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LOW LEVEL LASERS stimulate cell function. The effect is not thermal as in the case of surgical lasers. These non-surgical therapeutic lasers are certified Class 3A by the FDA. The energy produced by the photons of these lasers is low and does not have a thermal component that can cause injuries to users and/or operators. This low level energy does not alter molecular structures, but STIMULATES the body's mechanisms to REPAIR AND HEAL itself.
Low level (energy) laser light photons are absorbed by the chromophores within the cells. This induces increased production of cellular energy in the form of ATP, which leads to normalization of cell function, pain relief and healing. These effects are especially striking in areas of the body where cells are under stress.
The photo-energy from these low level lasers is low and remains a long way below the levels needed for ionization of the atoms and molecules of the cells. Thus no induction of cancer growth has been linked to these lasers. The risk of eye injury is almost non-existent, but goggles are recommended.
LLLT FOT HAIR LOSS (ANDROGENETIC ALOPECIA)
What type of laser device would benefit patients with androgenetic alopecia? The devices being promoted must be safe for use. They must be effective to meet the manufacturer's claims. The consumer must know what he/she is buying, and the device must not expose the consumer to undo risks.
The therapeutic factors in choosing a laser are as follows:
(a) The wavelength of the light is important as it determines penetration depth in the target tissue. For example, red light at 670 nanometers penetrates greater than other lasers close to the red spectrum. Since wavelengths of 670-690 nanometers support the oxidation processes, it is believed that the 670 nanometer wavelengths show better efficacy in therapeutics than lower wavelength lasers.
(b) For hair applications, the first and most significant condition in choosing laser wavelength is depth penetration, which should be sufficient to target hair bulbs typically resting at 5-6 mm depth.
(c) Visible red light at a wavelength of 660 nanometers penetrates tissue to a depth of 8-10 mm so that the entire hair organ will be covered to a depth just beyond the hair bulb. Visible red light could theoretically be effective in the entire scalp and might include wounds, cuts, scars, folliculitis, etc.
(d) There is the question of continuous wave vs. pulsed operation of the laser. Pulsed operation has been shown to stimulate tissue repair and regeneration to a greater degree than continuous wave operation. Pulses have been shown to stimulate cellular activity. Pulses can regulate biologic rhythms or cycles. Finally, pulsed operation exhibits greater anti-inflammatory effects than the continuous mode.
The GOAL of LLLT is to increase the circulation of the blood to the follicle area and to stimulate the hair organs (nerves, muscles and growth centers of the follicle). The effects of LLLT to stimulate, enhance or speed up the normal life cycle and production cycle of the exposed hair follicles is presently being studied and will fast become the science by which this technology will be judged:
In 1996 Pontien published a Microcirculation study with the Laser Hair Care Device and showed an increase in blood flow.
In 2005 Weiss and McDaniel showed that photo modulation using visible light can alter the expression of genes associated with the stimulation of hair growth. They described it as more of a "minoxidil-like" effect.
EFFECTS OF LLLT
The physics of laser light, along with its known properties, led the way to a practical application for low energy lasers in medicine. Various studies have confirmed these properties on the living organism. Taken together, the data points to the following effects of low level laser light on the scalp:
(1) Increased scalp blood flow and microcirculation by 20-30%
(2) Increases nutrient supply to enhance hair growth
(3) Stimulates and accelerates hair growth
(4) Stops the progression of hair loss
(5) Repairs and improves hair shaft quality
(6) Reduces excess levels of skin 5 alpha reductase and DHT which contribute to genetic thinning
(7) Relieves scalp conditions such as psoriasis, seborrhoeic dermatitis, itchy/scaling scalp (anti-inflammatory properties)
(8) Normalizes sebum production (also increases production in under activity and dryness and decreases production in over activity or greasiness)
(9) Reduces tight, tender scalp
These effects also make LLLT excellent adjunct therapy for pre-operative and post-operative Hair Restoration procedures.
TREATMENT PROGRAMS
In developing treatment programs with LLLT one must first consider whether the treatment will be administered with a Class 3A laser machine, with a hand held laser device, or with both.
The larger Class 3A Laser Machine is a patented cool laser which creates a soft halo of light around the scalp. The light is delivered from multiple rotating laser positions designed to increase blood flow to the scalp. There are 30 diode lasers rotating in a half sphere around the head delivering pulsed low laser energy to the scalp. This requires twice weekly or more visits to the clinic. The use of adjunct products, including a vasodilator, is recommended. FDA approval for the use of this laser for hair loss is pending.
The hand held laser comb is a hand held wand-like instrument with laser light ports arranged across its surface like the teeth of a comb. It is used at home 3 to 4 times weekly for 10-15 minutes per use. It is easy to use and convenient for the patient, so compliance is high. FDA approval for its use for hair loss is pending. It is accepted as a medical device in Canada. This allows advertising to make therapeutic claims about the hand held laser device such as its ability to increase the strength of scalp hair in men and women, its ability to prevent scalp hair loss in men and women, and its ability to cause re-growth of scalp hair in men and women.
Studies with the hand held laser comb have reinforced these claims:
In 2003, Martin Unger showed that LLLT has been found to have biomodulating effects on human hair and hair follicles. 97% of the patients studied had some benefit in improvement of hair characteristics, stabilization of hair loss or hair re-growth (defined by Unger as an increase of hair count by 11% or more from baseline).
Santino and Markou, in 2003, studied 35 patients (28 males, 7 females) with androgenetic alopecia on the LaserMax Comb. The treatment regimen was an every other day application of the comb for 5-10 minutes for 6 months. The results showed that, all patients considered, 93.5% of patients had a hair count increase and 78.9% had an increase in hair tensile strength.
There are ongoing FDA trials for men and women with thinning hair. These individuals undergo two treatments per week with the hand held laser comb for 6 months. All of the details of the trials are not available but preliminary results show that in men, 10% had stabilization of both frontal and vertex hair loss, 84.6% had re-growth of some hair in the frontal area and 82.8% had re-growth of some hair in the vertex. In women, 100% had stabilization of hair loss in the vertex, 87.5% had stabilization of hair loss in the frontal area, 75% had re-growth of some hair in the frontal area and 96.4% had re-growth of some hair in the vertex. Thus far, no side effects or eye damage has been reported.
CANDIDATES FOR LLLT
Based upon the information thus far and the various clinical trials in progress, a potential list of candidates for LLLT for hair loss is as follows:
Men and women between the ages of 18 and 65
Thinning to moderate hair loss
Patients ineligible for hair Restoration Surgery due to early stages of hair loss
Women experiencing diffuse or general thinning including the sides and the back
Pre and Post operative hair restoration.
There are three general categories of user experience with LLLT as regards to hair loss. 45% of patients will see positive results after 8 weeks of treatment, 45% will see positive results after 10-16 weeks of treatment and 10% see improvement after 16 weeks.
Finally, to give an idea of the types of laser programs that exist, the Hair Restoration Group has three different programs. Patients choose a program based upon specific needs.
The IN-CLINIC PROGRAM consists of 46 sessions of LLLT over 12 months with three cappilliscope readings to measure hair density. The AT HOME AND IN CLINIC PROGRAM utilizes the hand held laser comb three times a week for ten minutes at home with 12 monthly LLLT sessions in the clinic. Finally, there is a POST-OPERATIVE LLLT PROGRAM consisting of 2 twenty minute sessions of LLLT per week for 8 weeks. The patients undergoing post-operative LLLT notice that healing is accelerated, scarring is minimized (especially in the donor area), graft growth is accelerated, graft appearance is improved and post-operative swelling does not occur.
Richard P. Giannotto, MD is President and Medical Director of
Hair Restoration Group, PC , in McLean, Virginia. He has studied and published widely on the subject of hair loss and hair restoration, for which he is a recognized international authority.
For further information, please visit
http://www.iwanthair.com.
What she said. I can't believe there is no way to avoid 'confusing' the equipment and that surgery (the more expensive option) would be recommended.
