Montgomery DermatologyBy Ilene Raymond Rush, For The Inquirer | September 14, 2015 | Read Full Article Here

To women struggling with hair loss, a recent announcement from the U.S. Food and Drug Administration may have sounded like good news indeed: official sanction for another new laser device that promises to stimulate hair growth.

Such gadgets are marketed to women, who are rarely candidates for hair transplantation because female hair loss tends to occur all over the head, unlike male-pattern baldness.

Alas, the FDA only said the LCPRO from LaserCap Co. of Cleveland, Ohio, is safe, staying silent on the effectiveness question. Which doesn’t mean it doesn’t work, but it’s no slam dunk, say dermatologists.

The LCPRO is the latest in a series of devices, including laser combs and caps, that offer low-level light therapy via laser diodes.

About 80 million people in the United States have hereditary hair loss. According to the American Hair Loss Association, about 40 percent are women. Though there are many causes for hair shedding in women, top reasons include hereditary factors, hormonal changes, thyroid issues, low iron levels, and stress.

The American Academy of Dermatology does not take a position on at-home laser treatments for hair loss.

“It’s a little tricky,” says Erum N. Ilyas, chief of dermatology at Main Line Health. “We don’t like to recommend spending hundreds to thousands of dollars to buy devices that may not work.”

Still, she’s seen patients give it a try.

“People in my practice have used lasers for hair regrowth,” Ilyas said. “They don’t necessarily see an identifiable difference, but they don’t see any worsening. It’s not going to harm you.

“But while studies say that these devices may have potential, they don’t yet show proof. The studies have been too small and they don’t run beyond six months, so we don’t know what will happen long term.”

The LCPRO, shaped like a flexible dome, can be worn under a hat for 30 minutes at a time. The cap covers the entire scalp so that pulsating low-level laser energy is provided to all the hair follicles.

The manufacturer recommends using it for 30 minutes every other day; depending on the type, laser combs can be used from eight to 25 minutes at a time.

“I often add home-based laser devices adjunctively,” said Shani Francis, director of the Hair Disorders Center at NorthShore University HealthSystem near Chicago. “I recommend them primarily to people who don’t want to use minoxidil,” the medication that slows hair loss and promotes regrowth in some people.

Most often, she recommends the HairMax LaserComb, whose design maximizes the chance the low-level light therapy will reach the scalp.

“The light has to be absorbed by the scalp to make it work,” she said.

Various styles of the comb, which can be purchased over the counter, range from $300 to $800.

“They don’t work for everybody,” Francis said. “But when used in combination with other therapies, there are a small group of people who do respond to them. The key is it has to be used consistently.”

Paul Glat, a dermatologist in Bala Cynwyd, agrees with the multifaceted approach.

“Women have more problems with diffuse rather than hereditary patterns of hair loss,” he said. “They tend to require more types of topical treatments, like lasers.”

Glat has had about 10 patients who have used the LCPRO laser cap, which must be bought in a physicians’ office and retails for about $3,000.

“For those people using the cap, it’s been very good,” Glat said. The cap, he notes, is often combined with other treatments, including injections of platelet-rich plasma, which is thought to encourage growth factors to regrow hair; and minoxidil.

“I see it as a good adjunct,” Glat said of the laser cap. “Not a cure-all, but it can help people who may be losing hair all over.”

Other dermatologists are less enthused.

“In general, I do not recommend home-based laser devices, caps, or combs,” said Susan Taylor of Society Hill Dermatology in Philadelphia. “I don’t think that the results are dramatic and they are very time-consuming and expensive. Often, patients give up before they achieve results.”

She noted that in one study, the test subjects had to use a laser comb for 25 minutes every other day for 16 weeks.

“Try holding your arm up for 25 minutes and continuing therapy for 16 weeks.”

Prerna Khemka, director of LaserCap, disagrees, pointing out that the new cap is easier to use and will be used more consistently. She attributes some dermatologists’ hesitation over the technology to how gradual the process is.

“Regrowing hair is not like skin problems, which can often be fixed in one session,” she said. “The nature of the hair follicle is that it takes four to five months before it reappears.”

How lasers – which also can be used for hair removal – can help regrow hair is not completely understood, Ilyas said.

“At any time, 80 to 90 percent of your hair is growing and 10 percent is resting,” she said. Part of the reason people lose or shed hair is due to imbalances in that cycle.

“It’s thought maybe that the heat of the low-level light may be just intense enough to heat the follicle up and spur growth,” she said. “It’s also possible that it may release a hair-growth factor, although there need to be more studies to show that.”

Before deciding on any hair-loss treatment, Ilyas recommends an early and thorough evaluation by a dermatologist to diagnose the cause of the problem.

“Treatments are far more effective in the earlier stages of most forms of hair loss and vary based on the type of hair loss,” she said.

Beyond lasers, there are a number of tried and true treatments that have been proven to work. Among them is minoxidil, which sends hair back into the growth phase, thickens individual hairs, and keeps hair in the growth phase. Injecting steroids into the scalp can help with alopecia areata, a condition that causes small, round bald spots.

In some cases, where stress has produced shedding, simply identifying and lowering the source of the stress can cause hair to naturally return within six months. The same with hair loss due to pregnancy: Lost tresses may return after a relatively short period without additional treatments.

“The metabolism of the body dictates hair loss,” Ilyas said. “If there is an identifiable problem, we routinely see people grow their hair back.”

“It’s also worth remembering that it takes at least four to six months to see hair grow back,” said Francis.

In the end, Ilyas remains cautiously optimistic about the future of lasers for hair regrowth.

“There may be something behind the science of lasers,” she said. “But it needs work so the technology can be funneled in the right direction. Right now, there is no good science to know how and if these devices work.”

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