The largest randomized sham-controlled study was with the FDA-cleared HairMax Lasercomb, published in the 

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 

 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 

, 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 

 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.

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.

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.

Articles

Study evidence for at-home hair treatment devices is mixed. Some show promise while others don’t, suggesting more research is needed.

Research and Evidence in Home Hair Therapies

Pandemic lockdowns and concerns might prompt many hair loss patients to look for combs, caps, and other laser and light devices they can use in the safety of their homes.

Some have been shown in studies to safely grow hair. However, data is limited to a few device types, treatment recommendations vary greatly, and so can device cost, according to Ronda S. Farah, MD, who presented “Updates on the Use of Lasers Trending for Hair Loss” at the American Society for Dermatologic Surgery (ASDS) 2020 Virtual Annual Meeting, in early October.

Dr. Farah, assistant professor of dermatology at the University of Minnesota, talked about the evidence for using photobiomodulation devices to treat androgenetic alopecia and other types of hair loss and offered clinical pearls for making device recommendations.

According to Dr. Farah and coauthors in a paper published in 2018 in the 

, “The market for home-use photobiomodulation devices to treat androgenetic alopecia has rapidly expanded, and the Food and Drug Administration (FDA) has recently cleared many devices for this purpose. Patients increasingly seek the advice of dermatologists regarding the safety and efficacy of these hair loss treatments.”

The pandemic likely fueled already high consumer demand, making this is an especially important time to become familiar with consumer options for at-home hair growth devices.

“I think these home-based devices might really see a growth in the market,” says Dr. Farah.

Today’s photobiomodulation devices include lasers and light-emitting diodes (LEDs), also known as low-level laser therapy and low-level light.

Photobiomodulation therapy devices used for hair loss contain anywhere from seven diode lasers or LED to more than 272, with wavelengths typically between 650 nm and 655 nm.

“Nobody really understands how photobiomodulation therapy works. However, the hypothesis is that it stimulates telogen follicles into anagen through alteration of oxidative metabolism in the mitochondria, thereby increasing [adenosine triphosphate] ATP and implicating transcription factors,” Dr. Farah says.

At-home devices include helmets, bands, and combs, priced from a few hundred dollars to several thousand dollars.

NEXT: Research and Evidence in Home Hair Therapies

The pandemic has fueled high demand for at-home hair growth devices, making it especially important to become familiar with consumer options. 

At-Home Devices for Hair Loss

The dermatology, plastic surgery, facial plastic surgery, and oculoplastic surgery cosmetic multi-specialties have developed techniques and tools that can be used to keep the aging process at bay. Those tools can be used to improve patient results and experience over the course of time, according to Suneel Chilukuri, MD, Refresh Dermatology, Houston, Tex., who spoke to 

 about his presentation, “Through the Years—What do Patients Look Like After 2 to 15 Years of Aesthetic Treatments?,” at the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) virtual meeting 2020.

“Everybody that's in this room understands how the face ages,” he says. “And we also understand [that] when filler and other tools are used incorrectly, people get a very unnatural result.”

Ultimately, natural-looking results come from a strategic anatomical approach.

“We want to respect the anatomy,” Dr. Chilukuri says. “We want to make sure that we're using the products that are going to best give [the patient] either anterior projection or structural support.”

Dr. Chilukuri shares his thoughts here on the nonsurgical tools and approaches that help to maintain and improve facial rejuvenation results.

Videos

Dr. Suneel Chilukuri discusses taking nonsurgical tools and approaches that help to maintain and improve facial rejuvenation results.

Keeping the Aging Process at Bay

 explains the TikTok influence on “basic” skincare brands, 

 highlights the benefits of LED face masks, the 

 talks simplifying skincare routines, and 

 details Korea’s most popular injectables for “glass skin” and a new search tool to close the gap in racial disparity between patient and dermatologist.

Is TikTok Killing ‘Millennial’ Beauty?

This New Dermatologist Search Tool Pairs People of Color With "Culturally Competent" Doctors

I Tried Three of Korea’s Most Popular Injectables for Glass Skin

These Six LED Face Masks Will Transform Your Skin

This week, consumer magazines highlight the skin elimination diet, a new search tool to find culturally competent derms, and more. 

Skin Elimination Diet

This week in aesthetics, Dr. Stephen Perkins explains dry eye syndrome post-blepharoplasty, Dr. Gregory Chernoff provides an update on exosomes, Cheryl Whitman talks patient loyalty programs, Dr. Mark Hamilton highlights nonsurgical skin tightening techniques, Dr. Michael Kluska reviews InMode’s Bodytite, and Dr. Michael Somenek discusses how to deliver the ultimate jawline.

Dr. Stephen Perkins explains the incidence and treatment of dry eye syndrome and chemosis in patients post-blepharoplasty.

According to Dr. Gregory Chernoff, exosomes have a powerful role to play in aesthetic medicine, including fibroblast stimulation, wound angiogenesis, collagen extracellular matrix production, inflammation/immune response, hair follicle growth, and dermal papilla cell regeneration.

Business Tip of the Week: Patient Loyalty is Golden

This week, Cheryl Whitman highlights the benefits of patient loyalty programs as a less expensive option to retain existing patients and create advocates for the practice.

Demand for facelift-like skin tightening results with nonsurgical treatments continues to grow… Are we there yet?

In this monthly technology review, Dr. Michael Kluska examines Bodytite by InMode, including device overview, cost, ROI, patient perceptions, and candidate considerations.

Dr. Michael Somenek discusses different treatment areas for achieving the ultimate jawline.

This week in aesthetics, we highlight exosomes, the surgical vs. nonsurgical skin tightening debate, and more.

This Week in Aesthetics: November 16-20

At the 2020 American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) virtual meeting, Stephen Perkins, MD, facial plastic surgeon, Meridian Plastic Surgery Center, Indianapolis, Ind., discussed the incidence of and treatment options for exacerbated dry eye syndrome post-blepharoplasty.

In his presentation, “Dry Eye Syndrome After Blepharoplasty with Treatment Alternatives for Severe Chemosis,” Dr. Perkins explains that in an interview and research study conducted by Jess Prischmann, MD, and himself, about 26% of his patients complained of varying degrees of dry eye symptoms prior to blepharoplasty procedure, and up to 36% of patients experienced symptoms post-procedure.

Study parameters included procedures of upper and lower blepharoplasty or only lower blepharoplasty using a transcutaneous approach skin muscle flap with a suture suspension.

Dr. Perkins explains that dry eye symptoms can last four to six weeks, and sometimes eight weeks. In some cases, patients have to use eyedrops for their symptoms indefinitely.

As treatment for dry eye syndrome, he suggests gel at night and eyedrops during the day. In severe chemosis cases, he uses steroid eye drops, tapes the eyelid up to help minimize the issue and, when necessary, performs a surgical conjunctivectomy to speed up resolution of the problem. In chemosis cases, it can take up to three months to heal.

Dr. Stephen Perkins explains the incidence and treatment of dry eye syndrome and chemosis in patients post-blepharoplasty. 