Low Level Laser Therapy, LLLT

Low-Level Laser Therapy (LLLT) for Hair Loss

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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 body hair growth stimulation in some people. A phenomenon termed as paradoxical hypertrichosis, which affects 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.

American Academy of Dermatology, Baricitinib

2022 AAD Annual Meeting

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— Yet another interesting conference will take place in Monaco from March 31-April 2 (h/t “Ben” yet again). It is the 20th edition of the Aesthetic & Anti-Aging Medicine World Congress.

Among the highlights (see full abstract here) will include:

  • An update from HairClone’s Dr. Paul Kemp.
  • Several presentations on exosomes for hair growth.
  • Several new reports of PRP reducing hair loss.
  • An interesting report form Dr. Pietro Gentile where he analyzes the benefits of hair follicle mesenchymal stem cell (HF-MSC) injections.
  • An update on ARTAS robotic hair transplants.

AAD 2022: Key Hair Loss Related Updates

— Update from AAD2022.

— Baricitinib JAK inhibitor leads to significant hair regrowth in Alopecia Areata patients. Dr. Brett King video. Amazing before and after photos, but we have seen similar results from other JAK inhibitors in the past.

Baricitinib Hair Growth
Baricitinib Hair Growth in Alopecia Areata Patients. Before and After. Source: Dr. Brett King et al in the New England Journal of Medicine.

— At AAD2022, Alma launched an ultrasound based laser system called Alma TED™. It benefits hair growth via improving blood flow. Also see my recent post on sound therapy for hair growth. Some before and after photos here.

— Update from the 2022 Oscars, where a hair loss issue leads to violence.

Introduction

American Academy of Dermatology (AAD) Logo

The 2022 American Academy of Dermatology (AAD) Annual Meeting will run from March 25, 2022-March 29, 2022 in Boston, Massachusetts. After being cancelled in 2020, this time it is an in-person event.

The AAD was founded in 1938 and currently counts most practicing dermatologists in the United States as members. In the past, I wrote about the 2016 AAD annual meeting and the 2018 AAD annual meeting. I also covered the lesser known Society for Investigative Dermatology (SID) conferences several times.

Make sure to follow on Twitter the AADmember account and the AADskin account for more information. #AAD2022.

2022 AAD Meeting Hair Loss Sessions

Unlike conferences focused solely on hair loss (e.g., WCHR, ISHRS, EHRS and AHRS), the AAD meetings include a wide range of dermatological conditions. Skin issues are of foremost importance.

Nevertheless, hair related sessions and posters (18 pages) are still numerous. The AAD hair loss sessions tend to focus more on existing treatments and recent developments and improvements in technology. You do not see much on long-term future developments.

Among the interesting presentations this time around include:

Disclosures and Corporate Affiliations

What I always find interesting in these conferences is the company affiliation disclosures. In some cases, hair loss product vendors provide fees to the presenters. In other cases, research funding and grants. And in other case, I assume just advisory support. Some of the “type of relationship” acronyms in the disclosure statements are not defined.

  • It is great to see Cassiopea so active. I still have hopes that Breezula will be at least as good as Minoxidil, while targeting an entirely different pathway.
  • Other hair loss companies that I have covered that are also mentioned as sponsors/funders/affiliates include AbbVie; Allergan; Almirall; Applied Biology; Follica and L’Oréal.
  • I find it interesting that low-level laser device manufacturers such as Capillus, HairMax LaserComb and Theradome are associated with so many of the researchers.
  • A number of smaller companies that I have discussed on this blog seem to be involved with a number of researchers. The most surprising of these is DS Laboratories.
  • The disclosure list of some of the scientists presenting is unbelievably lengthy. It is worth checking out Dr. Neil Saddick and Dr. Adelaide Hebert. Surprisingly, Dr. Ken Washenik only shows two companies (Cassiopea and Follica) in his disclosure list.