Category Archives: Fractional Laser

Fractional Laser, Er:YAG, Erbium YAG, Wnt/Beta-Catenin

Fractional Lasers to Stimulate Hair Regrowth

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Fractional Erbium:YAG (or Er:YAG) lasers can lead to scalp hair growth per a number of recent studies. Both ablative and non-ablative Erbium lasers have been used to treat hair loss.

Note that the fractional lasers discussed in this post have significantly higher wavelengths (1,500-3,000 nm) than typical low-level laser therapy (LLLT) home-use devices (650 nm). Fractional laser treatments must be undertaken at professional clinics and never at home.

Fractional laser treatments are unique in that they work at both the upper epidermal and lower dermal layers of the skin. Other laser light treatments are either ablative or non-ablative.

Here is some information on ablative versus non-ablative lasers and on fractional lasers. Also see this excellent overview from 2012 of all four combinations of lasers being implied here. Note that fractional carbon dioxide (CO2) lasers have also been used for hair growth.

Update: January 21, 2024

Non-Ablative Fractional Laser Superior to 5% Minoxidil

A new study from China (h/t “Kyle”) just found that a 1565 nm non-ablative fractional laser (NAFL) exhibits superior hair growth in comparison to topical minoxidil 5%. The better results were seen in: total hair count; total hair density; terminal hair count; terminal hair density; number of follicle units; and average hair numbers per hair follicle unit. Quite convincing.

The study consisted of 30 male participants with androgenetic alopecia (AGA). Half got treated with the lasers, and the other half with minoxidil. No significant side effects were noticed. Below is one of the before (baseline) and after (week 10) photos. While the hair regrowth is not easily evident in the scalp photo, the magnified close-up and the tables in the actual study garner greater confidence.

Fractional Laser Hair Growth
1565 nm non-ablative fractional laser hair growth, before and after (10 weeks) photos. Source: Journal of Cosmetic Dermatology.

Update: April 14, 2022

Er:YAG Lasers for Hair Growth

A number of new studies have been published since I originally wrote this post. All seem to use the Erbium lasers for hair growth.

— Ablative fractional 2940-nm erbium:YAG laser to treat hair loss in a male Korean patient. They used the locally made PURAXEL laser. The before and after photo from this September 2021 study is shown below:

Fractional Laser Hair Growth
Fractional Erbium:YAG Laser Hair Growth. Before an After.

— A study from August 2021 concluded that a non-ablative 2940-nm Er:YAG laser is an effective tool in the treatment of androgenetic alopecia. The authors made use of the Fotona’s SP Dynamis laser system in SMOOTH ™ mode.

Erbium Laser and PRP Hair Loss
Erbium Laser and PRP combination hair loss treatment.

— A unique 2021 study from Russia found that combination therapy consisting of non-ablative 2940-nm Er:YAG laser plus platelet-rich plasma injections resulted in very significant hair regrowth.

The SP Dynamis (Fontona) fractional laser was utilized in SMOOTH™ mode. The before and after image on the right is impressive.

May 11, 2015

Fractional Laser Hair Growth Stimulation via Wounding

The reason I thought about lasers again this week is because several days ago an interesting May 2015 article from South Korea was published in the Lasers in Surgery and Medicine journal.

The conclusion of this article is that ablative fractional lasers appear to be effective in inducing hair regrowth via activation of the Wnt/Beta-Catenin pathway. I have discussed the Wnt/Beta-Catenin pathway in numerous posts on this blog before. Note that the way these lasers work is somewhat related to the concept of wounding and hair growth.

Apparently, even before this latest development, there have already been a few published journal articles from Asian researchers covering both ablative and non-ablative fractional lasers and their positive impact on hair growth. For example see:

  • April 2015: Enhancing hair follicle regeneration by non-ablative fractional erbium-glass laser: The laser wavelength was 1550 nm. Note that the erbium laser is almost always ablative, but this one was non-ablative.
  • December 2011: The effect of a 1550 nm fractional erbium-glass laser in female pattern hair loss.
  • January 2011: Fractional photothermolysis laser treatment of male pattern hair loss. Also using the 1550 nm erbium-glass laser.

In the latest South Korean study in mice, it was found that the most effective (ablative) laser dosage was “the 10 mJ/spot and 300 spots/cm2 setting”. Hopefully some of these scientists will soon conduct studies on humans.

It does seem like light amplification by stimulated emission of radiation (LASER) can now legitimately be considered as a tool in the fight against hair loss. It is likely that in the years ahead, scientists will experiment with many newer lasers and with various duration and power settings.

LLLT Wavelength, Blue Light, Fractional Laser, LLLT, Low Level Laser Therapy, Red Light

Lasers, Wavelength and Hair Growth

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I have covered lasers and hair growth on this blog a number of times in the past. A spate of new studies on this subject suggest an emphasis on laser light wavelength during treatment.

New Low Level Laser Therapy Hair Studies

When people discuss laser treatments for hair loss, low-level laser therapy (LLLT) is usually what they mean. There have been many studies done in the past that show LLLT to be beneficial towards scalp hair growth. However, a large number of those studies have been of subpar quality (e.g., small sample size, bad photos) or biased (e.g., sponsored by a laser device manufacturer).

So this subject remains somewhat controversial. However, in the past month, three new studies have been published in support of low level laser therapy to treat hair loss:

  • A 2017 study from China concluded that low level laser therapy stimulates hair growth in mice via upregulating the expression of Wnt10b and β-catenin. Hair follicle count remained the same in LLLT treated mice versus untreated mice, but hair length increased in the former. If this holds true in humans, perhaps LLLT can really make existing hair stronger and less likely to die from the attack by dihydrotestosterone (or at least prolong the battle). However, long-lost hair is probably not going to return from LLLT.
  • A 2017 study from Iran tested a new laser scanner device (with a combination 655 nm red laser plus 808 nm infrared laser) by comparing it with a 655 nm red light laser hat. Both products led to hair growth benefits, but the laser scanner was superior. So laser wavelength may make a difference in outcome.
  • A 2017 study from Egypt on female hair loss sufferers found that combination LLLT+Minoxidil 5% treatment led to the better outcomes (measured via Ludwig scale classification and patient satisfaction) in comparison to LLLT only or Minoxidil 5% only treatments.

LLLT Wavelength: Blue Light > Red Light?

A 2017 study via a European collaboration effort found that a UV-free blue light laser (453 nm wavelength) led to hair growth via prolongation of the anagen phase of the hair cycle, but a red light laser (689 nm length) did not do the same. Update: February 2021 — From the same scientists, a new study on blue light, cryptochrome 1 (CRY1) and hair growth.

This result is surprising since most commercially available LLLT laser products (combs, caps, helmets) are of around 650 nm wavelength (i.e., in the red light spectrum). Interestingly, a 2015 study from South Korea found that 830 nm laser was superior to lower wavelength lasers (of 632 nm, 670 nm and 785 nm) when it came to hair growth in rats.

LLLT Light Wavelength
LLLT Laser Wavelength Spectrum.

The above mentioned European study also made an important finding: “We provide the first evidence that OPN2 and OPN3 are expressed in human hair follicles”.

Update: A November 2021 report finds that photobiomodulation response from 660 nm is more durable than that from 980 nm.

Update: A June 2021 report finds that blue light therapy is a promising therapy for patients affected by androgenetic alopecia. Moreover, blue light-emitting diodes seem to darken grey hair in some people.

Combining Fractional CO2 Laser and Hair Growth Factors

I discussed fractional lasers and hair growth in a post in 2015. Now a new study from China finds that a combination treatment using carbon dioxide fractional laser treatment plus growth factors is significantly superior to using growth factors alone.