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Treating Hair Loss w/ Low Level Laser Therapy EMAA-2012 Paris
This document discusses the role of low level laser therapy (LLLT) in the medical management of androgenetic alopecia. It provides an overview of androgenetic alopecia and the mechanisms by which LLLT may stimulate hair follicles. It then describes the author's LLLT dosing protocol and experience treating patients, showing before and after photos demonstrating hair growth with LLLT. The document concludes by referencing supporting literature on LLLT for hair loss.
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Treating Hair Loss w/ Low Level Laser Therapy EMAA-2012 Paris
- 1. The Role ofLow Level Laser Therapy in the Medical Management of Androgenetic Alopecia Alan J. Bauman, M.D. Diplomate, American and Int’l Board of Hair Restoration Surgery European Masters in Aesthetic & Anti-Aging Medicine 2nd International Hair Surgery Masters Course October 13th, 2012 Paris, France
- 2. Disclosures The following conflictsof interest are germane to my presentation: NONE LaserSpa at Bauman Medical Group
- 3. Alan J. Bauman,M.D. Bauman Medical Group – Boca Raton, FL (1997) New York Medical College Beth Israel Medical Center – NY Mt. Sinai Medical Center – NY Hair Transplantation – NY American Bd of Hair Restoration Surgery American Hair Loss Association Low Level Laser Therapy (1999)
- 4. Overview AndrogeneticAlopecia Mechanisms of Laser Therapy (LLLT) Role of LLLT in Hair Restoration Laser Therapy Dosing Protocol Our Experience w/ Laser Therapy Practical Concerns
- 5. Androgenetic Alopecia Hereditary :♀♂ HAIR LOSS CAUSES Androgen Receptors 4% Progressive AGA Patterned hair follicle miniaturization Other Shorter/Finer/Thinner/Less Pigmented 96%
- 6. Androgenetic Alopecia Multi-Therapy Medical Management Eliminate/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, PRP Redistribute (Transplant) Permanent Follicles • NeoGraft / FUE – no linear scar Surgically Reduce/Remove Bald Areas • Scalp Reduction/Flaps *off-label
- 7. Low Level LaserTherapy < 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. Phototherapy/LLLT Concepts Mechanism: Cytochrome–C–Oxidase ↑ATP production Non-ionizing Non-thermal No side-effects Tuner J/Hode L, Laser Therapy, (2004) Prima Books
- 9. growth factor production extracellular matrix deposition near infrared light cell proliferation & motility anti-apoptosis and pro-survival Gene signaling transcription - Michael Hamblin, Ph.D. – Harvard/MIT
- 10. Photomodulation & HumanDermal 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. 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 alopecia who 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 hair density than… placebo.” #K091496, Nov. 13th 2009 650nm female AGA MEP90 82 x 5mW in-office Midwest RF prescription
- 12. FDA 510(k) Clearances (con’t) FDA 510(k): #K091496, Nov 13, 2009 Device: MEP90 Hair Growth Stimulation System Manufacturer: 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. LLLT Dosing Strategy Wavelength Biphasic Dose Response 635-670nm Total Power # diodes x output (mW) Treatment Area Duration (min) Tuner J, Hode L, Laser Therapy Handbook (2004) Prima Books. Interval – too short v. too long Protocol: Device Dependent
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- 15. Cosmetic Devices 650 nm 5mW X 224 Diodes 80% Duty Cycle 30 Minutes Hands-Free Rechargeable/Cordless Significant coverage High compliance LaserCap™
- 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. Densitometry – CanfieldScientific
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- 19. Laser Therapy inFemales 25 y/o female In-office Laser Hood 2 / week x 6 months
- 20. LLLT x 8months 63 y/o female Laser Therapy regimen: 3x/wk x 3 mo 1-2x/wk since Photos after 12mo.
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- 22. 24 y/o Female:3 mos. of LLLT
- 23. Male Patient :LLLT x 6 mos
- 24. Male Patient: LLLTx 12 mos
- 25. References National Institutes ofHealth: 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. Pontinen, PJ; et.al. Comparative effects of exposure to different light sources (He-Ne laser, InGaAl Diode laser, non-coherent LED) on skin blood flow of the head, Int J Acupuncture & Electro-therapeutics Research 1996 21(105-118). 670nm Weiss R., McDaniel D.H., Geronemus R.G., Weiss M., LED Photomodulation induced hair growth stimulations, presented at ASLMS Annual Meeting – Orlando FL (April 2005), www.interscience.wiley,.com DOI.1002/lsm.20164.
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- 27. Bauman Medical Group Boca Raton, Florida USA THANK YOU! doctorb@baumanmedical.com www.twitter.com/DrAlanBauman www.linkedin/in/alanjbauman