INTERNATIONAL JOURNAL OF COSMETIC SURGERY and AESTHETIC DERMATOLOGY Volume 5, Number 2, 2003 © Mary Ann Liebert, Inc.

Hair Regrowth and Increased Hair Tensile Strength

Using the HairMax LaserComb for

Low-Level Laser Therapy

JOHN L. SATINO and MICHAEL MARKOU, D.O.

ABSTRACT The authors wished to confirm the efficacy of low level laser therapy (LLLT) using a Hair­ Max LaserComb for the stimulation of hair growth and also to determine what effect LLLT with this device had on the tensile strength of hair. Thirty-five patients, 28 males and 7 fe­ males, with androgenetic alopecia (AGA) underwent treatment for a six-month period. Both the hair counts and tensile strength of the hair were affected very beneficially in both sexes in the temporal and vertex regions, with the males and vertex areas showing the most im­ provement.

INTRODUCTION

A LTHOUGH LOW-LEVEL LASER THERAPY

(LLLT), ~ the therapeutic application of low-energy lasers to medicine, has been used for photo­ biostimulation for more than thirty years now, in the past it has primarily been used to accel­ erate the healing of bums or wounds, or alter­ natively, to ease or relieve pain. Furthermore, LLLT has gained credibility and common us­ age in some parts of the world, such as Japan, the Scandinavian countries, and Australia, while in other parts of the world, such as North America, a lack of recognition of its efficacy has remained. Even though there are more than 2,500 pa­ pers related to LLLT in the scientific litera­ ture,o) only one printed reference, Professor Pekka Pontinen's text, was found which actu­ ally discussed the use of LLLT "to stimulate hair growth."(2) Even in this source, the infor­ mation was limited to one paragraph, which refers to one paper given in Sorrento in 1982 which reported increased hair growth after LLLT in animalsP) and a foreign language

publication in 1983 which reported favorable results with LLLT in the treatment of Alopecia areata.(4) The authors heard about Dr. Martin Unger's paper in Puerto Vallarta, Mexico, dis­ cussing the use of LLLT for hair biostimula­ tion, (5) and around this same time period, the fall of 2001, became interested in the HairMax LaserComb (Lexington International, Boca Ra­ ton, FL), secondary to several anecdotal reports that they had heard about this device. It was at this time that the authors decided to carry out their own study to determine whether the Hair­ Max LaserComb was effective with regard to stimulating hair growth. The authors also wished to determine what affect LLLT had on the tensile strength of hair and undertook to determine this during the same study. MATERIALS AND METHODS The HairMax LaserComb (Figs. I, 2) was se­ lected as the LLLT device for many important reasons. As noted above, the authors had heard several favorable anecdotal reports about its ef­

113

115

HAIR REGROWTH AND INCREASED HAIR TENSILE STRENGTH

hair for the hair counts. Accordingly, they created a clear acrylic mold of each patient's head, with the front of the mold positioned at the hairline, and a one-centimeter square removed from the mold in the area of greatest alopecia in either the temporal or vertex region (Fig. 3). For the hair count, the hairs within the one square centimeter space were pulled through the opening, and then counted using a surgical skin

TABLE 1.

hook and a lens with five times magnification. Hair counts were carried out by both authors to confirm the accuracy of the data. To test the tensile strength of the hair before treatment and after six months of treatment, three typical terminal hairs were removed from the one square centimeter area and a VIP HairOScope (Belson Imports, Hialeah, FL) used to determine the tensile strength (Fig. 4).

HAIRMAx LASERCOMB HAIR COUNT DATA

Hair Count Number 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32

Patient

RC CP DL SH WG JC TM JH LM JT AT Average (T) DB RK PP EL JI BG SA DB EW JS MB PL JL CR PH RH JB Average (V) Average (V + T) JL FP

EL LW Average (T) NC 33 34 PJ 35 RM Average (V) Average (T + V) Average (T, M + F) Average (V, M + F) Average (T + V, M + F)

Age

Sex

Area

47

M M M M M M M M M M M

T T T T T T T T T T T

M M M M M M M M M M M M M M M M M

V V V V V V V V V V V V V V V V V

F F F F

T T T T

F F F

V V V

34

28 56 35 29 34

51 63 29 36 40.2 55 37 29 34

51 48 59 29 38 56 35 46 72 42 60 42 30 44.9 43.1 56 66 71 46 59.8 64 76 49 63.0 59.8 45.4 47.6 46.7

M, malei F, femalei T, temporali V, vertex.

Baseline 23 33 22 6 16 38 12 18 16 15 28 20.6 8 36 22 19 18 14 12 18 22 18 22 12 12 12 12 24 4 16.8 18.2 32 19 22 8 20.3 19 18 19 18.7 20.3 20.5 17.1 18.5

6 months after 45 51 31 11 28 56 46 27 16 23 37 33.7 22 41 61 36 27 64 23 26 28 31 39 23 33 23 27 38 17 32.9 33.2 51 27 29 15 30.5 29 36 27 30.7 30.5 32.9 32.6 32.7

Difference

Change(%)

22 18 9 5 12 18

95.7 54.5 40.9 83.3 75.0 47.4 283.3 50.0 0.0 53.3 32.1 74.1 175.0 13.9 177.3 89.5 50.0 357.1 91.7 44.4 27.3 72.2 77.3 91.7 175.0 91.7 125.0 58.3 325.0 120.1 102.7 59.4 42.1 31.8 87.5 55.2 52.6 100.0 42.1 64.9 55.2 69.1 111.9 93.5

34

9 0 8 9 13.1 14 5 39 17 9 50 11 8 6 13 17 11 21 11 15 14 13 16.1 15.0 19 8 7 7 10.3 10 18 8 12.0 10.3 12.3 15.5 14.1

116

SATINO AND MARKOV RESULTS

The scientific data for the hair counts is demonstrated in Table I, and the data for the tensHe strength of the hair recorded in Table 2. One-third of the patients did report some temporary slightly increased hair shedding during the first one or two months of treatment, but after two months, this no longer occurred. In summary, Table 1 shows that the hair TABLE 2.

counts increased in the temporal area an aver­ age of 55.2% in women, 74.1% in men, and 69.1% for all patients. In the vertex area, the corresponding percentages were 64.9% for women, 120.1% for men, and 111.9% for all pa­ tients. There was a hair count increase of 93.5% when all temporal and vertex patients were combined. In general, males and the vertex area did the best, but both sexes and all areas did demonstrate significant improvement.

HAIRMAX LASERCOMB HAIR TENSILE STRENGTH DATA

Hair tensile Age

Sex

Area

Baseline

6 months after

Difference

Change(%)

47 34 28 56 35 29 34 51 63 29 36 40.2 12 55 37 13 14 29 15 34 16 51 17 48 18 59 19 29 20 38 21 56 22 MB 35 23 PL 46 24 72 JL 25 CR 42 26 PH 60 27 RH 42 28 30 JB Average (V) 44.9 Average (V + T) 43.1 29 56 JL 30 FP 66 31 EL 71 32 46 LW Average (T) 59.8 64 33 NC 34 76 PJ 35 RM 49 Average (V) 63.0 Average (T + V) 59.8 Average (T, M + F) 45.4 Average (V, M + F) 47.6 Average (T + V, M + F) 46.7

M M M M M M M M M M M

T T T T T T T T T T T

M M M M M M M M M M M M M M M M M

V V V V V V V V V V V V V V V V V

5.9 6.1 4.2 3.5 3.6 4.1 5.2 6.3 2.9 4.9 5.7 4.8 3.7 5.8 5.8 5.4 3.1 4.7 5.0

F F F F

T T T T

F F F

V V V

4.5 3.8 3.7 2.1 2.3 2.4 1.2 5.5 2.4 4.2 4.6 3.3 1.6 4.0 2.9 4.1 1.9 3.5 2.3 too short 2.9 1.1 0.8 1.7 2.9 2.8 2.4 1.3 3.8 2.5 2.8 2.0 3.2 2.2 2.7 2.5 1.7 2.1 2.1 2.0 2.5 3.1 2.4 2.7

1.4 2.3 0.5 1.4 1.3 1.7 4.0 0.8 0.5 0.7 1.1 1.4 2.1 1.8 2.9 1.3 1.2 1.2 2.7 N/A 0.2 2.0 1.5 2.3 1.7 1.5 1.9 2.2 1.3 1.7 1.6 2.6 0.6 1.8 2.7 1.9 1.2 1.3 1.7 1.4 1.9 1.6 1.7 1.6

31.1 60.5 13.5 66.7 56.5 70.8 333.3 14.5 20.8 16.7 23.9 64.4 131.3 45.0 100.0 31.7 63.2 34.3 117.4 N/A 6.9 181.8 187.5 135.3 58.6 53.6 79.2 169.2 34.2 89.3 79.5 130.0 18.8 81.8 100.0 82.6 70.6 61.9 81.0 71.1 82.6 69.3 86.4 78.9

Number 1 2 3 4 5 6 7 8 9 10 11

Patient RC CP DL SH WG JC TM JH LM JT AT Average (T) DB RK PP EL JI BG SA DB EW JS

M, male; F, female; T, temporal; V, vertex.

3.1 3.1 2.3 4.0 4.6 4.3 4.3 3.5 5.1 4.2 4.4 4.6 3.8 4.0 5.4 4.5 2.9 3.4 3.8 3.4 4.5 4.7 4.1 4.4

117

HAIR REGROWTH AND INCREASED HAIR TENSILE STRENGTH

Similarly, in Table 2, the hair tensile strength increased in the temporal area 82.6% in women, 64.4% in men, and 69.3% in both sexes. In the vertex area, the percentages were 71.1% for women, 89.3% for men, and 86.4% for both sexes. The hair tensile strength was increased 78.9% when all temporal and vertex patients were considered. There was greater improve­ ment in the vertex area in males, but more im­ provement in the temporal area in females. Both sexes and all areas did benefit significantly.

DISCUSSION

In general, the results far exceeded the ex­ pectations of the authors, and they were pleased to be able to document the benefits that LLLT with the HairMax LaserComb can achieve for both men and women in both the temporal and vertex regions. Although there were four times as many men as women pa­ tients in the study, each sex did demonstrate significant benefits from the LLLT. The mechanism or mechanisms of action of LLLT are unknown with regard to the stimu­ lation of hair growth or how the hair tensile strength is increased so greatly. From wound healing studies, it is known that LLLT causes an increase in the microcirculation of tissue and a reduction in inflammation.(2) The amount of cellular energy in the form of adenosine triphosphatase (ATP) is also increased follow­ ing LLLTP) Perhaps one or more of these ben­ eficial effects are responsible for the results that we were able to achieve. The authors hypoth­ esized that the early temporary hair shedding experienced by some patients was most likely related to an accelerated hair cycle in generaL Obviously, more research is required if we are

to fully understand the scientific findings noted in this paper.

CONCLUSION

LLLT with the HairMax LaserComb is an ef­ fective treatment for stimulating hair growth and increasing the tensile strength of hair in both sexes in both the temporal and vertex re­ gions. In the authors' opinion, LLLT should be given serious consideration as an option in the treatment of AGA in view of its safety, ease of patient home administration, and the benefits documented in this study.

REFERENCES 1. LaserWorid LLLT Internet Guide (http://www.laser.nul). 2. Pontinen, P.: Low Level Laser Therapy as a Medical Treatment Modality. Art Urpo, Ltd., Publishers, 1992, pp 99-10l. 3. Trelles, M., and Mayayo, E.: The Growth of Hair un­ der Influence of the He-Ne Laser Beam: Histological Study. Sorrento. World Congress of Laser-Therapy, 1982. 4. Trelles, M., Mayayo, E., Schmidt, c., Igllesias, J., and Barber, J.: Laser Para la Salud y la Estetica. Etecnes, 2nd. edition, 1983, pp 98-107. 5. Unger, M.: Low Level Laser Therapy (LLLT) for Hair Biostimulation, 9th Annual Meeting of the International Society of Hair Restoration Surgery, Puerto Vallarta,

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