Research and Evidence in Home Hair Therapies

This is part 2 in a 2-part series.

Part 1: At-Home Devices for Hair Loss

The largest randomized sham-controlled study was with the FDA-cleared HairMax Lasercomb, published in the American Journal of Clinical Dermatology.¹

Researchers studied 128 males and 141 females and reported a significant difference in the increase in terminal hair density between lasercomb- and sham-treated subjects, with no serious adverse events. They concluded that the results suggest that low-level laser treatment might be an effective option for treating pattern hair loss in men and women, but more research is needed to determine the long-term effects of the treatment on hair growth and maintenance, and to optimize laser use.

A review of 11 studies looking at low‐level laser therapy as a treatment for androgenetic alopecia, published in 2017 in Lasers in Surgery and Medicine² found overall improved hair regrowth, thickness and patient satisfaction following therapy. In a systematic review looking at the efficacy of nonsurgical treatments for androgenetic alopecia in men and women published in April 2020 in the Journal of Dermatological Treatment,³ the authors concluded that that low-level laser therapy may be more efficacious than traditional treatment options like 5% minoxidil, but that needs validation in randomized controlled trials.

Researchers Lanzafame RJ et al. reported in 2013⁴ and 2014⁵ in Lasers in Surgery and Medicine that men and women with androgenetic alopecia experienced hair growth post low level laser light therapy.

“This demonstrates a 37% increase in hair growth in the active treatment group as compared to the placebo group,” the authors reported in the 2014 study. “[Low level laser light therapy] of the scalp at 655 nm significantly improved hair counts in women with androgenetic alopecia at a rate similar to that observed in males using the same parameters.”

Not all studies are positive or suggest the therapy is promising for hair loss. There are small studies in the literature evaluating photobiomodulation that show no improvement, according to Dr. Farah.

Recommendations for use vary with the device, from seconds each session a few times a week to 36 minutes every other day.

“I ask my patients to use the devices as they are labeled, but nobody really knows what is too much and what is too little,” Dr. Farah says.

In general, the devices appear to be safe. Among the side effects from their use: dry skin, itch, scalp tenderness, irritation, a warm sensation, hives, redness, and acne.

Patients should avoid using the devices around their eyes.

There is a report of initial shedding in some patients. And Dr. Farah has presented new evidence linking use of the devices to headaches.

“Think twice before recommending this to someone who gets a lot of headaches,” she says.

Dr. Farah is conducting a pilot comparison study of FDA-cleared home use devices for the management of androgenetic alopecia. These are preliminary findings over the course of the study, which followed patients from baseline, through treatment to 49 weeks: According to physician photography assessment, 36% of patient hair growth improved, 36% did not change, and 27% worsened. In the patient self-assessment for hair growth, more than 54% reported worsening, more than 27% improvement, and more than 18% reported no change from baseline.

About 25 patients are now enrolled, representing all skin tones and including scarring alopecia, according to Dr. Farah.

Clinical Pearls

Among the considerations for purchasing an at-home hair loss treatment device are affordability and ease of use. Combs generally cost less than caps or helmets, according to Dr. Farah. And some devices are hands free, which might be better choices for people who want to do other tasks during treatment.

Consider devices with teeth or pegs for curly hair so that the comb portion is parting the hair and maybe helping the light get through, she says.

Patients should use only FDA-approved devices and consider the warranty when making the purchase. Some devices come with phone apps that allow patients to set reminders and more, she says.

In general, more data is needed to understand how these devices might play a role in scarring alopecia. Optimal treatment regimens and the best way to treat hair loss remains to be answered in studies.

“Nobody knows if LEDs, laser light, or a combination are better. We need to figure that out,” she says.

Disclosure

University of Minnesota received donated devices for the pilot research study from Capillus, Theradome, HairMax, Laser Cap, Canfield Photography, and an institution grant from Revian Red.

References

1. Jimenez JJ, Wikramanayake TC, Bergfeld W, et al. Efficacy and safety of a low-level laser device in the treatment of male and female pattern hair loss: a multicenter, randomized, sham device-controlled, double-blind study. Am J Clin Dermatol. 2014;15(2):115-127.
2. Afifi L, Maranda EL, Zarei M, et al. Low-level laser therapy as a treatment for androgenetic alopecia. Lasers Surg Med. 2017;49(1):27-39.
3. Gupta AK, Bamimore MA, Foley KA. Efficacy of non-surgical treatments for androgenetic alopecia in men and women: a systematic review with network meta-analyses, and an assessment of evidence quality. Journal of Dermatological Treatment. Published online April 13, 2020:1-11.
4. Lanzafame RJ, Blanche RR, Bodian AB, Chiacchierini RP, Fernandez-Obregon A, Kazmirek ER. The growth of human scalp hair mediated by visible red light laser and LED sources in males. Lasers Surg Med. 2013;45(8):487-495.
5. Lanzafame RJ, Blanche RR, Chiacchierini RP, Kazmirek ER, Sklar JA. The growth of human scalp hair in females using visible red light laser and LED sources. Lasers Surg Med. 2014;46(8):601-607.