Q: Dr. Bernstein, I saw you on TV where you explained why you haven’t had a hair transplant. If you had better donor hair and you could do the surgery on yourself, then would you consider having a hair transplant? — M.U., Westport, CT
A: Yes.
Q: I heard that you could get a laser treatment for hair loss in a doctor’s office with a new laser called the Revage. What is this and how does it compare to the laser comb that I can buy myself?
A: The Revage Laser is a Low Level Laser Therapy (LLLT) treatment for thinning hair manufactured by the company Laser Hair Therapy of North America, LLC. It is FDA classified or permitted to be sold as a cosmetic device, but not as a medical device at this time.
The Revage system contains 30 laser diodes that rotate 180 degrees around the scalp. This dynamic process increases the contact of the laser energy with the hair follicles. It is available only through a physician’s office.
Q: I heard that you can buy a laser for hair loss and use it at home. What are the advantages or disadvantages of doing this?
A: The advantages of home use are convenience and that it is generally less expensive than going to a doctor’s office for treatment.
The main disadvantage of using laser treatments without a doctor’s supervision is that a more effective treatment for hair loss may be available and you may not know about it. By spending time using the laser, the window for a more effective treatment may be missed. A good example is the 20 year old male who has extensive hair loss in his family and is just starting to thin. It is very important for this person to start Propecia (finasteride) as soon as possible, since the long-term benefits of using this medication are well established.
Q: I am a 33 year old woman and have been told my hair is too thin on the sides for me to have a hair transplant. Could I benefit from laser treatments?
A: Although the long-term benefits on hair growth are not known, Low Level Laser Therapy (LLLT) is able to stimulate hair to become fuller in appearance in the clinical trials that have been carried out for six month periods.
Since the laser light serves to thicken fine, miniaturized hair, it is particularly suitable to areas of diffuse thinning, rather than areas of complete baldness.
Since hair loss in women commonly has a diffuse pattern, because women can’t take Propecia (finasteride), and the fact that women are less often candidates for surgery (as compared to men), laser therapy in females is particularly appealing.
Q: I heard about the laser comb and other lasers for hair loss, how do they work?
A: Low Level Laser Therapy (LLLT) is based on the scientific principle of photobiotherapy. Photobiotherapy occurs when laser light, absorbed by cells, causes stimulation of cell metabolism and improved blood flow.
Although the exact mechanism by which lasers promote hair growth is still unknown, they appear to stimulate the follicles on the scalp by increasing energy production and partially reversing the miniaturization process leading to thicker hair shafts and a fuller look.
Q: Is the use of Low Level Light Laser Therapy (LLLT) for hair loss new?
A: These lasers have been used for hair loss in Europe for almost ten years. Classified as a cosmetic laser, they are safe for human cosmetic use.
The original research in this technology was carried out at the Wellman Labs for Photomedicine at Harvard University.
Q: I have heard the term “cold lasers,” what exactly are they?
A: The lasers used in Low Level Laser Therapy (LLLT) are referred to as “cold lasers” because they are able to alter tissue function without having to raise the temperature of the target tissue above 37 degrees C (body temp).
Q: I had my hair transplant done 10 days back, I was a regular smoker (8-10) cigarettes every day from last 10 years. I have stopped smoking from the day of my surgery, how long should I stop smoking after surgery? — E.D., Glendale, N.Y.
A: I would wait a minimum of 10 days, but the longer the better. The nicotine in the smoke constricts blood vessels and decreases the oxygen to the tissues and the carbon dioxide in smoke displaces the oxygen. Both chemicals retard healing.
Q: Will cutting my hair short – skin level – adversely affect it? — M.H., Larchmont, NY
A: Hair shafts are not alive (only the follicle is), so cutting the hair will not affect its growth.
Q: I am 22 yrs old and I started shedding hair in a very limited form since I was 20. I have now been on Propecia for nearly 8 months. To date I have not experienced any benefit. In fact, I have seen my hair continue to thin. Is it possible that this thinning is a result of Propecia? — M.M., Boston, Massachussetts
A: Usually the shedding associated with finasteride will subside by 6 months.
If you are still losing hair at 8 months, most likely the medication is not working. Unfortunately, it is not effective in about 15% of patients.
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