Lasercap

[Alan Bauman, MD]

The widely varied biological effects of low level laser therapy have been studied for decades and not only hair loss patients have been helped by this non-chemical, non-invasive technology. There are thousands of clinical peer-reviewed papers, dozens of textbooks, medical societies, conferences and organizations and prominent research facilities (Harvard, MIT, etc.) and many clinical institutions in the U.S. and abroad where photomedicine devices, concepts and protocols are discussed, debated and used.

Laser therapy and Phototherapy have been successfully used for pain control, wound healing, fat-reduction, brain injuries/stroke, dentistry, skin rejuvenation, hair growth and more. There are several online communities dedicated specifically to laser therapy--some for physicians and some for patients.

However, unfortunately most people (including doctors) don't understand what laser therapy is likely to do before they start or recommend a laser regimen and most physicians are still unfamiliar with how to prescribe the right dose, ensure compliance or even effectively track their patients results. These same statements can be said also for other medical treatments, like minoxidil and finasteride, for example.

I will be the first to tell you that laser therapy is NOT a miracle cure.
Like minoxidil, finasteride, etc., the effects of laser therapy can be subtle at first, because it works NOT to create new hair follicles, but to enhance the quality of hair that follicles produce. This cannot be overstated: density changes are NOT the main effect. The best visual improvements with laser therapy are typically seen in areas which have a significant amount of miniaturized of hair.

A completely bald area or receded hairline is simply not going to regrow from laser therapy. Generally, women with hair loss have large areas of miniaturization and thinning and tend to respond 'visually well' from laser therapy. Men who have significant visible miniaturization can do well too.

By far, until only very recently, our best results over the past ten years have been with in-office devices, 100+ diodes, 650nm, 5mW continuous power, 30 minute treatments, at least three times per week. This regimen is NOT easy for patients to be compliant with.

Small areas can be treated with weak at-home devices but it is difficult for patients to remain compliant--much like with minoxidil, and to treat large areas with the small numbers of diodes that you have to aim around the scalp. Consider the analogy of trying to grow your lawn armed with a water bottle... it's the right technology, but the wrong delivery system. You had better be ready to make some serious investment in time.

In my opinion, the portable LaserCap (finally) provides what appears to be a large enough dose of laser energy over a wide enough area in a device which is easy to use because it is cordless, rechargeable and fits under a hat. Patients are therefore more compliant than with the laser brushes or combs. This could be the reason we are seeing improvements in hair growth--not only on close inspection with a microscope and measurements with Cross-Section Bundle Trichometry (HairCheck), but also on standardized global photography. "Thicker, Fuller, Healthier" may sound like a 'weak' claim, but thicker hair does cover the scalp better!

The LaserCap contains 224 laser (non-LED) diodes at 5mw power each, at 65nm wavelength. However, LaserCap is NOT a continuous dose... it has a factory-set 80% "duty cycle." In laser terms, this mean that the LaserCap is not delivering energy 20% of the time. Many physicians are not aware of this fact (as evidenced by some of the websites mentioned in this thread).

Without getting into a huge discussion about dosage, it's clear that 224 laser diodes (even at 80% duty cycle) deliver 15 to 25 times more energy than the traditional hand-held units that contain 7, 9 or 12 diodes. It also efficiently delivers the energy over a larger area of scalp because of the non-spot, divergent/unfocused beams it produces.

Like minoxidil, finasteride and other medications, laser therapy will never replace what we as surgeons do using hair transplantation, but laser therapy CAN be used as a chemical-free and side-effect free part of a hair restoration regimen. Improvements occur for the first 6-12 months then plateau after that, depending on hair length.

My main suggestion is to make sure you have your Hair Restoration Physician take standardized global photos and take careful cross-sectional bundle measurements. In my practice, we perform bundle trichometry every 90 days until a steady state is reached and global photos about every six months for our patients. Hundreds of patients each year are medically-managed this way so they know (and we know) if their treatment regimen is working.

Skepticism amongst physicians and the general public is normal and natural, especially when the mechanisms are not widely taught or understood. My thanks goes out to Dr. Michael Hamblin PhD from the Wellman Center of Photomedicine (Harvard/MIT) for helping me more deeply understand the mechanisms of low level laser therapy.