Q: How does laser therapy work?
A: The actual mechanism by which Low Level Laser Therapy (LLLT) stimulates hair growth (i.e., increases the anagen phase of the hair cycle) is still unknown. Possible mechanisms include the following:
Q: I am interested in trying home laser therapy for my androgenic alopecia? Which handheld laser device do you recommend? — N.M., Northfield, NJ
A: There are several handheld lasers currently marketed as a home use treatments for androgenic alopecia. To my knowledge there has never been a clinical study comparing different laser devices. Most of the devices use diodes to emit a narrow band red light. This wavelength of light is actually similar to those that are used in hair removal lasers, except they are at a much lower intensity. The theory is that high intensity laser damage hair follicles causing hair loss, but low level laser energy can have a bio-stimulation effect and actually induce hair growth.
If you would like to try laser therapy for hair loss, I suggest using a HairMax laser comb. This is the only device that is FDA approved. They sell a few different “strengths” of lasers for different costs. They have not shown any clinical evidence supporting one laser comb versus another. The more expensive ones have more diode lights so it would be reasonable to conclude that they are “stronger” and require less frequent use. I have patients who have used the “mid tier” laser comb, the Premium Lux 9 successfully, so that is the one I recommend to other patients.
Read more about Laser Therapy.
Posted byQ: Is the LaserComb FDA approved for women? — V.F., New Rochelle, NY
A: Yes, on June 11, 2011 the FDA cleared the HairMax LaserComb Lux 9 to treat female hair loss and promote hair growth.
Read this article in the Laser Therapy section for more information on this development.
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Dr. Eric S. Schweiger, an Associate at Bernstein Medical – Center for Hair Restoration, was interviewed recently for an article in the Wall Street Journal.
The article — Can Lasers Stimulate a Hair-Growth Spurt? — discusses the efficacy of the HairMax LaserComb and low level laser therapy (LLLT) and also touches on Dr. Schweiger’s main area of expertise, the diagnosis and treatment of hair loss in women:
Eric S. Schweiger, a clinical instructor of dermatology at Mount Sinai Medical Center in New York, says the LaserComb helps grow hair, but adds that effects are often modest, typically take at least six months and aren’t seen in all patients.
The only home laser device cleared for hair growth by the Food and Drug Administration is the LaserComb, which claims to increase hair growth in men. While used by Dr. Schweiger and others for women, the device isn’t FDA cleared for them; a clinical trial is continuing, the company says.
Read more about low level laser therapy (LLLT) and the HairMax LaserComb. For further reading you can explore the Laser Therapy topic.
Posted byQ: 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. What do you suggest?
A: 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.
Posted byQ: I am currently using the Hair Max Laser Comb. I am starting on my third week and am scheduled for a hair transplant in one week. My question is: how long do I have to wait to restart the laser comb after my hair restoration procedure? This is not my first procedure and I understand the grafts are delicate for the first couple of weeks. If I keep the teeth away from the scalp and just let the light hit the grafts will this promote faster growth?
A: You can start using the laser comb again right after the surgery, as long as it doesn’t touch the scalp.
At 10 days after the hair transplant you can use it normally, as the grafts are permanent and there is no risk of dislodging them.
Posted byQ: I’m nervous about using the LaserComb alone and unmonitored. Can I have the HairMax treatment done at a clinic or doctors office?
A: The LaserComb is a home treatment.
Posted byQ: I have been told I am a Norwood Class 6; will the HairMax LaserComb or other types of laser therapy work for me?
A: Laser treatments, as with other medical treatments for hair loss, only work when there is some existing hair in the area.
Posted byQ: Are there any side effects to the laser comb?
A: There can be an early temporary hair shedding in some patients. This is felt to be due to an acceleration of the hair cycle and is probably a mechanism similar to the one that causes early shedding when using Rogaine (Minoxidil) or Propecia (Finasteride).
Posted byQ: The makers of the HairMax LaserComb have claimed that it will “revolutionize the hair growth industry.” What do you think?
A: This claim is obviously overstated.
Since the Low Level Laser Therapy (LLLT) doesn’t affect the action of DHT on hair follicles, it doesn’t affect the underlying cause of genetic hair loss, and thus would be expected only to have limited effectiveness. The company’s own studies show that this is, indeed, the case.
It was also predicted that Rogaine would revolutionize the field of hair restoration and it had little impact.
In my opinion, only finasteride has made a significant impact on the long-term course of hair loss, particularly in its ability to postpone the need for surgical intervention such as hair transplants.
Posted byQ: Can the laser comb grow hair back in bald areas of scalp?
A: The HairMax LaserComb only works in areas where there is still some hair.
It will not bring back hair that has been lost. You need hair transplantation to do this. The laser comb works by thickening fine, miniaturized hair.
Posted byQ: Can the laser comb be used with other treatments, such as Minoxidil or Propecia?
A: Yes, it appears so, but there have been no scientific studies examining the interaction or possible synergy between these hair loss treatments.
Posted byQ: Do I need a doctor’s prescription to get the Laser Comb?
A: The HairMax Laser Comb is an over-the-counter hair loss treatment so it does not require a doctor’s prescription. You can order a Laser comb without consulting a physician and you do not need to be monitored by a doctor when using it.
Posted byQ: Where can I buy the HairMax Laser Comb?
A: The Laser Comb is currently available for purchase on-line at a variety of hair loss and hair related websites including Drugstore.com, Amazon.com and Hairmax.com.
Posted byQ: How much does the LaserComb cost?
A: There are two types of HairMax Laser Combs currently available:
Q: How effective is the HairMax Laser Comb?
A: 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 Propecia (Finasteride) and, of course, is not a substitute for surgical hair restoration.
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