Advertisement

Lasers in Medical Science

, Volume 31, Issue 2, pp 363–371 | Cite as

Low level laser therapy and hair regrowth: an evidence-based review

  • Mina Zarei
  • Tongyu C. Wikramanayake
  • Leyre Falto-Aizpurua
  • Lawrence A. Schachner
  • Joaquin J. Jimenez
Review Article

Abstract

Despite the current treatment options for different types of alopecia, there is a need for more effective management options. Recently, low-level laser therapy (LLLT) was evaluated for stimulating hair growth. Here, we reviewed the current evidence on the LLLT effects with an evidence-based approach, focusing more on randomized controlled studies by critically evaluating them. In order to investigate whether in individuals presenting with hair loss (male pattern hair loss (MPHL), female pattern hair loss (FPHL), alopecia areata (AA), and chemotherapy-induced alopecia (CIA)) LLLT is effective for hair regrowth, several databases including PubMed, Google Scholar, Medline, Embase, and Cochrane Database were searched using the following keywords: Alopecia, Hair loss, Hair growth, Low level laser therapy, Low level light therapy, Low energy laser irradiation, and Photobiomodulation. From the searches, 21 relevant studies were summarized in this review including 2 in vitro, 7 animal, and 12 clinical studies. Among clinical studies, only five were randomized controlled trials (RCTs), which evaluated LLLT effect on male and female pattern hair loss. The RCTs were critically appraised using the created checklist according to the Critical Appraisal for Therapy Articles Worksheet created by the Center of Evidence-Based Medicine, Oxford. The results demonstrated that all the performed RCTs have moderate to high quality of evidence. However, only one out of five studies performed intention-to-treat analysis, and only another study reported the method of randomization and subsequent concealment of allocation clearly; all other studies did not include this very important information in their reports. None of these studies reported the treatment effect of factors such as number needed to treat. Based on this review on all the available evidence about effect of LLLT in alopecia, we found that the FDA-cleared LLLT devices are both safe and effective in patients with MPHL and FPHL who did not respond or were not tolerant to standard treatments. Future randomized controlled trials of LLLT are strongly encouraged to be conducted and reported according to the Consolidated Standards of Reporting Trials (CONSORT) statement to facilitate analysis and comparison.

Keywords

Low-level laser therapy Hair regrowth Evidence-based medicine 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no competing interests.

References

  1. 1.
    Ghanaat M (2010) Types of hair loss and treatment options, including the novel low-level light therapy and its proposed mechanism. S Med J103(9):917–921CrossRefGoogle Scholar
  2. 2.
    Chung PS, Kim YC, Chung MS et al (2004) The effect of low-power laser on the murine hair growth. J Korean Soc Plastic Reconstruct Surg 31:1–8Google Scholar
  3. 3.
    Yu HS, Wu CS, Yu CL et al (2003) Helium-neon laser irradiation stimulates migration and proliferation in melanocytes and induces repigmentation in segmental vitiligo. J Invest Dermatol 120:56–64CrossRefPubMedGoogle Scholar
  4. 4.
    Conlan MJ, Rapley JW, Cobb CM (1996) Biostimulation of wound healing by low-energy laser irradiation. J Clin Periodontol 23:492–496CrossRefPubMedGoogle Scholar
  5. 5.
    Wikramanayake TC, Villasante AC, Mauro LM et al (2013) Low-level laser treatment accelerated hair regrowth in a rat model of chemotherapy-induced alopecia (CIA). Lasers Med Sci 28(3):701–706CrossRefPubMedGoogle Scholar
  6. 6.
    Rampen FH (1983) Hypertrichosis in PUVA-treated patients. Br J Dermatol 109:657–660CrossRefPubMedGoogle Scholar
  7. 7.
    Moreno-Arias G, Castelo-Branco C, Ferrando J (2002) Paradoxical effect after IPL photoepilation. Dermatol Surg 28(11):1013–1016PubMedGoogle Scholar
  8. 8.
    Bernstein EF (2005) Hair growth induced by diode laser treatment. Dermatol Surg 31(5):584–586CrossRefPubMedGoogle Scholar
  9. 9.
    Desai S, Mahmoud BH, Bhatia AC et al (2010) Paradoxical hypertrichosis after laser therapy: a review. Dermatol Surg 36:291–298CrossRefPubMedGoogle Scholar
  10. 10.
    Mester E et al (1967) Effect of laser on hair growth of mice. Kiserl Orvostud 19:628–631Google Scholar
  11. 11.
    Sackett DL, Richardson WS, Rosenberg Q et al (1997) Evidence-based medicine: how to practice and teach EBM. Churchill Livingstone, LondonGoogle Scholar
  12. 12.
    Bigby M (2000) Evidence-based medicine in dermatology. Dermatol Clin 18:261–276CrossRefPubMedGoogle Scholar
  13. 13.
    Howick J, Chalmers I, Glasziou P, et al. OCEBM Levels of Evidence Working Group*. "The Oxford 2011 levels of evidence". Oxford Centre for Evidence-Based Medicine. http://www.cebm.net/index.aspx?o=5653 (accessed October 19th, 2014)
  14. 14.
    Schulz KF, Altman DG, Moher D, CONSORT Group (2010) Consort 2010 statement: updated guidelines for reporting parallel group randomised trials. BMC Med 8:18CrossRefPubMedCentralPubMedGoogle Scholar
  15. 15.
    Juni P, Altman DG, Egger M (2001) Assessing the quality of controlled clinical trials. Br Med J 323:42–46CrossRefGoogle Scholar
  16. 16.
    RCT Appraisal Sheet 2005. Oxford Centre for Evidence-Based Medicine. http://www.cebm.net/critical-appraisal/ (accessed October 19th, 2014)
  17. 17.
    Leavitt M (2010) Evaluation of the activity of laser light doses compared to an inactive control dose on ex vivo hair growth. J Am Acad Dermatol 62(3Supp1):AB76. doi: 10.1016/j.jaad.2009.11.319 Google Scholar
  18. 18.
    Hamblin M. Evaluation of activity of laser doses on ex-vivo hair growth. http://www.hairmax.com/downloads/PDF/EX_VIVO_STUDY_SLIDES_7_09.pdf (accessed October 19th, 2014)
  19. 19.
    Wikramanayake TC, Rodriguez R, Choudhary S et al (2012) Effects of the Lexington LaserComb on hair regrowth in the C3H/HeJ mouse model of alopecia areata. Lasers Med Sci 27(2):431–436CrossRefPubMedGoogle Scholar
  20. 20.
    Shukla S, Sahu K, Verma Y et al (2010) Effect of helium-neon laser irradiation on hair follicle growth cycle of Swiss albino mice. Skin Pharmacol Physiol 23(2):79–85CrossRefPubMedGoogle Scholar
  21. 21.
    Fushimi T, Inui S, Ogasawara M et al (2011) Narrow-band red LED light promotes mouse hair growth through paracrine growth factors from dermal papilla. J Dermatol Sci 64(3):246–248CrossRefPubMedGoogle Scholar
  22. 22.
    Olivieri L, Cavina D, Radicchi G et al (2015) Efficacy of low-level laser therapy on hair regrowth in dogs with noninflammatory alopecia: a pilot study. Vet Dermatol 26(1):35–39, e11 CrossRefPubMedGoogle Scholar
  23. 23.
    King LE Jr, Silva KA, Kennedy VE et al (2014) Lack of response to laser comb in spontaneous and graft-induced alopecia areata in C3H/HeJ mice. J Invest Dermatol 134(1):264–266CrossRefPubMedGoogle Scholar
  24. 24.
    Satino JL, Markou M (2003) Hair regrowth and increased hair tensile strength using the HairMax LaserComb for low-level laser therapy. Int J Cos Surg Aest Dermatol 5:113–117CrossRefGoogle Scholar
  25. 25.
    Avram MR, Rogers NE (2009) The use of low-level light for hair growth: part I. J Cosmet Laser Ther 11:110–117CrossRefPubMedGoogle Scholar
  26. 26.
    Leavitt M, Charles G, Heyman E et al (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):283–292CrossRefPubMedGoogle Scholar
  27. 27.
    Kim H, Choi JW, Kim JY et al (2013) Low level light therapy for androgenetic alopecia: a 24-week, randomized, double-blind. Sham Device-Controlled Multicenter Trial. Dermatol Surg 39(8):1177–1183CrossRefPubMedGoogle Scholar
  28. 28.
    Lanzafame R, Blanche R, Bodian A et al (2013) The growth of human scalp hair mediated by visible red light laser and LED sources in males. Lasers Surg Med 45:487–495CrossRefPubMedGoogle Scholar
  29. 29.
    Lanzafame R, Blanche R, Chiacchierini R et al (2014) The growth of human scalp hair in females using visible red light laser and LED sources. Lasers Surg Med 46:601–607CrossRefPubMedGoogle Scholar
  30. 30.
    Jimenez JJ, Wikramanayake TC, Bergfeld W et al (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. Am J Clin Dermatol 15:115–127CrossRefPubMedCentralPubMedGoogle Scholar
  31. 31.
    Munck A, Gavazzoni MF, Trüeb RM (2014) Use of low-level laser therapy as monotherapy or concomitant therapy for male and female androgenetic alopecia. Int J Trichol 6(2):45–49CrossRefGoogle Scholar
  32. 32.
    Kim SS, Park MW, Lee CJ (2007) Phototherapy of androgenetic alopecia with low level narrow band 655-nm red light and 780-nm infrared light. J Am Acad Dermatol 56(2 Suppl 2):AB112, American Academy of Dermatology 65th Annual Meeting Google Scholar
  33. 33.
    Rushton DH, Gilkes JJ, Van Neste DJ (2012) No improvement in male-pattern hair loss using laser hair-comb therapy: a 6-month, half-head, assessor-blinded investigation in two men. Clin Exp Dermatol 37(3):313–315CrossRefPubMedGoogle Scholar
  34. 34.
    Waiz M, Saleh AZ, Hayani R et al (2006) Use of the pulsed infrared diode laser (904 nm) in the treatment of alopecia areata. J Cosmet Laser Ther 8:27–30CrossRefPubMedGoogle Scholar
  35. 35.
    Yamazaki M, Miura Y, Tsuboi R et al (2003) Linear polarized infrared irradiation using Super Lizer is an effective treatment for multiple-type alopecia areata. Int J Dermatol 42(9):738–740CrossRefPubMedGoogle Scholar
  36. 36.
    Frigo L, Luppi JS, Favero GM et al (2009) The effect of low-level laser irradiation (In-Ga–Al–AsP—660nm) on melanoma in vitro, in vivo. BMC Cancer 9:404CrossRefPubMedCentralPubMedGoogle Scholar
  37. 37.
    Sakurai Y, Yamaguchi M, Abiko Y (2000) Inhibitory effect of low-level laser irradiation on LPS-stimulated prostaglandin E2 production and cyclooxygenase-2 in human gingival fibroblasts. Eur J Oral Sci 108(1):29–34CrossRefPubMedGoogle Scholar
  38. 38.
    Mafra de Lima F, Villaverde AB, Salgado MA et al (2010) Low intensity laser therapy (LILT) in vivo acts on the neutrophils recruitment and chemokines/cytokines levels in a model of acute pulmonary inflammation induced by aerosol of lipopolysaccharide from Escherichia coli in rat. J Photochem Photobiol B 101(3):271–278CrossRefPubMedGoogle Scholar
  39. 39.
    De Lima FM, Villaverde AB, Albertini R et al (2011) Dual effect of low-level laser therapy (LLLT) on the acute lung inflammation induced by intestinal ischemia and reperfusion: action on anti- and pro-inflammatory cytokines. Lasers Surg Med 43(5):410–420CrossRefPubMedGoogle Scholar
  40. 40.
    Arany PR, Nayak RS, Hallikerimath S et al (2007) Activation of latent TGF-beta1 by low-power laser in vitro correlates with increased TGF-beta1 levels in laser enhanced oral wound healing. Wound Repair Regen 15(6):866–874CrossRefPubMedGoogle Scholar
  41. 41.
    Saygun I, Nizam N, Ural AU et al (2012) Low-level laser irradiation affects the release of basic fibroblast growth factor (bFGF), insulin-like growth factor-I (IGF-I), and receptor of IGF-I (IGFBP3) from osteoblasts. Photomed Laser Surg 30(3):149–154CrossRefPubMedGoogle Scholar
  42. 42.
    Weiss R, McDaniel DH, Geronemus RG et al (2005) LED photomodulation induced hair growth stimulation. Ann Meet Am Soc Laser Med Surg, Orlando. doi: 10.1002/lsm.20164 Google Scholar

Copyright information

© Springer-Verlag London 2015

Authors and Affiliations

  • Mina Zarei
    • 1
  • Tongyu C. Wikramanayake
    • 1
  • Leyre Falto-Aizpurua
    • 1
  • Lawrence A. Schachner
    • 1
  • Joaquin J. Jimenez
    • 1
  1. 1.Department of Dermatology and Cutaneous SurgeryUniversity of Miami Miller School of MedicineMiamiUSA

Personalised recommendations