Treating Hair Loss w/ Low Level Laser Therapy EMAA-2012 Paris

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Low Level Laser Therapy is a non-chemical, side-effect free option for those with hair loss and hair thinning. Does Laser Therapy actually work? What are the mechanisms of low level laser therapy on the scalp and hair follicle. Are there any adverse effects?

Low Level Laser Therapy (LLLT) has been used for wound healing, pain control, lipolysis, anti-inflammatory properties and more. The mitochondrial-based cytochrome-c-oxidase molecule in the electron transport chain accepts the photon which then causes a cascade of events leading to increased ATP production and more.

Over time, when hair follicles that are producing weak, thin, wispy hair are exposed to significant doses of LLLT at regular intervals improvement in hair quality can be seen and measured.

As the delivery of LLLT has become easier for patients (portable) and more powerful over time due to the decreasing cost of laser-diodes, results have improved.

Old-style hand-held devices are relatively weak and many head-worn units contain weak non-laser, non-coherent LED's.

Newer devices like the cordless, rechargeable, 100% hands-free, discreet LaserCap and the hand-held Nutreve personal laser are making it easier for patients to achieve the results they seek.

LaserCap contains 224 diodes at 5mw in a paper-thin circuit board that is sized to fit underneath a standard baseball hat, bandana or scarf. It's rechargeable battery pack makes it the most powerful, portable device available for hair loss patients. 30 min every other day.

Nutreve's Personal Laser, hand-held rechargeable 35 diode unit contains the most diodes of any hand-held on the market today. 20 minutes over one area every other day.

Patients can see thicker, fuller and healthier hair within a few months of use but it does not reverse severe baldness where depletion of hair follicle density has already occurred.

Dr. Alan J. Bauman, M.D.
doctorb@baumanmedical.com
ABHRS Certified

Published in: Health & Medicine

Treating Hair Loss w/ Low Level Laser Therapy EMAA-2012 Paris

  1. 1. The Role of Low Level Laser Therapy in the Medical Management of Androgenetic Alopecia Alan J. Bauman, M.D. Diplomate, American and Int’l Board of Hair Restoration SurgeryEuropean Masters in Aesthetic & Anti-Aging Medicine 2nd International Hair Surgery Masters Course October 13th, 2012 Paris, France
  2. 2. DisclosuresThe following conflicts of interest are germane to my presentation: NONE LaserSpa at Bauman Medical Group
  3. 3. Alan J. Bauman, M.D.Bauman Medical Group – Boca Raton, FL (1997)New York Medical CollegeBeth Israel Medical Center – NYMt. Sinai Medical Center – NYHair Transplantation – NYAmerican Bd of Hair Restoration SurgeryAmerican Hair Loss AssociationLow Level Laser Therapy (1999)
  4. 4. Overview Androgenetic Alopecia Mechanisms of Laser Therapy (LLLT) Role of LLLT in Hair Restoration Laser Therapy Dosing Protocol Our Experience w/ Laser Therapy Practical Concerns
  5. 5. Androgenetic AlopeciaHereditary : ♀♂ HAIR LOSS CAUSESAndrogen Receptors 4%Progressive AGAPatterned hair follicle miniaturization OtherShorter/Finer/Thinner/Less Pigmented 96%
  6. 6. Androgenetic Alopecia Multi-Therapy Medical ManagementEliminate/Reduce ‘Triggers’• Medical conditions, meds, social habits, nutrition, stress, etc.↓DHT production and/or Androgen Effects• Finasteride, Dutasteride*, Spironolactone*Stimulate Hair Follicles• 2%, 5%, 6%* Minoxidil, 0.03% Bimatoprost*,• Laser Therapy, Phototherapy, PRPRedistribute (Transplant) Permanent Follicles• NeoGraft / FUE – no linear scarSurgically Reduce/Remove Bald Areas• Scalp Reduction/Flaps *off-label
  7. 7. Low Level Laser Therapy < 500 mW (5mW) Non-chemical 630-670nm (650nm) Non-invasive Non-cutting/burning Non-thermal 3,000 papers No side-effects 8 textbooks Photobiomodulation 6 societies 2 peer-reviewed journals
  8. 8. Phototherapy/LLLT ConceptsMechanism: Cytochrome–C–Oxidase ↑ATP production Non-ionizing Non-thermal No side-effects Tuner J/Hode L, Laser Therapy, (2004) Prima Books
  9. 9. growth factor production extracellular matrix deposition near infrared light cell proliferation & motility anti-apoptosis and pro-survival Genesignaling transcription - Michael Hamblin, Ph.D. – Harvard/MIT
  10. 10. Photomodulation & Human Dermal Papilla Cells April 2005 Effects of light on HDP gene activity in culture & clinical trials VEGF (+1.8) HGF (+2.0) MMP-2 (+2.7) 5-AR (0)
  11. 11. FDA 510(k) Clearances #K060305, Jan. 18th 2007 650nm male AGA HairMax LaserComb 9 x 5mW at-home Lexington Int’l, LLC“...indicated to promote hair growth in males with androgenetic alopeciawho have NW Class IIa-V…and does not present any safety issues”“A Multi-Center, Randomized, Placebo-Controlled Study…”“treatment group had significantly greater increases in terminal hairdensity than… placebo.” #K091496, Nov. 13th 2009 650nm female AGA MEP90 82 x 5mW in-office Midwest RF prescription
  12. 12. FDA 510(k) Clearances (con’t)FDA 510(k): #K091496, Nov 13, 2009Device: MEP90 Hair Growth Stimulation SystemManufacturer: Midwest RF “ Medically prescribed for the treatment of androgenetic alopecia in females.” “After 20 treatments, 92% of subjects had increased hair count ≥10% with 57% demonstrating an increase of ≥30%” “After 36th treatment, 97% of the subject population demonstrated increased hair count of ≥20%, 89% increased hair count ≥30%, with 57% demonstrating increase of ≥50%” “87% of subjects indicated it helped their condition, 60% reporting slowing of hair loss by 10 weeks, 65% reported their area of hair loss had gotten smaller.” In-Office / 650nm / 5mW x 82 diodes
  13. 13. LLLT Dosing StrategyWavelength Biphasic Dose Response 635-670nmTotal Power # diodes x output (mW)Treatment AreaDuration (min) Tuner J, Hode L, Laser Therapy Handbook (2004) Prima Books.Interval – too short v. too longProtocol: Device Dependent
  14. 14. LLLT & Hair
  15. 15. Cosmetic Devices 650 nm 5mW X 224 Diodes 80% Duty Cycle 30 Minutes Hands-Free Rechargeable/Cordless Significant coverage High compliance LaserCap™
  16. 16. Results Tracking Patient History / Intake Questionnaire Physical Exam of Scalp & Hair Standardized Global Photography Video Microscopy Combined Cross-sectional Hair Bundle Trichometry What’s your “HAIR NUMBER?”
  17. 17. Densitometry – Canfield Scientific
  18. 18. LaserCap Results:
  19. 19. Laser Therapy in Females 25 y/o female In-office Laser Hood 2 / week x 6 months
  20. 20. LLLT x 8 months 63 y/o female Laser Therapy regimen: 3x/wk x 3 mo 1-2x/wk since Photos after 12mo.
  21. 21. 6 Months: At-Home LLLT
  22. 22. 24 y/o Female: 3 mos. of LLLT
  23. 23. Male Patient : LLLT x 6 mos
  24. 24. Male Patient: LLLT x 12 mos
  25. 25. ReferencesNational Institutes of Health: National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS): Q&A AlopeciaAreataAl-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 thetreatment 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 pulsedlight 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 ofalopecia areata. Journal of Cosmetic and Laser Therapy 8(1):27-30.Pontinen, PJ; et.al. Comparative effects of exposure to different light sources (He-Ne laser, InGaAl Diode laser, non-coherentLED) on skin blood flow of the head, Int J Acupuncture & Electro-therapeutics Research 1996 21(105-118). 670nmWeiss R., McDaniel D.H., Geronemus R.G., Weiss M., LED Photomodulation induced hair growth stimulations, presented atASLMS Annual Meeting – Orlando FL (April 2005), www.interscience.wiley,.com DOI.1002/lsm.20164.
  26. 26. References (con’t)
  27. 27. Bauman Medical Group Boca Raton, Florida USATHANK YOU! doctorb@baumanmedical.com www.twitter.com/DrAlanBauman www.linkedin/in/alanjbauman

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