Category Archives: LLLT

Low-Level Laser Therapy (LLLT) for Hair Loss

HairMax LaserComb LLLT
Low-Level Laser Therapy with HairMax LaserComb.

Until several years ago, I used to be a skeptic when it comes to low-level laser therapy (LLLT) for hair loss. This is not to say that I felt there was zero logic in using lasers to treat scalp hair loss.

In fact, for years, I have heard of laser body hair removal causing the unwanted and opposite side effect of laser hair growth stimulation in some people. A phenomenon termed as paradoxical hypertrichosis. Affecting 3 percent of hair removal patients per a recent study.

However, I felt that the benefits of LLLT aka photobiomodulation (PBM) on scalp hair are modest at best. Lasers used for body hair removal at clinics are far more powerful and different from those used to treat scalp hair loss. Even less powerful at-home laser hair removal devices are often stronger than those used to treat scalp hair loss.

Updated: April 13, 2022

New Studies on LLLT for Hair Loss

Since I first wrote this post, a number of new studies in support of low-level laser light therapy for hair growth have been published.

  • An April 2022 study from China finds that low-level laser treatment promotes skin wound healing in mice by activating hair follicle stem cells. I always think of LLLT and wounding as somewhat overlapping in concept.
  • A December 2021 study from China found hair growth promoting effects from 650 nm red light stimulation.
  • September 2021 findings from Dr. Gentile of Italy: “All the articles selected and analyzed reported a positive effect of LLLT for MPHL and/or FPHL treatment without side effects”.
  • A May 2021 study concluded that low-level light therapy downregulates scalp inflammatory biomarkers in men with androgenetic alopecia. Moreover, LLLT also boosts the effectiveness of Minoxidil on hair growth. Note that this research was conducted in France by the reputable L’Oréal.
  • Also from May 2021, yet more findings that photobiomodulation therapy activates β-Catenin in hair follicle stem cells.
  • A 2020 literature review of ten controlled clinical trials concludes that LLLT appears to be safe and effective for treating pattern hair loss in both men and women. However, the authors caution that some studies “have a relationship with the industry”.
  • According to this summary, as of September 2020 there were 66 LLLT devices registered with the US FDA.
  • A 2019 study from Thailand conducted proteomic analysis of dermal papilla cells before and after treatment with low-level laser therapy. The analysis revealed 11 up-regulated and 2 down-regulated proteins in LLLT treated DP cells compared with baseline.

Also of note, at the recent 2022 AAD conference, there was a session on Photobiomodulation (PBM) therapy and hair growth. One of the items of discussion pertained to the use of LLLT in combination with PRP.

Low-Level Laser Therapy Wavelengths

The lasers that are used in LLLT typically have a wavelength of anywhere between 600 to 900 nanometers (nm). Anything below 600 nm tends to work less effectively. However, one study found lower wavelength blue light (453 nm) to be more effective.

The bestselling laser hair growth devices all use wavelengths of red or near-infrared light (i.e., around 650 nm). Of note, a study from South Korea found that a higher wavelength of 830 nm gave the best results (albeit in mice). For more on this subject, see my posts on low level laser therapy for hair loss wavelengths. Also check out my post on the use of higher wavelength fractional lasers for stimulating hair growth.

LLLT Debate

This old debate from 2008 between Dr. Feller and Dr. Bauman is quite interesting. Dr. Bauman was also part of a now famous 2004/2005 Dateline NBC show that followed 5 patients on different treatment protocols. The HairMax Lasercomb resulted in the most favorable (but not stellar) hair regrowth results. See patient “George” and his before and after photos at 8:10 onwards in this video:

Laser Devices for Hair Growth

Nowadays, numerous physicians support the use of FDA cleared at-home low-level laser devices for hair growth. The Amazon.com customer reviews for LLLT products typically average around 4.0 out of 5.0 stars.

However, I would advise always looking at reviews with a critical eye. Only give credence to reviewers who have their names verified. Make sure to focus on those who have posted reviews of many different types of products over several years.

HairMax LaserComb 9 vs LaserComb 12

When it comes to the best laser hair growth devices, the HairMax LaserComb is the oldest well known product on the market. I briefly covered the company a few years ago when its president Leonard Stillman commented on this blog. However, I did not discuss its hair loss treatment products at the time.

HairMax LaserComb

HairMax LaserComb
HairMax LaserComb.

The LaserComb’s inventor and CEO is David Michaels. The first LaserComb device obtained US FDA 501(k) clearance to market for use in balding male androgenetic alopecia sufferers in 2007. Approval for female pattern hair loss patients came in 2011.

A study in 2009 concluded that:

“HairMax LaserComb is an effective, well tolerated and safe laser phototherapy device for the treatment of AGA in males.”

Another study from 2014 found “a statistically significant difference in the increase in terminal hair density” between lasercomb-treated versus sham-treated subjects.

HairMax (part of Lexington International) currently has two laser comb models on the market: The Ultima 9 Classic LaserComb and the Ultima 12 LaserComb. The older cheaper device seems to have slightly better online customer reviews for hair regrowth. Both products come with money-back guarantees and warranties.

A directly competing product is the NutraStim Laser Hair Comb. Other more expensive laser products for hair growth include Theradome and Revian Red.

Dateline covered the LaserComb quite favorably in 2011, with before and after photos and patient feedback included. I even mentioned that story in a post in 2014. Thereafter, a whole bunch of new companies have come out with FDA-cleared low-level laser devices to grow hair. None are laser comb or brush type products that entail combing one’s hair daily or several times a week.

Safety and Side Effects

In 2012, Lexington released the results of its sponsored clinical study on the efficacy of the LaserComb 7 beam model. Laser combs are safe and well tolerated phototherapy devices used to treat androgenetic alopecia (male pattern baldness). I have never heard of anyone complaining about major side effects upon using these products to promote hair growth. However, lasers and light can be dangerous to the eyes, so do not do this type of thing.

Note that almost no-one claims that lasers will regrow hair follicles on totally bald regions of the scalp. At best, they can make existing thinning hair stronger via photo-biostimulation and light energy. And possibly regrow recently miniaturized hair follicles.

Some studies suggest that laser light energy stimulation of the mitochondria and cells can also promote new hair growth. At least in modest quantities. However, some of these same studies are sponsored by laser device manufacturers. Hopefully this does not bias results, but one needs to be careful when analyzing findings in support of LLLT.

HairMax Ultima 9 Classic LaserComb

HairMax Ultima 9 Classic LaserComb.
HairMax Ultima 9 Classic LaserComb.

Recently, I saw the HairMax Lasercomb 9 for sale at Costco for $199 (with bonus shampoo and conditioner bottles). Of the numerous well known brand name low-level laser therapy devices on the market, this is by far the best price. You can purchase lesser known unproven brands at lower prices. Some people even try to made their own laser combs at home.

Update: 2021 — On Amazon, the price of the Ultima 9 is currently $199, with a bonus 15 percent off coupon available as an add-on. The HairMax Ultima 9 Classic LaserComb comes with the following features and properties:

  • FDA Clearance.
  • 9 Medical grade lasers (but no LEDs).
  • Cordless with rechargeable battery.
  • Power cord also available.
  • 11 minute treatment time.

Make sure to also see this official Lexington video on how to use the HairMax Ultima 9 Classic LaserComb.

Laser Comb Reviews and Ratings

Amazon has 611 customer reviews, with a respectable average rating of 4.1 out of 5 stars. On Costco’s site, customers in the past gave the HairMax Ultima 9 LaserComb an average review of 3.8/5, but it is no longer on sale. Walmart currently has a refurbished Hairmax Prima 9 Classic LaserComb for sale at just $145. On the manufacturer’s own site, 204 customers have rated the product at 4.3/5 as of today. Best Buy has 4 reviews averaging 4.5/5.

I am honestly quite surprised at these HairMax LaserComb reviews. An average of 4.2/5 across the diverse list of vendors and retailers that I listed above is quite impressive for a laser product. In online hair loss forum reports, a large number of people seem to say that they did not benefit from laser treatment for hair growth.

HairMax Ultima 12 LaserComb

HairMax Ultima 12 LaserComb.
HairMax Ultima 12 Laser Comb.

HairMax’s newest LaserComb model is the Ultima 12. On Amazon, it has a rating of 4.1 out of 5 stars, based on 97 customers. Current offer comes with a 15% off coupon. An older now inactive page on Amazon had an average rating of 4/5 across 25 reviews in 2019. The price of the Ultima 12 LaserComb is around $395 across various sites.

Average rating on Walmart’s website is a much better 4.4/5, based on 34 customer reviews. Almost the same numbers can be seen on HairMax’s Ultima 12 product page. On Bed Bath & Beyond’s site, Beyond+ members discounted current price is $317.

The main advantage of Ultima 12 over Ultima 9 is that while the former has 12 lasers, the latter has 9. Treatment time is just 8 minutes with the Ultima 12, versus 11 minutes with the Ultima 9.