Bernstein Medical - Center for Hair Restoration - Laser Comb Long-term Results
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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:

  1. Stimulating the production of various growth factors (insulin-GF, vascular endothelial-GF, fibroblast-GF)
  2. Dilating the blood vessels of the hair follicles
  3. Increasing the production of ATP (molecular energy) in the cells through its effects on mitochondria.
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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.

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Losing one’s hair can be an uncomfortable topic of conversation for any adult, but, given the importance many women place on their appearance, hair loss in women is an especially taboo subject of conversation. Whether it is a bald patch, diffuse thinning, balding from a medical condition, or scarring from an accident, hair loss can be upsetting or even traumatic for many women.

The good news is that hair restoration pioneers like Dr. Bernstein are bringing the treatment of women’s hair loss out of the cosmetics bag and into the modern era of hair restoration. What a better way of squashing the taboo once and for all than for Dr. Bernstein to appear on national television and confront the issue head-on. Dr. Mehmet Oz invited Dr. Bernstein to appear on his show, the Dr. Oz Show, to discuss the causes and diagnosis of hair loss in women.

As seen in the image above, Dr. Bernstein used a densitometer to evaluate the hair loss of a female member of the audience. The device enables a physician to determine the amount of miniaturization, or genetic thinning, present in the patient’s scalp. Dr. Bernstein also commented on the treatment of hair loss with low level laser therapy (LaserComb).

Dr. Oz and Dr. Bernstein are colleagues at The New York Presbyterian Hospital of Columbia University. They first appeared together on the Oprah Winfrey Show where Dr. Bernstein explained his new hair transplant techniques to Oprah.

See before and after hair transplant photos of some of our female patients.

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Q: I am interested in a hair transplant, but am turned off by the apparent side effects of follow up Propecia. Could herbs serve the purpose of Propecia? Regarding laser treatments, do they work on their own, or do you need drugs to supplement? Can laser damage in some cases, rather than benefit? It seems odd that laser therapy has been undertaken in Europe for 10 years, yet there are no published studies on the results. Might this be because it doesn’t work in the longer term? — D.D., Richmond, U.K.

A: Finasteride is the best medication. Herbs are not particularly effective for hair loss. You should consider trying finasteride.

If you are in the 2% group that has side effects with Propecia, just stop taking the medication. If you do not experience side effects, then there is no problem taking the medication long-term. Hair transplant surgery doesn’t prevent the progression of hair loss. That is why it is used in conjunction with medication.

Laser therapy can cause shedding initially (as can Propecia and Rogaine), but this means it is working. It does not cause actual hair loss. Your skepticism of the value of Laser therapy long term is one we have as well. Keep in mind, however, that while long-term studies are extremely important, they are very hard and costly to run and there is little incentive for companies to do this.

It is interesting that the FDA does not require longer term data on medications or devices that need to be used on a continued basis.

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Q: 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.

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Q: How long will Low Level Laser Therapy (LLLT) treatments for hair loss last?

A: The studies submitted to the FDA looked at the effects of low level lasers over a 6-month period. There is no published data for use beyond this time period.

Therefore, the long-term effectiveness of these lasers in treating hair loss is not currently known.

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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.

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Q: 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.

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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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