laser therapy may play a potentially significant role in health care providers' armamentarium for the disease androgenic alopecia.
... Among them two were animal studies and two did not investigate AGA. Eleven were eventually evaluated including one case report, one case series, four cohort studies, and five RCTs [7][8][9][10][11][12][13][14][15][16][17]. ...
... Ten studies evaluated a total of 444 males, compared to six studies with a total of 236 females. The efficacy of the HairMax LaserComb and TOPHAT 655 were investigated in five [7][8][9][10]17] and two [11,12] studies, respectively. Other lasers studied include an LLLT hood device [16], application of 655 nm red light and 780 nm of infrared light [14], a Helmet type LLLT [13], and the X5 Hair-Laser [15]. ...
... Other lasers studied include an LLLT hood device [16], application of 655 nm red light and 780 nm of infrared light [14], a Helmet type LLLT [13], and the X5 Hair-Laser [15]. Nine studies out of the 11 exclusively utilized a wavelength between 630 nm and 660 nm, with the most popular being 655 nm [7][8][9][10][11][12][13]16,17], while one study used a mix of 655 nm and 780 nm [14] and another study did not specify the wavelength of the laser device [15]. Nine out of 11 studies utilized a power setting of 5 mW or less [7][8][9][10][11][12][13]16,17], while one study utilized a power setting of 30-34 mW [15], and one did not report a power setting [14]. ...
Background and objectives:
Androgenetic alopecia (AGA) affects 50% of males by age 50 and 50% of females by age 80. Recently, the use of low-level laser therapy (LLLT) has been proposed as a treatment for hair loss and to stimulate hair regrowth in AGA. This paper aims to review the existing research studies to determine whether LLLT is an effective therapy for AGA based on objective measurements and patient satisfaction.
Study design:
A systematic literature review was done to identify articles on Medline, Google Scholar, and Embase that were published between January 1960 and November 2015. All search hits were screened by two reviewers and examined for relevant abstracts and titles. Articles were divided based on study design and assessed for risk of bias.
Results:
Eleven studies were evaluated, which investigated a total of 680 patients, consisting of 444 males and 236 females. Nine out of 11 studies assessing hair count/hair density found statistically significant improvements in both males and females following LLLT treatment. Additionally, hair thickness and tensile strength significantly improved in two out of four studies. Patient satisfaction was investigated in five studies, and was overall positive, though not as profound as the objective outcomes.
Conclusion:
The majority of studies covered in this review found an overall improvement in hair regrowth, thickness, and patient satisfaction following LLLT therapy. Although we should be cautious when interpreting these findings, LLLT therapy seems to be a promising monotherapy for AGA and may serve as an effective alternative for individuals unwilling to use medical therapy or undergo surgical options. Lasers Surg. Med. © 2016 Wiley Periodicals, Inc.
... Low-intensity laser therapy has been used in the treatment of wounds by accelerating the healing process and increasing cellular metabolism [11] as well as modulating both local and systemic immune responses [12]. Amongst the various therapies proposed for the treatment of wounds, the low-intensity laser stands out, and its use allows the acceleration of the wound healing process via growth factors [13][14][15][16][17][18][19] and by decreasing the inflammatory reaction [20]. The laser stimulation of fibroblasts during healing occurs through the maintenance of mitotic activity in the late period of healing [20], in which it has been demonstrated that low-intensity laser preferentially stimulates quiescent cells in detriment of those in activity [12]. ...
... Amongst the various therapies proposed for the treatment of wounds, the low-intensity laser stands out, and its use allows the acceleration of the wound healing process via growth factors [13][14][15][16][17][18][19] and by decreasing the inflammatory reaction [20]. The laser stimulation of fibroblasts during healing occurs through the maintenance of mitotic activity in the late period of healing [20], in which it has been demonstrated that low-intensity laser preferentially stimulates quiescent cells in detriment of those in activity [12]. ...
Introduction:
This study evaluated, from a histological point of view, the process of repairing skin wounds caused in the dorsal region of rats when subjected to treatment with vitamin C, low-intensity laser, and association of both.
Methods:
Forty-eight adult male rats (Rattus norvegicus, albinus, Wistar), weighing between 250 and 300 g were used in this study. The rats were anesthetized with sodium pentobarbital (10 mg/kg) intraperitoneally (IP) and a circular area of skin of approximately 8 mm in diameter was removed from the dorsal region of their back by a punch. The animals were randomly divided into four groups of 12 individuals: Group I, control group, was treated with saline solution; Group II was treated with topical application of vitamin C; Group III was treated with low-intensity laser; and Group IV was treated with both low-intensity laser and topical application of vitamin C. Samples were histologically analyzed through optical microscopy with hematoxylin and eosin staining and collagen I and III concentrations were quantified using the picrosirius-hematoxylin histochemical method and further submitted to statistical analysis.
Results:
Whilst the control and vitamin C groups admittedly showed slight epithelial proliferation at the wound edges, the group irradiated with low-intensity laser and the group treated with both laser and vitamin C had already partially formed epidermis, with a more organized underlying connective tissue and less evident inflammatory process. The group treated with laser alone obtained a higher concentration of type I collagen fibers and the group with the highest amount of type III collagen fibers was the one treated with the association of vitamin C and laser.
Conclusion:
The present findings suggest that in spite of all treatments being effective in the repair of skin wounds compared to the control group, the isolated use of low-intensity therapy laser and its combined use with topical vitamin C showed the most favorable results, indicating that those could be further used for the treatment of skin wounds.
... Another LLLT mechanism is an increased blood flow at the dermal papilla (Avram et al., 2007). Some LLLT applications include tissue regeneration (an adjuvant in the treatment of burns, ulcers, acne, scarring processes), dandruff and other microbial-related skin disorders, reduction of inflammation, and pain relief (Satino & Markou, 2003). However, one of the most commercially accepted LLLT applications is the stimulation of hair growth in individuals with some type of alopecia. ...
... After a 6-month treatment, both sexes and all areas (vertex and temporal) did demonstrate significant improvement. The tensile strength of hair increased (Satino & Markou, 2003) ...
Androgenetic alopecia (AGA) is the most diagnosed hair loss dysfunction. Its physiopathology comprises a genetic predisposition affording an exacerbated response of the hair follicles cells to androgens aggravated by scalp inflammation and extrinsic factors.
Objective:
To review the mechanisms and extrinsic factors involved in the AGA physiopathology as well as its conventional and emerging treatments.
Design:
The research focused on reports regarding AGA physiopathology and treatments published between January 2001 and July 2019 in medical and related journals.
Results:
The most used medical treatments for AGA - minoxidil and finasteride - present non-satisfactory results in some cases. Currently, the low-level laser therapy is recognized as a safe and effective treatment for AGA. Some minimally invasive techniques - mesotherapy, microneedling, carboxytherapy and platelet-rich plasma - are also used to stimulate hair growth. Pharmaceutical substances with mechanisms differing from the anti-androgen activity are under current investigation and many of them have botanical origins; however, formulations with higher performance are required, and the hair follicles ability of being a drug and nanoparticle reservoir has been researched.
Conclusions:
The association of different strategies, i.e., substances with synergic mechanisms and the use of advantageous technologies associated with lifestyle changes could improve the treatment outcomes. This article is protected by copyright. All rights reserved.
... (Table 3) Ten studies were selected for full-text review. Among these, five were excluded for not having a DB-RCT design (16)(17)(18)(19)(20) (Table 4, and five were included for qualitative and quantitative synthesis (21)(22)(23)(24)(25). (Figure 1, The search on clincaltrials.gov yielded three additional RCTs; two were terminated prematurely (26,27), and one was ongoing but had not recruited participants (28). ...
... Reason for exclusion Satino (20) Non-randomized controlled trial Bernstein (16) Rushton (19) Munck (18) Blum (17) Non-randomized controlled trial, sham device inadvertently therapeutic 26 weeks. The treatment durations for the 7-, 9-, and 12beam combs were 15, 11, and 8 min, respectively, to maintain an equivalent dose of power amongst the different models. ...
Alopecia is a common disorder affecting over half of the world’s population. Within this condition,androgenic alopecia (AA) is the most common type, affecting 50% of males over 40 and 75% of females over 65. Anecdotal paradoxical hypertrichosis noted during laser epilation has generated interest in thepossibility of using laser to stimulate hair growth.
In this study, we aimed to critically appraise the application of low-level laser therapy for the treatment of AA in adults. A systematic review was performed on studies identified on Medline, EMBASE, Cochrane database, and clinicaltrials.org. Double-blinded randomized controlled trials were selected and analyzed quantitatively (meta-analysis) and
qualitatively (quality of evidence, risk of bias).
Low-level laser therapy appears to be a promising noninvasive treatment for AA in adults that is safe for self-administration in the home setting. Although shown to effectively stimulate hair growth when compared to sham devices, these results must be interpreted with caution. Further studies with larger samples, longer follow-up, and independent funding sources are necessary to determine the clinical effectiveness of this novel therapy.
... Two studies assessing the efficacy of LLLT in male patients with AGA with grade of evidence A2 and C were included in the evaluation, resulting in a level of evidence 2. 108,109 Efficacyfemales ...
... Two studies assessing the efficacy of LLLT in female patients with AGA met the inclusion criteria of the guideline, with grade of evidence A2 and C, resulting in a level of evidence 2. 109,110 In total, three studies concerning LLLT fulfilled the inclusion criteria of the S3 guideline. When used for 16 and 26 weeks under different protocols and with two different devices, LLLT showed an increased hair count (level of evidence 2). ...
Androgenetic alopecia is the most common hair loss disorder, affecting both men and women. Initial signs of androgenetic alopecia usually develop during teenage years leading to progressive hair loss with a pattern distribution. Moreover, its frequency increases with age and affects up to 80% Caucasian men and 42% of women. Patients afflicted with androgenetic alopecia may undergo significant impairment of quality of life. The European Dermatology Forum (EDF) initiated a project to develop evidence-based guidelines for the treatment of androgenetic alopecia. Based on a systematic literature research the efficacy of the currently available therapeutic options was assessed and therapeutic recommendations were passed in a consensus conference. The purpose of the guideline is to provide dermatologists with an evidence-based tool for choosing an efficacious and safe therapy for patients with androgenetic alopecia.
... The detected improvement achieved by LLLT in the current study was in agreement with others. Back in 2003, Santino and Markou evaluated the HairMax Laser-Comb 1 , which was used for 5-10 minute on alternating days for 6 months in patients with AGA [22]. It yielded significant increase in hair growth in both the temporal and vertex areas, respectively, in both sexes. ...
... It yielded significant increase in hair growth in both the temporal and vertex areas, respectively, in both sexes. Santino and Markou reported no statistical analysis unlike our study [22]. Another difference is that iGROW 1 used in the current study is not only LLL but also has light emitting diode. ...
Background:
Female pattern hair loss (FPHL) is the most common form of hair loss in women. Nevertheless, its management represents a real challenge. Among the FDA approved therapeutic modalities for FPHL are topical minoxidil and more recently low-level light therapy (LLLT).
Aim of work:
Assess the efficacy and safety of LLLT in comparison to topical minoxidil 5% and to a combination of both therapies in the treatment of FPHL.
Patients and methods:
This study included 45 female patients with proven FPHL. They were randomly divided into three equal groups, where group (i) patients were instructed to apply topical minoxidil 5% twice daily, group (ii) patients received LLLT using the helmet iGrow® device for 25 minutes 3 days weekly, and group (iii) patients received a combination of both topical minoxidil 5% twice daily and LLLT for 25 minutes 3 days weekly for 4 months (study duration). Evaluation was done according to clinical, dermoscopic (folliscopic), and ultrasound bio-microscopic (UBM) parameters. Patient satisfaction and side effects were reported.
Results:
The efficacy and safety of both topical minoxidil and LLLT were highlighted with comparable results in all parameters. The combination group (iii) occupied the top position regarding Ludwig classification and patient satisfaction. UBM and dermoscopic findings showed significant increase in the number of regrowing hair follicles at 4 months in all groups, whereas only UBM showed such significant increase at 2 months in the combination group (iii). A non-significant increase in the hair diameter was also documented in the three groups.
Conclusion:
LLLT is an effective and safe tool with comparable results to minoxidil 5% in the treatment of FPHL. Owing to the significantly better results of combination therapy, its usage is recommended to hasten hair regrowth. Lasers Surg. Med. © 2017 Wiley Periodicals, Inc.
... [12][13][14][15] PBMT represents an effective treatment for AGA based on a meta-analysis of randomized controlled trials, and is the only FDA-cleared device for the treatment of AGA. 1 The effects of PBMT on hair growth were also investigated in an animal model. 5,[16][17][18][19] Several studies demonstrated the hair growth effect of PBMT in alopecia areata, 16 AGA, 4,18-20 and chemotherapyinduced alopecia. 21 PBMT, particularly at wavelengths in the red and near-infrared range affects the functioning of the stem cells that contribute to hair re-growth. ...
Background:
Photobiomodulation therapy (PBMT) appears to be safe and effective for hair loss. Pulsed electromagnetic field therapy (PEMF) also has a positive biological effect on hair re-growth.
Objectives:
We evaluated the efficacy and safety of both PBMT and PEMF for the treatment of androgenetic alopecia (AGA).
Materials and methods:
This study was a 24-week, randomized, double-blind, sham device-controlled trial. We recruited 80 subjects with androgenetic alopecia. The subjects got treatment every week for the 1st 12 weeks, every other week for the next 8 weeks. PBMT entails 15-min therapy, and PEMF was carried out for 10 min.
Results:
The baseline hair density was 114.57 (±28.75)/cm2 and 113.31 (±30.07)/cm2 in both treatment and control groups. After 24 weeks of treatment, the mean hair density increased to 139.37 (±31.4)/cm2 in the treatment group but only to 119.78 (±31.92)/cm2 in the control group. The difference between two groups was statistically significant (p < 0.05). Based on the global assessment of independent experts, the score was 0.41 (±0.62) in the treatment group and 0.07 (±0.45) in the control group. Only very mild erythema or irritation was reported, and no serious adverse reactions were reported.
Conclusions:
A combination of PBMT and PEMF is a valid and safe treatment option for AGA.
... 82 On the other hand, King et al did not have positive results for AA treatment by LLLT in mice, as opposed to the results of a study by Wikramanayake et al. 83 Clinical trials revealed the positive effects of LLLT on hair re-growth. [84][85][86][87][88][89][90] Pemphigus Vulgaris Pemphigus vulgaris (PV) is a chronic blistering disease with antibodies directed against keratinocytes. 91 Management of PV is difficult. ...
Introduction: Given the inconsistencies in the literature regarding laser performance in non-surgical treatments, this study investigated the available literature to determine the advantages and disadvantages of low-power lasers in treating non-surgical complications and diseases. Methods: Authentic information from articles was extracted and evaluated to assess low-power laser performance for non-surgical treatments. A systematic search of studies on low-level laser therapy (LLLT) for non-surgical treatments was conducted mainly in PubMed and google scholar articles. Results: Four categories of diseases, including brain-related diseases, skin-related diseases, cancers, and bone-related disorders, which were treated by LLLT were identified and introduced. The various types of LLLT regarding the studied diseases were discussed. Conclusion: Positive aspects of LLLT versus a few disadvantages of its application imply more investigation to find better and efficient new methods.
... The results showed that testosterone-treated mice to the He-Ne laser led more hair follicles in the anagen phase when compared to the other groups. Satino and Markou [56] tested the efficacy of LLLT on hair growth and tensile strength on 28 male and 7 female androgenic alopecia patients who were given a HairMax LaserComb® 655 nm, to use at home for 6 months for 5-10 min every other day. Results show in the case of hair tensile strength it was seen that better improvement in the vertex area for males and temporal areas for females but both sexes got benefited in all areas ominously. ...
Androgens have an intense consequence on the human scalp and body hair. Scalp hair sprouts fundamentally in awol of androgens whereas the body hair hike is vulnerable to the activity of androgens. Androgenetic alopecia (AGA) invoked as males emulate Alopecia due to the cause of the dynamic reduction of scalp hair. Androgens are medium of terminus growth of hair although the body. Local and system androgens convert the extensive terminal follicles into lesser vellus like structure. The out start of this type of alopecia is intensely irregular and the reason behind this existence of enough circulating steroidal hormones androgens and due to genetic predisposition. Effective treatments are available in the market as well as under clinical and preclinical testing. Many herbal formulations are also available but not FDA approved. Different conventional and NDDS formulations are already available in the market. To avoid various systemic side effects of both Finasteride and Minoxidil, topical formulations and natural products (nutrients, minerals, vitamins) now a days are being widely used to treat Androgenic alopecia. CAM (complementary and alternative medicine) provides the option to elect favorable, low-risk, adjuvant and alternative therapies. Herein, we offer a widespread review of topical marketed formulations, natural products, and CAM treatment options for AGA.
Graphic Abstract
... The term AGA is synonymous with male and female pattern baldness. [6][7][8] LLLT has been a treatment option for AGA in both clinical and non-clinical settings; devices carrying this technology can have in-home and in-office use. 1 While there is substantial empirical evidence regarding the effect of LLLT on hair density, [9][10][11] the literature lacks evidence regarding factors that influence photobiomodulation of LLLT in AGA. While some have decided that the term "photobiomodulation therapy" be used instead of LLLT, 12 the interchangeable use of these two terms is still evident 13,14 Our study aimed to determine the factors associated with photobiomodulation of LLLT in AGA: device-related factors (eg, number of laser diodes/light-emitting diodes and the energy fluence of the device) and usage (eg, total irradiation time). ...
Low‐level laser therapy (LLLT) is used to treat androgenetic alopecia (AGA). The therapeutic effect of LLLT on AGA has been evaluated; however, there is a paucity of studies that investigated device‐ and usage‐related factors that may influence the effect of LLLT on hair regrowth. The literature was systematically searched to identify eligible studies; PubMed, Scopus, EMBASE and clinicaltrials.gov databases were searched on April 30th, 2020. Eligible studies were randomized trials that investigated the effect of LLLT on hair density in AGA. Robust linear regressions were used to make comparisons. An increase in the per‐session energy fluence by 1 J/cm² is significantly associated with an increase in hair density by 0.23 hairs/cm² (95% CI: 0.21 hairs/cm², 0.25 hairs/cm²). The number of laser or light‐emitting diodes is not significantly associated with change in hair density. Increasing the total duration of exposure to treatment is associated with a significant increase in hair density (β = 0.53, P < 0.05). Switching from continuous to pulse irradiation was associated with a significant increase in hair density (β = 10.11, P < 0.01). Energy fluence, irradiation session duration, and light pulsing has a significant therapeutic effect on AGA, while the number of diodes does not.
This article is protected by copyright. All rights reserved.
... Temporary increased hair shedding was also reported in another clinical trial of a 655-nm laser comb. By contrast, it arose in about one third of studied subjects [28]. Increased hair shedding induced by LLLT is most likely related to the synchronization of hair cycle by stimulating telogen hair follicles to reenter the anagen phase, leading to an increase of the exogen phase. ...
Low-level laser/light therapy (LLLT) has been increasingly used for promoting hair growth in androgenetic alopecia (AGA). Our institute developed a new home-use LLLT device, RAMACAP, with optimal penetrating energy, aiming to improve therapeutic efficacy and compliance. To evaluate the efficacy and safety of the new helmet-type LLLT device in the treatment of AGA, a 24-week, prospective, randomized, double-blind, sham device-controlled clinical trial was conducted. Forty subjects with AGA (20 men and 20 women) were randomized to treat with a laser helmet (RAMACAP) or a sham helmet in the home-based setting for 24 weeks. Hair density, hair diameter, and adverse events were evaluated at baseline and at weeks 8, 16, and 24. Global photographic assessment for hair regrowth after 24 weeks of treatment was performed by investigators and subjects. Thirty-six subjects (19 in the laser group and 17 in the sham group) completed the study. At week 24, the laser helmet was significantly superior to the sham device for increasing hair density and hair diameter (p = 0.002 and p = 0.009, respectively) and showed a significantly greater improvement in global photographic assessment by investigators and subjects. Reported side effects included temporary hair shedding and scalp pruritus. In conclusion, the novel helmet-type LLLT device appears to be an effective treatment option for AGA in both male and female patients with minimal adverse effects. However, the limitations of this study are small sample size, no long-term follow-up data, and use of inappropriate sham devices, which do not reflect the true negative control. Trial registration: http://clinicaltrials.in.th/index.php?tp=regtrials&menu=trialsearch&smenu=fulltext&task=search&task2=view1&id=2061, identifier TCTR20160910003.
... The first study investigating low-level light therapy for hair loss was published in 2003 in a non-peer-reviewed journal [57]. It was supported by the manufacturers of HairMax LaserComb™. ...
Results from hair transplantation are consistently natural.
... several hundred grams or more and a thickness of several centimeters or more. [22,38,44] Owing to this advantage, there is no inconvenience when OLED PBM patch is attached to the body. In addition, the wearable PBM patches are reliable enough to operate normally even when bent or attached to the body. ...
... several hundred grams or more and a thickness of several centimeters or more. [22,38,44] Owing to this advantage, there is no inconvenience when OLED PBM patch is attached to the body. In addition, the wearable PBM patches are reliable enough to operate normally even when bent or attached to the body. ...
Photobiomodulation (PBM) is a safe and noninvasive method that can provide various clinical effects. However, conventional PBM devices using point light sources, such as light-emitting diodes and lasers have various disadvantages, such as low flexibility, relatively heavy weight, and nonuniform effects. This paper presents a novel wearable PBM patch using a flexible red-wavelength organic light-emitting diode (OLED) surface light source, which can be attached to the human body as a personalized PBM platform. The palm-sized wearable PBM patch can be very light (0.82 g) and thin (676 µm). It also has a reasonable operation life (>300 h), flexibility (20 mm bending radius), and low-temperature operation (<40 °C), and it can provide wide and safe application irrespective of location and time. Fibroblasts, a major type of dermal cells, play a key role in the wound healing process. The results show that OLEDs may have excellent in vitro wound healing effects because they effectively stimulate fibroblast proliferation (over 58% of control) and enhance fibroblast migration (over 46% of control) under various conditions. For maximum effect, peak wavelength control is necessary to optimize cell proliferation and enhance in vivo wound healing effects.
... Each patient received a 655 nm Hair Max Laser Comb at home for 6 months. The results showed a significant improvement in hair growth (18). Another study, conducted by Lanzafame et al, using 655±5 nm every day for 16 weeks presented 35% increase in hair growth among male patients with AGA (19). ...
Background:
This study aimed to evaluate the effectiveness of a combined set of low level diode laser scanner (665 nm and 808nm) on hair growth, and assessment of safety and effectiveness of a new laser scanner on hair growth treatment procedure in androgenic alopecia.
Methods:
90 patients (18 to 70 years) with androgenic alopecia were randomized into three groups. The first group (n=30) received 655 nm red light using laser hat, the second group (n=30) received 655 nm red laser plus 808 nm infrared laser using a laser scanner of hair growth device (with the patent number: 77733) and the third group (n=30) received no laser as the control group.
Results:
Patients in laser scanner group had better results and showed a higher increase in terminal hair density compared with laser hat group (mean of 9.61 versus 9.16 per cm(2)). We found significant decrease in terminal hair density from baseline in control group (mean -1.8 per cm(2), p<0.0001).
Conclusion:
Results showed a statistically significant improvement in the laser scanner of the hair growth group compared with laser hat and the control group. The study showed that treatment with new laser devise had a promising result without any observable adverse effects.
... In curing the various diseases, a laser and LED are now applied to many people of a worldwide. LED related research has been progressed and in the specific LED wavelength, it was reported that there was an effect including wound healing acceleration [1,2,3,4], anti-inflammation [5,6,7,8], pigmentation prevention [9,10], and etc. Besides, it was clarified that there is an effect of the cellulite removal [11,12], and depilation [13]. ...
The purpose of this study is to determine the effect of the light-emitting-diode (LED) to investigate proliferation of human epidermal keratinocyte and collagen, procollagen expression. In order to determine whether LED irradiation can safely be applied to human skin, the proliferative effects of LED irradiation were determined by MTS assay in Human Epidermal Keratinocytes. Wavelength of 470nm LED irradiation increased mRNA expression of collagen, procollagen without cytotoxity. Our results suggest that 470nm LED irradiation may have a proliferative effects and collagen synthesis property. In order to determine whether LED irradiation can safely be applied to human skin, the cytotoxic effects of LED irradiation were determined by MTS assay in Human Dermal Fibroblasts (HDF). As far as we know, this is the first report demonstrating in vitro collagen synthesis activity of 470nm LED irradiation and being a scientific basis for the cosmetic.
... Some studies have investigated the efficacy of LLLT for AGA. A company-sponsored small prospective study of 35 male and female patients with patterned alopecia reported increased hair counts and tensile strength of the hair in both the temporal and vertex areas for men and women using the HairMax LaserComb Ò [114]. In 2009, a double-blind, sham device-controlled, multicenter, randomized 26-week trial of MAGA demonstrated a significant increase in mean terminal hair density with the device, which was used three times a week for 15 min [115]. ...
Androgenetic alopecia (AGA) is characterized by a non-scarring progressive miniaturization of the hair follicle in predisposed men and women with a pattern distribution. Although AGA is a very prevalent condition, approved therapeutic options are limited. This article discusses the current treatment alternatives including their efficacy, safety profile, and quality of evidence. Finasteride and minoxidil for male androgenetic alopecia and minoxidil for female androgenetic alopecia still are the therapeutic options with the highest level evidence. The role of antiandrogens for female patients, the importance of adjuvant therapies, as well as new drugs and procedures are also addressed.
... Badania wykazały, że cellulit pozytywnie reaguje na antycellulitowy żel w połączeniu z ekspozycją czerwonym lub podczerwonym promieniowaniem diod LED [269]. Leczenie oparte na naświetlaniu promieniowaniem emiterów LED prowadzi też do odrastania włosów i ich zwiększonej wytrzymałości na rozciąganie [270]. Efekty te są skutkiem rozszerzania naczyń krwionośnych i zwiększenia ukrwienia mieszków włosowych. ...
Light emitting diodes are used for research and treatments of a wide variety of medical indications. Selected problems of interaction of LEDs radiation from the UV-VIS-NIR spectral range with basic structures of organism (cells, tissues) and these emitters’ applications in medical and treatment procedures were considered in the work. Also, the impact of physical parameters of LEDs light on obtained biological effects in in vitro tests and therapeutic effects in in vivo research was discussed. The developed optoelectronic diagnostic set for objectification of light irradiation and for studies the effect of low-energy optical radiation to cell lines as well as for measurements spectral parameters of patients’ skin and thin biological centers was presented too.
Praca poświęcona jest wybranym problemom oddziaływania promieniowania diod elektroluminescencyjnych z zakresu UV-VIS-NIR na podstawowe struktury organizmu (komórki, tkanki) oraz ich zastosowaniu w procedurach medycznych i terapeutycznych. Przedstawione zostały półprzewodnikowe źródła LED wykorzystywane do badań i terapii bardzo różnych wskazań medycznych, a także wpływ ich fizycznych parametrów na uzyskiwany efekt biologiczny w przypadku badań in vitro i leczniczy w przypadku badań in vivo. Przedstawiono też opracowany optoelektroniczny układ diagnostyczny do obiektywizacji naświetlań i badań wpływu niskoenergetycznego promieniowania optycznego na linie komórkowe oraz pomiaru parametrów spektralnych skóry pacjentów i cienkich ośrodków biologicznych.
... 6,7 Although different LLL devices for the treatment of hair loss have been manufactured, limited studies have assessed their effectiveness. 15 In our study, the lack of laser therapy effect might be attributed to some reasons. The duration of radiation was short while the effect of LLL on hair growth in androgenic alopecia is observed after multiple sessions during several months. ...
Introduction:
Photobiostimulation with low level laser (LLL) has been used in medicine for a long time and its effects have been shown in many diseases. Some studies have evaluated the effect of LLL on androgenic alopecia. One of the most important limitations of the use of LLL in the treatment of alopecia is the requirement for multiple sessions, which is hardly accepted by patients. This study was conducted to evaluate the effect of the irradiation of extracted follicular hair units by LLL on the outcome of hair transplantation.
Methods:
We enrolled 10 patients with androgenic alopecia and after screening tests for infections and other diseases, we extracted hair follicular units. The hair units were divided in two groups. One group was irradiated by LLL 20 minutes before transplantation (660 nm, 80 Hz, 100 mW) and the other one was used as control. The containing plates were labeled as A and B and sent to the operation room. The surgeon was unaware of the therapy assigned to the plates and transplanted them randomly on the right or left side of the head. One hundred follicular units on each sides of the scalp were transplanted symmetrically. The follicles on both sides were evaluated at 3 and 6 months of transplantation for hair growth rate by another physician, blinded to the treatment assigned to each side.
Results:
Ten patient with androgenic alopecia and mean (SD) age of 31.5 (6.6) years (range 25-45 years) completed the study. All patients had 100% hair growth at 3 and 6 months follow-up except one who had hair growth of 20% at three months of transplantation, which changed to 100% at sixth months. There was no significant difference between the groups regarding hair growth (P > 0.8).
Conclusion:
One session of LLL irradiation has no significant effect on the outcome of transplanted hair follicles. Studies with larger sample size are needed to draw a definite conclusion.
Background:
Photobiomodulation is a promising therapy for hair loss with negligible side effects. However, the reported effects of photobiomodulation therapy for hair loss are inconsistent.
Objective:
To assess the curative effect of photobiomodulation therapy for the treatment of hair loss.
Methods:
A systematic review of self-controlled studies and randomized controlled trials was conducted. ScienceDirect, PubMed, and Wiley Online Library were searched from the earliest date to May 30, 2021.
Results:
Thirty-six studies (966 patients) were included. Two to 4 meta-analyses with different indices were performed separately on 4 groups of studies to test the effectiveness of the following hair loss treatments: ultraviolet light for alopecia areata (AA), red light for androgenetic alopecia (AGA), infrared light for AA, and infrared light for AGA. All meta-analyses showed that treatments were superior to control (p < .05).
Conclusion:
The meta-analyses strongly suggested that photobiomodulation therapies with ultraviolet and infrared light were effective for treating AA, and photobiomodulation therapies with red light and infrared light were effective for treating AGA.
BACKGROUND Home-based light and laser devices are effective for the treatment of various dermatological problems OBJECTIVES To systematically review and evaluate the efcacy and safety of commercially available home-based laser devices for various dermatological applications METHOD A comprehensive literature search was performed on Google Scholar and PubMed. Prospective clinical trials were included, while animal studies, non-English articles, and studies that did not focus on home use or dermatological indication were excluded. A total of 675 articles were identied regarding home use devices. After screening the articles for inclusion and exclusion criteria, 44 studies involving 1,951 participants were selected, including 21 randomized control trials, 5 non-randomized controlled trials, and 18 case series. RESULTS There was signicantly more evidence for the safety or efcacy of Intense pulse light, but this study focused on using home-based laser devices. Most studies evaluated short-term hair reduction up to 3 and 6 months. Devices were found to be effective for short-term hair removal, with side effects ranging from erythema and edema to blisters. The use of laser for skin rejuvenation is based on the fact that laser-treated areas can have islands of healthy skin left behind, which accelerate recovery. Patients who underwent treatment in a recent prospective, split-face study were evaluated by a blinded dermatologist and showed at least a 1-point improvement in wrinkles, dyschromia, and diffuse redness in 75% of participants Low-level laser therapy stimulates hair growth. Patients who used the device for 15 minutes per week for 26 weeks demonstrated signicant improvement in mean terminal hair density and overall hair growth compared to the control group. CONCLUSION Available information from current clinical trials indicates that home-based laser devices are adequate for the short treatment of hair removal, skin rejuvenation, and hair removal. Additional controlled trials are recommended to better quantify the safety and efcacy of available devices.
Hair is a deeply rooted component of identity and culture. Recent articles in this series have focused on scientific evidence relating to hair growth and new insights into the pathogenesis and mechanism of hair loss. This article reviews emerging evidence that has advanced our understanding of hair growth in both of these areas to provide a context for outlining current and emerging therapies. These include finasteride, minoxidil, topical prostaglandins, natural supplements, microneedling, low-level laser light, platelet-rich plasma, fractional lasers, cellular therapy, Wnt activators and SFRP1 antagonism.
Background:
Low-level light/laser therapy (LLLT) can potentially stimulate hair growth in pattern hair loss (PHL), with many available home-use LLLT devices of different designs and technology on the market. However, not all devices are cleared by the United States (US) Food and Drug Administration (FDA), with very few studies to support their efficacy.
Objectives:
This systematic review and meta-analysis aimed to investigate the effectiveness of FDA-approved LLLT devices for PHL treatment.
Methods:
We included articles related to FDA-approved home-use LLLT devices on PubMed and Medline, using the FDA 510(K) Premarket Notification database and the systematic search of articles up to January 2020. The standardized mean difference (SMD) for the changes of hair density treated by LLLT versus sham devices was analyzed.
Results:
Only 32 home-use LLLT devices have been approved by the FDA as of January 2020. The meta-analysis comprised seven double-blinded, randomized, controlled trials. The overall quantitative analysis yielded a significant increase in hair density in those treated by LLLT versus sham groups (SMD: 1.27, 95% confidence interval [CI]: 0.993-1.639). The subgroup analysis demonstrated the increased hair growth in male and female subjects with both comb- and helmet-type devices. There were significant LLLT sources in the LDs alone (SMD: 1.52, 95% CI: 1.16-1.88) and the LDs combination (SMD: 0.85, 95% CI: 0.55-1.16) (p=0.043).
Conclusion:
LLLT is potentially effective for PHL treatment. Nonetheless, the long-term follow-up study in patients with severe PHL with combined standard treatment and comparison between LLLT devices and energy sources is recommended.
A new biotechnology based on micro-needling (MND) with low-level light/laser therapy (LLLT) that is used for hair re-growth (HR-G) needs to be standardized. The study aims to report the clinical outcomes resulting from a multicentric, retrospective, observational, case-series study in which MND with LLLT was used on patients affected by androgenic alopecia (AGA). Twenty-six patients were initially enrolled of which 15 males were classified as stages I–III of vertex by the Norwood–Hamilton scale, and 11 females was classified in stages I–II by the Ludwig scale. Twenty patients (10 females and 10 males) were analyzed after their screening (the exclusion and inclusion criteria evaluation). The HR-G assessment was evaluated with photography, as well as the physician’s and patient’s global assessment scales, in addition to standardized phototrichograms, during a short follow-up at T0-baseline, T1-16 weeks. Encouraging results represented by a hair density increase of 12 ± 2 hairs/cm2 at T1 after 16 weeks (16 weeks vs. 0 weeks) in the targeted area, compared with the baseline results (59 ± 2 hairs/cm2 at T1 versus 47 ± 2 hairs/cm2 at baseline), were observed using computerized trichograms with a statistically significant difference in hair re-growth (p = 0.0238). The effectiveness of MND with LLLT use has been demonstrated in mild to moderate AGA patients.
Background: A systematic review on low-level light/laser therapy (LLLT) in male pattern hair loss (MPHL) and female pattern hair loss (FPHL) has been performed. Objectives: Compare the reported effectiveness of LLLT in MPHL and FPHL with any control, through randomized controlled trials (RCTs) analysis. Methods: The protocol was developed in accordance with the Preferred Reporting for Items for Systematic Reviews and Meta-Analyses-Protocols guidelines. A multistep search of the PubMed, MEDLINE, Embase, PreMEDLINE, Ebase, Clinicaltrials.gov, Scopus database, and Cochrane databases has been performed to identify articles on MPHL and/or FPHL treatment with LLLT. Results: Of the 298 articles initially identified, 136 articles focusing on MPHL and FPHL were selected and, consequently, only 36 articles focused exclusively on LLLT. Of this amount, 23 articles were clinical trials while 13 articles were systematic reviews. Systematic reviews were excluded, and only seven articles were analyzed as RCTs. Conclusions: All the articles selected and analyzed reported a positive effect of LLLT for MPHL and/or FPHL treatment without side effects.
Treatment options for hair loss have traditionally been limited to topical and systemic therapies. Systemic therapies for inflammatory hair disorders are often immunosuppressive, and systemic treatment of androgenetic hair loss can cause undesired effects on sexual and reproductive health. Topical agents have a favorable side effect profile compared with systemic therapies, but many topicals have poor transcutaneous absorption, limiting their concentration and action at follicular targets in the dermis.
There is increasing demand for home-based devices for the treatment of dermatologic conditions and cosmesis. Commercially available devices include intense pulsed light, laser diodes, radiofrequency, light-emitting diodes, and ultraviolet B phototherapy. The objective of this report is to evaluate the current evidence regarding the efficacy and safety of home-based devices for the treatment of skin conditions. A systematic search of PubMed, Embase, and Cinahl was conducted on November 9, 2020 using PRISMA guidelines. Original research articles that investigated the efficacy and safety of home-based devices for dermatologic use were included. Bibliographies were screened for additional relevant articles. Strength of evidence was graded using the Oxford Centre for Evidence-Based Medicine guidelines. Clinical recommendations were then made based on the quality of the existing literature. After review, 37 clinical trials were included—19 were randomized controlled trials, 16 were case series, and 2 were non-randomized controlled trials. Ultimately, from our analysis, we recommend the home-based use of intense pulsed light for hair removal, laser diodes for androgenic alopecia, low power radiofrequency for rhytides and wrinkles, and light-emitting diodes for acne vulgaris. Trials investigating ultraviolet B phototherapy for psoriasis revealed mixed evidence for home treatments compared to clinic treatments. All devices had favorable safety profiles with few significant adverse events. Limitations to our review include a limited number of randomized controlled trials as well as a lack of data on the long-term efficacy and safety of each device.
Low level laser therapy (LLLT), including coherent and non-coherent light sources, also known as photobiomodulation, is a non-ablative treatment modality that alters cellular biochemical processes through its action on the mitochondria and by changing the cellular redox state. Treatment is delivered by exposing cells or tissue to light of low energy densities for a specific amount of time. This process has been reported to have beneficial therapeutic effects on a wide variety of conditions that benefit from alleviation of pain or inflammation, immunomodulation, and promotion of wound healing and tissue regeneration. LLLT’s use in dermatology is still considered experimental and investigational, hence it is currently used primarily as an adjunct therapy. Skepticisms mostly stem from ambiguities in its mechanism of action and the complexity of its dosimetry. For the same reasons, guidelines directing its use are not yet well established. Nonetheless, many recent studies have reported favorable outcomes achieved with LLLT in a number of indications (e.g. wound healing, hair growth, skin rejuvenation, fibrosis) with minimal adverse events.
Androgenetic alopecia (AGA) affects predisposed men and women and is characterized by nonscarring progressive miniaturization of the hair follicle accompanied by shortening of the anagen phase, leading to a gradual conversion of terminal hairs into vellus hairs with a pattern distribution. The etiology of AGA is multifactorial and polygenetic. Male androgenetic alopecia, also known as male pattern hair loss (MPHL), is clearly an androgen-dependent condition, and although the mode of inheritance is uncertain, a genetic predisposition is observed. In female androgenetic alopecia, also known as female pattern hair loss (FPHL), the role of androgens is still uncertain. It is more frequent in Caucasians than in Asians and Africans, and the prevalence increases with age.
Laser and light-based therapies including low-level laser and light therapy, fractional, excimer, and other lasers are increasingly well-regarded treatment options for patients with hair loss.
Androgenetic alopecia (AGA) is a common, non-scarring form of hair loss characterized by progressive miniaturization of terminal hair follicles on the scalp. First-line therapy for AGA consists of medical therapy with topical minoxidil and oral anti-androgens. Two emerging procedural therapies, platelet-rich plasma (PRP) injections and low-level light therapy (LLLT), represent novel therapeutics for the management of AGA. The details of these procedural treatment modalities are discussed within this chapter.
Low level laser therapy (LLLT) uses a monochromatic and coherent beam in the red or near infrared wavelength.
We asked whether the literature supports the effectiveness of LLLT for androgenic and female patter hair loss?
The logic behind the use of LLLT comes from observation of paradoxical hypertrichosis while attempting laser
hair removal, especially in skin of color. The mechanism of this is unknown. We conducted a systematic review
of the literature on the topic of LLLT and phototherapy for hairgrowth. The overwhelming results show that
light in the red spectrum is effective in hair growth, but larger case-controlled studies are required to back up
this conclusion.
Since the initial Food and Drug Administration clearance of the first photobiomodulation device for androgenetic alopecia in 2007, the market for these devices has rapidly expanded. Sixteen unique devices are currently available to consumers with varying designs, treatment durations and frequency. While the precise mechanism for hair growth stimulation remains to be elucidated, current evidence suggests the laser light alters hair cycle duration to promote the anagen growth phase. Photobiomodulation devices have an excellent safety profile with pruritus and skin dryness reported to be the most common side effects. Overall, research has demonstrated clinical efficacy of these devices, including randomized controlled studies. As photobiomodulation continues to emerge as a treatment modality for androgenetic alopecia, additional information on the most effective light sources, precise light wavelength, treatment schedule, and effectiveness on various hair diseases is still needed.
In this book, the authors have provided the latest and most in-depth information on one of clinical medicine's most useful tools: Low-Level Laser Therapy (LLLT). Written by over a dozen experts from five continents, from Jerusalem to Johannesburg and San Diego to Sao Paolo, the breadth of knowledge provided herein expands not only the globe, but many medical fields. LLLT is an inexpensive, easily employed therapeutic strategy that has validated clinical utility in dermatology, oncology, dentistry, veterinary field, wound healing and many other medical arenas. This book provides the most up-to-date information on recent clinical trials as well as catalogs the optimal therapeutic settings for a myriad of disease states. In the past, biochemical mechanisms associated with LLLT therapy have not been well-described; however, this book provides comprehensive and simple biochemical processes pieced together from theories provided by the most recent and reputable publications. The mechanisms involved in the numerous diseases covered by each chapter are also included herein. Low-Level Laser Therapy: History, Mechanisms, and Clinical Uses captures the incredible dynamic usefulness of this simple technology while also listing the therapeutic settings that have been deemed the most effective for dozens of medical ailments. Whether you are a student of medicine or a clinical practitioner, this book will serve as a helpful guide on how LLLT could play a role in the care you or your team provides on a daily basis.
Alopecia is a common disease affecting more than half of the world total number of people. Alopecia exists in different types, but one of the most common of these types is the Androgenic Alopecia which has affected approximately 51% of the total number of males ranging between the age bracket of 40 years and 75 years. This type of alopecia is more common in females who are above the age of 65 years and above. Despite this widespread effect, much has not been done regarding identifying the possible drugs for treating this disease. At present, there exist only two possible medications that have been scientifically approved to cure this disease, include finasteride and minoxidil. Also, another possible form of treatment has been the case of hair transplantation.
Despite the new possible treatment options available for treatment of different types of hair loss, there is a need for the invention for more efficient management and treatment options that are less costly, environmentally friendly, and most importantly human consumption friendly. Due to the recent evaluation that low-level laser therapy stimulated hair growth. This systematic review and meta-analysis was to determine whether the use of low-level laser therapy is an effective therapy for treatment of the Androgenic alopecia and also to some degree we reviewed the level of the patient’s satisfaction. Some earlier studies had shown that the use of low-level laser therapy stimulated the hair growth when mice were treated with chemotherapy which was induced by the alopecia and also the other type of alopecia called alopecia areata. The researchers hypothesized that the primary mechanism of treating Androgenic alopecia to be the stimulation of the epidermal stem cells which are in the hair follicle making them bulge and shift the follicles into the anagen phase.
The market for home-use photobiomodulation devices to treat androgenetic alopecia has rapidly expanded, and the Food and Drug Administration (FDA) has recently cleared many devices for this purpose. Patients increasingly seek the advice of dermatologists regarding the safety and efficacy of these hair loss treatments. The purpose of this guide was threefold: (1) to identify all home-use photobiomodulation therapy devices with FDA-clearance for treatment of androgenetic alopecia; (2) to review device design, features and existing clinical evidence; and (3) to discuss practical considerations of photobiomodulation therapy, including patient suitability, treatment goals, safety, and device selection. A search of the FDA 510(k) Premarket Notification database was conducted using product code “OAP” to identify all home-use devices that are FDA-cleared to treat androgenetic alopecia. Thirteen commercially available devices were identified and compared. Devices varied in shape, wavelength, light sources, technical features, price, and level of clinical evidence. To date, there are no head-to-head studies comparing the efficacy of these devices. Photobiomodulation therapy devices have an excellent safety profile and mounting evidence supporting their efficacy. However, long-term, high quality studies comparing these devices in diverse populations are lacking. As these devices become increasingly popular, dermatologists should be familiar with this treatment modality to add to their therapeutic armamentarium.
Abbreviations: AGA, androgenetic alopecia; FDA, Food and Drug Administration; IEC, International Electrotechnical Commission; LED, light-emitting diode; PBMT, photobiomodulation therapy.
Few dermatologic problems carry as much emotional overtones as the complaint of hair loss. The best way to alleviate the emotional distress related to hair loss is to effectively treat it. As with any medical problem, the patient complaining of hair loss requires a comprehensive medical and drug history, physical examination of the hair and scalp, and appropriate laboratory evaluation to identify the cause.
The use in dermatology of light-emitting diodes (LEDs) continues to be surrounded by controversy. This is due mainly to poor knowledge of the physicochemical phases of a wide range of devices that are difficult to compare to one another, and also to divergences between irrefutable published evidence either at the level of in vitro studies or at the cellular level, and discordant clinical results in a variety of different indications: rejuvenation, acne, wound healing, leg ulcers, and cutaneous inflammatory or autoimmune processes. Therapeutic LEDs can emit wavelengths ranging from the ultraviolet, through visible light, to the near infrared (247-1300 nm), but only certain bands have so far demonstrated any real value. We feel certain that if this article remains factual, then readers will have a different, or at least more nuanced, opinion concerning the use of such LED devices in dermatology.
Copyright © 2016 Elsevier Masson SAS. All rights reserved.
The proportion of men receiving non-surgical cosmetic procedures has risen substantially in recent years. Various physiologic, anatomic, and motivational considerations differentiate the treatments for male and female patients. Nevertheless, research regarding approaches to the male cosmetic patient is scarce. We sought to provide an overview and sex-specific discussion of the most popular cosmetic dermatologic procedures pursued by men by conducting a comprehensive literature review pertaining to non-surgical cosmetic procedures in male patients. The most common and rapidly expanding non-surgical interventions in men include botulinum toxin, filler injection, chemical peels, microdermabrasion, laser resurfacing, laser hair removal, hair transplantation, and minimally invasive techniques for adipose tissue reduction. Important sex-specific factors associated with each of these procedures should be considered to best serve the male cosmetic patient.
Background:
Low-level laser therapy (LLLT) is currently in use to stimulate hair growth and is quickly gaining in popularity due to the ease of use and absence of side effects. In 2015 alone, the number of LLLT devices with the Food and Drug Administration clearance has doubled.
Objective:
To consolidate evidence and establish which data are still required for the widespread acceptance of LLLT for hair loss therapy.
Methods and materials:
A thorough search of the PubMed database was conducted to obtain studies investigating LLLT for androgenetic alopecia in men and women.
Results:
Nine trials were identified for comb and helmet/cap devices, five of which were randomized controlled trials. Data comparison across LLLT trials and with traditional hair loss therapy (minoxidil, finasteride) was not straight forward because there was a lack of visual evidence, sample sizes were low, and there were large variations in study duration and efficacy measurements.
Conclusion:
There are a number of unanswered questions about the optimum treatment regimen, including maintenance treatment and the long-term consequences of LLLT use. Moving forward, protocols should be standardized across trials. Moreover, it is recommended that future trials include visual evidence and trial duration be expanded to 12 months.
Background:
Female pattern hair loss (FPHL), or androgenic alopecia, is the most common type of hair loss affecting women. It is characterised by progressive shortening of the duration of the growth phase of the hair with successive hair cycles, and progressive follicular miniaturisation with conversion of terminal to vellus hair follicles (terminal hairs are thicker and longer, while vellus hairs are soft, fine, and short). The frontal hair line may or may not be preserved. Hair loss can have a serious psychological impact on women.
Objectives:
To determine the efficacy and safety of the available options for the treatment of female pattern hair loss in women.
Search methods:
We updated our searches of the following databases to July 2015: the Cochrane Skin Group Specialised Register, CENTRAL in the Cochrane Library (2015, Issue 6), MEDLINE (from 1946), EMBASE (from 1974), PsycINFO (from 1872), AMED (from 1985), LILACS (from 1982), PubMed (from 1947), and Web of Science (from 1945). We also searched five trial registries and checked the reference lists of included and excluded studies.
Selection criteria:
We included randomised controlled trials that assessed the efficacy of interventions for FPHL in women.
Data collection and analysis:
Two review authors independently assessed trial quality, extracted data and carried out analyses.
Main results:
We included 47 trials, with 5290 participants, of which 25 trials were new to this update. Only five trials were at 'low risk of bias', 26 were at 'unclear risk', and 16 were at 'high risk of bias'.The included trials evaluated a wide range of interventions, and 17 studies evaluated minoxidil. Pooled data from six studies indicated that a greater proportion of participants (157/593) treated with minoxidil (2% and one study with 1%) reported a moderate to marked increase in their hair regrowth when compared with placebo (77/555) (risk ratio (RR) = 1.93, 95% confidence interval (CI) 1.51 to 2.47; moderate quality evidence). These results were confirmed by the investigator-rated assessments in seven studies with 1181 participants (RR 2.35, 95% CI 1.68 to 3.28; moderate quality evidence). Only one study reported on quality of life (QoL) (260 participants), albeit inadequately (low quality evidence). There was an important increase of 13.18 in total hair count per cm² in the minoxidil group compared to the placebo group (95% CI 10.92 to 15.44; low quality evidence) in eight studies (1242 participants). There were 40/407 adverse events in the twice daily minoxidil 2% group versus 28/320 in the placebo group (RR 1.24, 95% CI 0.82 to 1.87; low quality evidence). There was also no statistically significant difference in adverse events between any of the individual concentrations against placebo.Four studies (1006 participants) evaluated minoxidil 2% versus 5%. In one study, 25/57 participants in the minoxidil 2% group experienced moderate to greatly increased hair regrowth versus 22/56 in the 5% group (RR 1.12, 95% CI 0.72 to 1.73). In another study, 209 participants experienced no difference based on a visual analogue scale (P = 0.062; low quality evidence). The assessments of the investigators based on three studies (586 participants) were in agreement with these findings (moderate quality evidence). One study assessed QoL (209 participants) and reported limited data (low quality evidence). Four trials (1006 participants) did not show a difference in number of adverse events between the two concentrations (RR 1.02, 95% CI 0.91 to 1.20; low quality evidence). Both concentrations did not show a difference in increase in total hair count at end of study in three trials with 631 participants (mean difference (MD) -2.12, 95% CI -5.47 to 1.23; low quality evidence).Three studies investigated finasteride 1 mg compared to placebo. In the finasteride group 30/67 participants experienced improvement compared to 33/70 in the placebo group (RR 0.95, 95% CI 0.66 to 1.37; low quality evidence). This was consistent with the investigators' assessments (RR 0.77, 95% CI 0.31 to 1.90; low quality evidence). QoL was not assessed. Only one study addressed adverse events (137 participants) (RR 1.03, 95% CI 0.45 to 2.34; low quality evidence). In two studies (219 participants) there was no clinically meaningful difference in change of hair count, whilst one study (12 participants) favoured finasteride (low quality evidence).Two studies (141 participants) evaluated low-level laser comb therapy compared to a sham device. According to the participants, the low-level laser comb was not more effective than the sham device (RR 1.54, 95% CI 0.96 to 2.49; and RR 1.18, 95% CI 0.74 to 1.89; moderate quality evidence). However, there was a difference in favour of low-level laser comb for change from baseline in hair count (MD 17.40, 95% CI 9.74 to 25.06; and MD 17.60, 95% CI 11.97 to 23.23; low quality evidence). These studies did not assess QoL and did not report adverse events per treatment arm and only in a generic way (low quality evidence). Low-level laser therapy against sham comparisons in two separate studies also showed an increase in total hair count but with limited further data.Single studies addressed the other comparisons and provided limited evidence of either the efficacy or safety of these interventions, or were unlikely to be examined in future trials.
Authors' conclusions:
Although there was a predominance of included studies at unclear to high risk of bias, there was evidence to support the efficacy and safety of topical minoxidil in the treatment of FPHL (mainly moderate to low quality evidence). Furthermore, there was no difference in effect between the minoxidil 2% and 5% with the quality of evidence rated moderate to low for most outcomes. Finasteride was no more effective than placebo (low quality evidence). There were inconsistent results in the studies that evaluated laser devices (moderate to low quality evidence), but there was an improvement in total hair count measured from baseline.Further randomised controlled trials of other widely-used treatments, such as spironolactone, finasteride (different dosages), dutasteride, cyproterone acetate, and laser-based therapy are needed.
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