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If you follow my social media, you have surely seen a picture of me wearing a LED mask on my head and asked yourself: “Has she completely lost her mind now?”
Well, I am not going to answer that, but I will explain why I used a LED mask on my scalp and why LED is only half of what you need for what I aimed for: The effects of Low Level Laser Therapy (or LLLT) on hair loss, specifically androgenetic alopecia or male respectively female pattern hair loss.

 

 

So in todays blogpost, let’s talk about the data we have on LLLT to prevent hair loss, about the stats you need to look for, the best devices to get and whom it is best for.

What does LLLT mean?

LLLT or Low Level Laser Therapy (sometimes also Low Level Light Therapy) is the application of a low amount of energy (around 4 J/cm²) via laser or LED to skin with an irradiance of 5 mW/cm², in this case the scalp, with the goal to stimulate hair follicles to go back into the anagen phase to grow new hair.

Usually a wavelength of around 655 nm is used in the devices available, which appears red to the eye, but there have been some studies using up to 694 nm and some with 630 nm that showed results as well.

The effect on hair regrowth was discovered by accident during an experiment looking at the risk of cancer after laser application to mouse skin – the mice didn’t get cancer, but their shaved backs grew hair much quicker and thicker than the ones of their counterparts.

 

How does the hair regrowth via LLLT work?

While studies show that at least for some people the use of Low Level Laser Therapy or phototrichogenesis leads to a reduction in hair loss and an increase in hair diameter – we will look at the quality of these studies in a bit – the mechanism of action is still unclear.

The theory is that the blood flow to the scalp is increased, stimulating the metabolism in resting hair follicles and beaming them back into the anagen or growth phase. That is supposed to work via the photons acting on Cytochrome C oxidase, which again triggers ATP production. ATP is the main energy source for cells, so if there is an abundance, the follicle basically says: I am so energized, let’s grow hair for a little longer!

It also seems to prevent the excessive buildup of Dihydrotestosterone or DHT, which is the main driver in androgenetic alopecia or male and female pattern hair loss.
(More info: The main causes for hair loss in men and women explained)

 

 

Are there studies done on LLLT to prevent hair loss?

There are a lot of studies done on Low Level Laser Therapy and hair loss, some in mice, but others on actual humans with different stages of hair loss, and we have had them from as early as the 1990s.

The main population studied were men or women with androgenetic alopecia, but there was also one that showed that a LLLT device used on women undergoing chemotherapy for breast cancer resulted in a reduction in hair lost during the treatment. That study was quite small though.

In fact, most of the studies we have had done including humans had only a limited number of participants, and quite a few were done by the manufacturers of LLLT devices for at home use that had an interest in getting positive results. Another problem we are facing when comparing the studies is that different treatment protocols were used, ranging from twice a week to daily for varying amounts of time.

What the studies showed though was that no adverse events were reported and that hair count compared to baseline and hair shaft diameter or hair thickness did increase in the people treated with a real device compared to the ones treated with a sham device – but not in all studies that increase was statistically significant and even if it were, the individual persons often didn’t notice the change themselves.

 

Side effects of LLLT for hair loss

So, in terms of safety I can assure you, even with long term use – that is needed to see results! – you don’t have to worry about adverse effects when using Low Level Laser Therapy. You should of course always opt for a device that is cleared by your local regulatory bodies and that tells you the stats it is using as well as make sure that you follow manufacturer instructions, but if you do that, you should be safe.

If you start using the device and see an increase in shedding in the first weeks, don’t worry – that is the hair that was in the telogen phase and would have shed eventually going at once so the regrowth can start.

Higher amounts of energy used though, for example around 5 J/cm², could have a contrary effect as they could damage the hair follicle.

 

 

Why the combination of LED and lasers in most devices?

Now I said in the beginning that using my beloved LED mask on my scalp was only giving me half of what I was looking for, and the reason for that is that most devices do combine LED and laser, used at the same wavelength.

While both are basically light emitted from a source, a laser is much more targeted, a focused beam of light that, at energies much higher than are used here could cut through tissue and destroy it, while LED are more diffuse, so the reach a broader area. And that is why they are usually combined, the laser to directly target the hair follicle, the LED to target the surrounding tissue.

As we don’t even know the exact mechanism of work, the ideal amount of time or frequency we need to use devices yet, we obviously don’t know the best ratio between LED and lasers in a device either, all I can say is that the devices tested combined both, so this is what I would look for.

 

 

Is LLLT as effective as minoxidil or other medication?

If you have looked into androgenetic alopecia, you might already know that there is medical therapy in the form of Minoxidil applied topically or Finasteride taken orally. The important question now is: Is Low Level Laser Therapy as effective as minoxidil or other medication for hair loss? As far as we know right now, the answer is no.

Medication is still more effective than LLLT, but: Medication doesn’t work for everyone, either due to side effects or simply because it just doesn’t work. Some people aren’t comfortable taking medication and want to try something else and some people want to get the maximum benefits possible, so they want to add LLLT to their medication, and for all of those people, LLLT might be something worth trying.

It of course depends on the cause of your hair loss, as so far Low Level Laser Therapy has only been shown to be effective for male or female pattern hair loss and maybe for the prevention of hair loss during certain forms of chemotherapy, but not for autoimmune conditions or one of the other many reasons you could be losing your hair for.

 

How long will it take to see results and will I lose my hair again when I stop using it?

When you commit to using a Low Level Laser Therapy device, you need to know that it will take a long time until you start noticing any effects. Hair regrowth is always slow, so give it at least 24 weeks of consistent use before you judge its effects.

If you have been using it for a while and then stop, the effects it had on your hair will of course stop as well, but not in a way that makes you lose all your hair overnight. Your underlying condition causing hair loss will slowly creep in again, with more and more hair follicles going dormant and not growing new hair, until you are at the point you would be if you had never used the device. It isn’t permanent, just like the medication isn’t.

 

 

Best LLLT devices for hair loss

Looking at the market for devices for at home use, you’ll see two varieties: Caps or helmets that you wear on your head for a defined amount of time and then combs or hair bands that go through the hair for a defined amount of time. While instinctively I thought that helmets or caps would be better, as they treat more area at the same time, the studies we have don’t really favor one device over the other – we don’t have studies comparing them directly though, we are just comparing different studies and their results, so I guess we have to say we don’t know which form is better.

What we do know is that you should pick the one you are most likely to use consistently – I have tried The Duo from Laduora that I will review separately in another blogpost and found that I personally prefer things I just put on and work. I am lazy like that. Someone else had the iRestore helmet and found it uncomfortable to wear, so was much happier with a brush.

As a rule of thumb you can say the helmets and caps don’t require as much effort, you just need to sit around wearing them for a bit (most of them need to be plucked in), while the combs and brushes allow you to focus on those areas that need it most and usually don’t require you to stay put.

 

TL;DR

Low Level Laser Therapy will stimulate dormant hair follicles in people with male or female pattern hair loss to go back into the anagen phase to grow new hair. While we do have studies confirming that its regular application leads to an increase in hair growth compared to baseline as well as an increase in hair thickness in many people, the study quality isn’t the best, meaning it often looked at relatively small groups of people and/or was conducted by the manufacturer of a device.

There seem to be no adverse effects, a little increase in shedding at the beginning of the treatment is normal, and patience is required as you need at least 24 weeks to see the first results. Compared to medication it isn’t as effective, but it seems to be good to support medication or for those that for different reasons can’t or don’t want to take medication.

 

Sources:

Promising Therapies for Treating and/or Preventing Androgenic Alopecia. (n.d.). Retrieved May 24, 2023, from https://www.skintherapyletter.com/alopecia/promising-therapies/

Avram, M. R., & Rogers, N. E. (2009). The use of low-level light for hair growth: part I. Journal of Cosmetic and Laser Therapy : Official Publication of the European Society for Laser Dermatology, 11(2), 110–117. https://doi.org/10.1080/14764170902842531

Jimenez, J. J., Wikramanayake, T. C., Bergfeld, W., Hordinsky, M., Hickman, J. G., Hamblin, M. R., & Schachner, L. A. (2014). 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. https://doi.org/10.1007/s40257-013-0060-6

Kim, H., Choi, J. W., Kim, J. Y., Shin, J. W., Lee, S. J., & Huh, C. H. (2013). Low-level light therapy for androgenetic alopecia: a 24-week, randomized, double-blind, sham device-controlled multicenter trial. Dermatologic Surgery : Official Publication for American Society for Dermatologic Surgery [et Al.], 39(8), 1177–1183. https://doi.org/10.1111/DSU.12200

Lanzafame, R. J., Blanche, R. R., Bodian, A. B., Chiacchierini, R. P., Fernandez-Obregon, A., & Kazmirek, E. R. (2013). The growth of human scalp hair mediated by visible red light laser and LED sources in males. Lasers in Surgery and Medicine, 45(8), 487–495. https://doi.org/10.1002/LSM.22173

Leavitt, M., Charles, G., Heyman, E., & Michaels, D. (2009). HairMax LaserComb laser phototherapy device in the treatment of male androgenetic alopecia: A randomized, double-blind, sham device-controlled, multicentre trial. Clinical Drug Investigation, 29(5), 283–292. https://doi.org/10.2165/00044011-200929050-00001

MADDIN, W. S., AMARA, I., & SOLLECITO, W. A. (1992). Electrotrichogenesis: further evidence of efficacy and safety on extended use. International Journal of Dermatology, 31(12), 878–880. https://doi.org/10.1111/J.1365-4362.1992.TB03550.X

Maddin, W. S., Bell, P. W., & James, J. H. M. (1990). The Biological Effects of a Pulsed Electrostatic Field with Specific Reference to Hair Electrotrichogenesis. International Journal of Dermatology, 29(6), 446–450. https://doi.org/10.1111/j.1365-4362.1990.tb03837.x

Zarei, M., Wikramanayake, T. C., Falto-Aizpurua, L., Schachner, L. A., & Jimenez, J. J. (2016). Low level laser therapy and hair regrowth: an evidence-based review. Lasers in Medical Science, 31(2), 363–371. https://doi.org/10.1007/S10103-015-1818-2

 

 

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