Laser Therapy for Alopecia (Hair Loss)

Alopecia is the medical term for hair loss or baldness. Alopecia can occur naturally as a part of the aging process in both men and women as pattern balding on the head, or it can occur as a result of medical treatments, such as chemotherapy for cancer. Other causes of hair loss include fungal infections of the scalp, and a mental disorder that causes a person to pull out his or her own hair; these however are less common than the alopecia that occurs with age.

Stopping hair loss or regrowing the hair lost through alopecia has become an industry in and of itself. For those who have tried topical treatments and not successfully regrown hair, or who wish to avoid the pain of hair transplants, low-level laser therapy can be an alternative treatment worth trying.

How Are Lasers Used to Treat Alopecia?

The lasers used in laser therapy to treat alopecia are different from the types of laser that can burn or cut. These lasers are called low-level lasers, or low-intensity lasers, and do not produce heat or damage the skin. Instead, these lasers produce light. The light energy passes through the upper layers of the skin without harming it and is absorbed by the cells in the scalp. Through this process, called phototherapy, it is said that the light energy improves cell function, thus stimulating the healing process of weak hair follicles.

Low level lasers are thought to stimulate blood flow to the hair follicles in the scalp, thus stimulating hair growth in healthy or weak hair follicles. Although laser therapy stimulates weak living hair follicles at the cellular level, it cannot revive dead follicles. The treatment is also temporary: hair follicles are not permanently reactivated. While some patients may see improvement to weak or thinning hair within weeks, major change takes from 6 to 12 months and requires regular treatments.

The patients who have successfully used laser therapy for alopecia experience thicker, fuller hair. Many patients have seen hair loss stop as a result of laser therapy. The best results are seen with multi-therapy treatments that can include over-the-counter medications (finasteride or minoxidil), nutritional supplements (saw palmetto, for example) and follicle unit transplants.

What are the Benefits of Laser Therapy?

As a non-invasive, external approach, laser therapy spares the patient the pain and physical appearance of surgical techniques such as scalp reduction and hair transplants. Laser therapy can also improve the appearance of the scalp following implant surgery, and promote faster healing. Patients do not have to comply with a regime of dietary supplements or prescription medications, nor do they have to discipline themselves to a daily application of medication to their scalps. Laser therapy works equally well for both men and women.

Handheld products are available for use at home, ranging in price from $400-$3,500. They vary in quality and in power, and so the results will also vary. Although some of the products may be approved by the United States Food and Drug Administration for home use in the treatment of alopecia, the devices sold for home use are generally less powerful than those used in a hair growth practitioner’s office.

What is Laser Therapy?

Low level laser therapy (LLLT) is also known as laser phototherapy, cold laser therapy, low-power laser therapy (LPLT), low-intensity laser, low-energy laser therapy, soft laser, biostimulation laser, therapeutic laser, and, when applied to acupressure points, laser acupuncture.

Laser therapies use low level monochromatic radiation to treat illnesses and conditions including hair loss. It is one of many treatments falling under the heading of "energy medicines," along with other veritable energies that use specific, measurable wavelengths and frequencies of electromagnetic forces for therapeutic effects. Low level laser therapy has been used to relieve pain, heal wounds and reduce inflammation, but research has not established a strong confirmation of its effectiveness.

The United Stated Food and Drug Administration (FDA) approved low level laser therapy (LLLT) for the treatment of androgenetic hair loss in January 2007 when it cleared Lexington's HairMax LaserComb, a product based on decades-old hair salon-based technology, as a medical device.

What Risks are Associated with Laser Therapy?

These therapies use red-beam or near-infrared lasers with a wave-length between 600 and 1000nm power from 5–500 milliwatts that have low absorption by human skin. Treatment does not require anesthesia or sedation. The treatment cost is a factor in both home-use devices and clinic- or salon-based treatments. Currently there are no widely accepted standards regarding the dose, number of treatments or the length of treatment, and little research on this therapy for the treatment of hair loss has been done to date. In contrast, LLLT has demonstrated some therapeutic effectiveness when applied to arthritis, pain, macular degeneration and wound healing.

What is Alopecia?

Alopecia is the general term for hair thinning and loss, whether in localized patches, scalp-wide, or across the body. There are several different types of hair loss:

• Alopecia areata is an autoimmune condition that can begin in childhood and produces small quarter-sized patches of hair loss. The condition occurs due to white blood cells attacking hair follicles. This condition can progress to complete loss of hair on the head (alopecia areata totalis) or, even more rarely, the entire body's hair, including facial hair, underarm and pubic hair (alopecia areata universalis).
• Androgenetic alopecia is a genetic condition. Baldness in an older generation could be an indicator of baldness in younger generations. Hair loss patterns are gender-specific: Male pattern baldness generally starts at the hairline and proceeds across the top of the head. Female diffuse baldness maintains the hairline, but hair thins gradually, mostly on the crown.

• Telogen effluvium is hair loss following a systemic shock, such as the body may experience post-operatively.

What Causes Alopecia?

Hair loss can be triggered by several different factors, including:

• Genetics. Male pattern baldness and female diffuse baldness are family traits.
• Diet, including malnutrition and starvation, consumption of insufficient nutrients that support hair health or consumption of a toxin.
• Over-the-counter and prescription medications, including non-steroidal anti-inflammatory drugs (NSAIDs).
• Stress and stress-induced behaviors, such as pulling hair.
• Chemical exposure, including some hair dyes.
• Systemic shock, such as postoperative shock hair loss (telogen effluvium).
• Exposure to radiation, environmentally or as a consequence of medical treatment.
• Hormonal imbalance due to a medical condition or the onset of menopause.

Additional Resources

International Alliance of Hair Restoration Surgeons: Q&A on Laser Therapy.

Photomedicine and Laser Surgery publishes research results on medical uses of laser therapies.

References

CIGNA HealthCare Coverage Position Paper: Low Level Laser Therapy

National Institutes of Health: National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS): Q&A Alopecia Areata

Al-Mutairi N. (2007): 308-nm Excimer laser for the treatment of alopecia areata. Dermatologic Surgery 33(12):1483-1487.

Avram M.R., Leonard R.T.Jr., Epstein E.S., Williams J.L., Bauman A.J. (2007): The current role of laser/light sources in the treatment of male and female pattern hair loss. Journal of Cosmetic and Laser Therapy 9(1):27-28.

Bernstein E.F. (2005): Hair growth induced by diode laser treatment. Dermatologic Surgery 31(5):584-586.

Chung P.S., Kim Y.C., Chung M.S., Jung S.O., Ree C.K. (2005): The effect of low-power laser on the murine hair growth. Journal of the Korean Society of Plastic & Reconstructive Surgeons.

Satino J.L., Markou M. (2003): Hair regrowth and increased hair tensile strength using the HairMax LaserComb for low-level laser therapy. International Journal of Cosmetic Surgery and Aesthetic Dermatology 5(2):113-117.

Vlachos S.P., Kontoes P.P. (2002): Development of terminal hair following skin lesion treatments with an intense pulsed light source. Aesthetic Plastic Surgery 26(4):303-307.

Waiz M., Saleh A.S., Hayani R., Jubory S.O. (2006): Use of the pulsed infrared diode laser (904 nm) in the treatment of alopecia areata. Journal of Cosmetic and Laser Therapy 8(1):27-30.