Skip to main content

Advertisement

SpringerLink
Log in

A randomized, investigator-blinded, controlled, split-scalp study of the efficacy and safety of a 1550-nm fractional erbium-glass laser, used in combination with topical 5% minoxidil versus 5% minoxidil alone, for the treatment of androgenetic alopecia

  • Original Article
  • Published:
Lasers in Medical Science Aims and scope Submit manuscript

Abstract

Fractional 1550-nm erbium-glass (Er:Glass) laser therapy is effective in inducing hair regrowth. Combining fractional Er:Glass laser therapy with topical minoxidil may yield therapeutic benefits for patients with androgenetic alopecia (AGA). To compare the efficacy and safety of fractional Er:Glass laser used in combination with topical 5% minoxidil versus 5% minoxidil alone for the treatment of male AGA, 30 men with AGA were randomized to 24 weeks of split-scalp treatment using fractional Er:Glass laser and 5% minoxidil on one side (combined therapy) or 5% minoxidil alone on the other side (monotherapy). The primary outcome was the difference in hair density and diameter, from baseline, between two treatment sides, at week 24. The secondary outcome was a global photographic assessment, evaluated by two dermatologists and the participants. Adverse events were evaluated. Twenty-nine participants completed the 24-week study period. Combination therapy provided significantly superior results for both the primary and secondary outcomes (all p < 0.05). No serious adverse events were identified for either treatment. In conclusion, combination therapy, consisting of fractional Er:Glass laser and topical minoxidil, is a promising treatment option for AGA. Laser-induced photothermolysis and the formation of effective routes for transdermal drug delivery are possible mechanisms. clinicaltrials.in.th, identifier TCTR20160912001

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Kaufman KD (2002) Androgens and alopecia. Mol Cell Endocrinol 198(1–2):89–95

    Article  CAS  Google Scholar 

  2. Varothai S, Bergfeld WF (2014) Androgenetic alopecia: an evidence-based treatment update. Am J Clin Dermatol 15(3):217–230

    Article  Google Scholar 

  3. Avram MR, Leonard RT Jr, Epstein ES, Williams JL, Bauman AJ (2007) The current role of laser/light sources in the treatment of male and female pattern hair loss. J Cosmet Laser Ther 9(1):27–28

    Article  Google Scholar 

  4. Gundogan C, Greve B, Raulin C (2004) Treatment of alopecia areata with the 308-nm xenon chloride excimer laser: case report of two successful treatments with the excimer laser. Lasers Surg Med 34(2):86–90

    Article  Google Scholar 

  5. Shukla S, Sahu K, Verma Y, Rao KD, Dube A, Gupta PK (2010) Effect of helium-neon laser irradiation on hair follicle growth cycle of Swiss albino mice. Skin Pharmacol Physiol 23(2):79–85

    Article  CAS  Google Scholar 

  6. 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. Clin Drug Investig 29(5):283–292

    Article  Google Scholar 

  7. Ito M, Yang Z, Andl T, Cui C, Kim N, Millar SE, Cotsarelis G (2007) Wnt-dependent de novo hair follicle regeneration in adult mouse skin after wounding. Nature 447(7142):316–320

    Article  CAS  Google Scholar 

  8. Levy V, Lindon C, Zheng Y, Harfe BD, Morgan BA (2007) Epidermal stem cells arise from the hair follicle after wounding. FASEB J 21(7):1358–1366

    Article  CAS  Google Scholar 

  9. Kim WS, Lee HI, Lee JW, Lim YY, Lee SJ, Kim BJ, Kim MN, Song KY, Park WS (2011) Fractional photothermolysis laser treatment of male pattern hair loss. Dermatol Surg 37(1):41–51

    Article  CAS  Google Scholar 

  10. Lee GY, Lee SJ, Kim WS (2011) The effect of a 1550 nm fractional erbium-glass laser in female pattern hair loss. J Eur Acad Dermatol Venereol 25(12):1450–1454

    Article  Google Scholar 

  11. Meephansan J, Ungpraphakorn N, Ponnikorn S, Suchonwanit P, Poovorawan Y (2018) Efficacy of 1,550-nm erbium-glass fractional laser treatment and its effect on the expression of insulin-like growth factor 1 and Wnt/beta-catenin in androgenetic alopecia. Dermatol Surg 44(10):1295–1303

    Article  CAS  Google Scholar 

  12. Bertin ACJ, Vilarinho A, Junqueira ALA (2018) Fractional non-ablative laser-assisted drug delivery leads to improvement in male and female pattern hair loss. J Cosmet Laser Ther:1–4. https://doi.org/10.1080/14764172.2017.1418516

    Article  Google Scholar 

  13. Cho S, Choi MJ, Zheng Z, Goo B, Kim DY, Cho SB (2013) Clinical effects of non-ablative and ablative fractional lasers on various hair disorders: a case series of 17 patients. J Cosmet Laser Ther 15(2):74–79

    Article  Google Scholar 

  14. Yoo KH, Kim MN, Kim BJ, Kim CW (2010) Treatment of alopecia areata with fractional photothermolysis laser. Int J Dermatol 49(7):845–847

    PubMed  Google Scholar 

  15. Ke J, Guan H, Li S, Xu L, Zhang L, Yan Y (2015) Erbium: YAG laser (2,940 nm) treatment stimulates hair growth through upregulating Wnt 10b and beta-catenin expression in C57BL/6 mice. Int J Clin Exp Med 8(11):20883–20889

    CAS  PubMed  PubMed Central  Google Scholar 

  16. Bae JM, Jung HM, Goo B, Park YM (2015) Hair regrowth through wound healing process after ablative fractional laser treatment in a murine model. Lasers Surg Med 47(5):433–440

    Article  Google Scholar 

  17. Huang Y, Zhuo F, Li L (2017) Enhancing hair growth in male androgenetic alopecia by a combination of fractional CO2 laser therapy and hair growth factors. Lasers Med Sci 32(8):1711–1718

    Article  Google Scholar 

  18. Yalici-Armagan B, Elcin G (2016) The effect of neodymium: yttrium aluminum garnet and fractional carbon dioxide lasers on alopecia areata: a prospective controlled clinical trial. Dermatol Surg 42(4):500–506

    Article  CAS  Google Scholar 

  19. Issa MC, Pires M, Silveira P, Xavier de Brito E, Sasajima C (2015) Transepidermal drug delivery: a new treatment option for areata alopecia? J Cosmet Laser Ther 17(1):37–40

    Article  Google Scholar 

  20. Cho SB, Goo BL, Zheng Z, Yoo KH, Kang JS, Kim H (2018) Therapeutic efficacy and safety of a 1927-nm fractionated thulium laser on pattern hair loss: an evaluator-blinded, split-scalp study. Lasers Med Sci 33(4):851–859

    Article  Google Scholar 

  21. Sklar LR, Burnett CT, Waibel JS, Moy RL, Ozog DM (2014) Laser assisted drug delivery: a review of an evolving technology. Lasers Surg Med 46(4):249–262

    Article  Google Scholar 

  22. Perper M, Aldahan AS, Fayne RA, Emerson CP, Nouri K (2017) Efficacy of fractional lasers in treating alopecia: a literature review. Lasers Med Sci 32(8):1919–1925

    Article  Google Scholar 

  23. Lim HK, Jeong KH, Kim NI, Shin MK (2014) Nonablative fractional laser as a tool to facilitate skin penetration of 5-aminolaevulinic acid with minimal skin disruption: a preliminary study. Br J Dermatol 170(6):1336–1340

    Article  CAS  Google Scholar 

  24. Werner S, Grose R (2003) Regulation of wound healing by growth factors and cytokines. Physiol Rev 83(3):835–870

    Article  CAS  Google Scholar 

  25. Krause K, Foitzik K (2006) Biology of the hair follicle: the basics. Semin Cutan Med Surg 25(1):2–10

    Article  CAS  Google Scholar 

  26. Lin WH, Xiang LJ, Shi HX, Zhang J, Jiang LP, Cai PT, Lin ZL, Lin BB, Huang Y, Zhang HL, Fu XB, Guo DJ, Li XK, Wang XJ, Xiao J (2015) Fibroblast growth factors stimulate hair growth through beta-catenin and Shh expression in C57BL/6 mice. Biomed Res Int 2015:730139. https://doi.org/10.1155/2015/730139

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  27. Goren A, Castano JA, McCoy J, Bermudez F, Lotti T (2014) Novel enzymatic assay predicts minoxidil response in the treatment of androgenetic alopecia. Dermatol Ther 27(3):171–173

    Article  Google Scholar 

  28. Rossi A, Cantisani C, Melis L, Iorio A, Scali E, Calvieri S (2012) Minoxidil use in dermatology, side effects and recent patents. Recent Patents Inflamm Allergy Drug Discov 6(2):130–136

    Article  CAS  Google Scholar 

  29. Lin TY, Manuskiatti W, Dierickx CC, Farinelli WA, Fisher ME, Flotte T, Baden HP, Anderson RR (1998) Hair growth cycle affects hair follicle destruction by ruby laser pulses. J Investig Dermatol 111(1):107–113

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Dermatology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, 270 Rama VI Road, Ratchathewi, Bangkok, 10400, Thailand

    Poonkiat Suchonwanit, Salinee Rojhirunsakool & Saranya Khunkhet

Authors
  1. Poonkiat Suchonwanit
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Salinee Rojhirunsakool
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Saranya Khunkhet
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Poonkiat Suchonwanit.

Ethics declarations

Conflict of interest

The authors declare that they have no conflicts of interest.

Ethical approval

This study was conducted in accordance with the principles of the Declaration of Helsinki and in compliance with the International Conference on Harmonization-Good Clinical Practice and local regulatory requirements. The study was reviewed and approved by the appropriate Independent Ethics Committees, and written informed consent was obtained from all subjects prior to study initiation.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

This study was approved by the MU-IRB (Mahidol University Institutional Review Board) on April 30, 2015 (protocol number 03-56-33).

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Suchonwanit, P., Rojhirunsakool, S. & Khunkhet, S. A randomized, investigator-blinded, controlled, split-scalp study of the efficacy and safety of a 1550-nm fractional erbium-glass laser, used in combination with topical 5% minoxidil versus 5% minoxidil alone, for the treatment of androgenetic alopecia. Lasers Med Sci 34, 1857–1864 (2019). https://doi.org/10.1007/s10103-019-02783-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10103-019-02783-8

Keywords

Search

Navigation