Female hair loss: Low-level laser therapy effective for female pattern hair loss

Key Points

Stony Brook, N.Y. - Low-level laser therapy can be employed as a treatment for female pattern hair loss, according to a recently conducted proof-of-concept study.

"It is effective, and patients are happy with the results," says Theodore J. Daly, M.D., F.A.A.D., F.A.S.D., F.S.P.D., director, Garden City Dermatology, and assistant professor of medicine, pediatrics and pathology, State University of New York (SUNY), Stony Brook, N.Y.

"They are enthusiastic about having another option for treatment," he says.

"There is no standard treatment for female pattern hair loss other than 2 percent minoxidil," Dr. Daly says.

Existing therapies for female pattern hair loss include topical 2 percent and 5 percent minoxidil solution, anti-androgens, birth control pills, aldactone, hair transplants and vitamin supplements. There are some undesirable side effects with existing treatments. Laser treatment is suggested as an alternative therapeutic option when patients are unable to take medications, or it can be a complement to therapy.

Low-level laser therapy has other clinical applications owing to its anti-inflammatory and antibacterial properties, such as in woundcare. In the area of hair growth, there are few peer-reviewed, blinded studies looking at the impact of low-level laser therapy to grow hair. To date, most have been anecdotal.

Laser therapy as a management option for hair loss first took hold in an animal study in which hair regrew faster on shaven backs of irradiated mice compared to mice that were not irradiated. Other terms to describe the intervention include cold laser therapy, photobiomodulation and laser biostimulation, all of which refer to the effect that the intervention is having at a cellular level.

Clinical results

"Other research has shown that the mitochondria are upregulated with low-level laser therapy," Dr. Daly says. "The mitochondria are the energy-producing component of the cell."

The study involved 10 women, aged 28 to 78, with a mean age of 50.5 years, who were treated with a visible, red-light, continuous-wave, rotating diode laser, the Revage 670 (Aspira Science), twice weekly for six weeks, followed by weekly administration for 16 weeks. The patients had mean hair loss duration of six years, with the range being 0.5 to 15 years.

The laser used in the study, which has a total output of about 120 mW, meets international laser standards for safety and is approved by the Food and Drug Administration. The advantage of the laser is that it is rotational, as opposed to stationary, allowing the scalp to be irradiated in a more consistent fashion. Most lasers in that power range are not rotational, Dr. Daly says.

"With this particular modality, there is no risk of burning the skin," Dr. Daly says.

The study was designed to assess if the technology demonstrated initial efficacy to see if it was worthy of being evaluated further, Dr. Daly tells Dermatology Times.

"The study was intentionally biased," he says, noting the final evaluation of the study was based on the least effective results post-treatment.

Both patients and investigators selected a rating to denote their measurement of the impact of the laser therapy, with investigators basing their rating on the effect of other hair loss treatments, including pharmaceutical therapies. Ratings ranged between one and seven, with one being much worse and seven being much improved.

A final assessment combining the patients' global assessments and the investigators' global assessments showed, from baseline, much improvement in one patient, some improvement in five patients, and slight improvement in two patients. No patients were worse, and the remaining two were unchanged from baseline.

Investigators observed no correlation between patient age or duration of hair loss and the outcome with the therapy.

Study shortcomings

Because of the small sample size, investigators were unable to arrive at any conclusions about which patients with female pattern hair loss are more likely to respond to low-level laser therapy.

"We don't know at this point whether it is more effective in combination with other treatments or as a stand-alone therapy," Dr. Daly says.

Future studies may use devices such as trichometers to objectively measure hair growth, so changes in hair mass, diameter and density can be precisely quantified, Dr. Daly says. Future studies would also use a control group and compare outcomes, using a trichometer, between subjects who received laser therapy and those who did not.

Disclosure: Dr. Daly is a speaker for Abbott Laboratories, Promius Pharma LLC, Warner Chilcott Pharmaceuticals and GlaxoSmithKline.