Laser therapy is marketed as a promising alternative to drugs and scalpels for treating hair loss, but what does the research say?
Do Low-Level Laser Therapy Devices Work for Hair Loss?
Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.
In my book How Not to Age, I discuss all the drugs, foods, supplements, and surgeries that can treat age-related hair loss. But what about non-dietary, non-drug, non-surgical interventions? Autologous platelet‐rich plasma, where concentrated portions of your own blood is repeatedly injected into your scalp, appears to have an efficacy similar to the available drugs, though the available evidence is considered insufficient to recommend it, and so remains unapproved in the U.S. or Europe for hair restoration purposes. Scalp Botox is also not recommended. The thought was that relaxing scalp muscles might improve blood flow, but when actually put to the test, actually caused hair loss in some pilot study participants. Then, there are lasers.
In the 1960’s, a Hungarian physician published the paper “The effect of laser beams on the growth of hair in mice,” detailing a serendipitous discovery that a low-powered ruby laser increased the hair growth on the shaved backs of mice. The mechanism appears to be increased blood flow. The floodgates opened when the FDA cleared the first low-level laser therapy device for age-related pattern hair loss in 2007, and now, there are clinics advertising lasers for everything from tennis elbow to “scrotal rejuvenation.”
There have been at least ten randomized, controlled trials of low-level laser therapy devices for hair loss, and the efficacy has been found comparable or even superior to the drugs. They are noninvasive, and appear to be relatively safe. Mild side effects include itching, acne, and scalp tenderness that usually resolve within two weeks. Reviews typically conclude that laser therapy may be a promising alternative to drugs and scalpels, but there remains considerable skepticism within the dermatology community, and for good reason.
Most of the laser therapy trials were funded by the manufacturers of the tested products themselves. This is true of hair loss treatments across the board, but laser studies appear particularly reticent to provide visual evidence or inquire about perhaps the most important outcome of all: patient satisfaction. When the first independent study was performed, blinded evaluations of before-and-after photographs could not detect a difference in hair density or caliber. In two studies that compared subjective satisfaction between laser and sham placebo devices, no significant difference could be found either. In other words, from the patient’s perspective, they just plain don’t work. So, while there are statistically significant improvements in hair density and thickness, there may be little clinically significant improvement.
If you want to give them a try anyway, there are at least 29 FDA-cleared devices currently on the market. There have been no head-to-head studies between them, but based on measured outcomes, there appear to be no difference between comb-style and hat-style devices––though those containing laser diodes exclusively may have an edge over devices that include a mix of both laser diodes and LED. Do not look into the light, as prolonged retinal exposure could be damaging. Thankfully, at least most cap designs have a built-in safety shut off to avoid accidental eye exposure. Otherwise, besides general safety caveats about using electrical contraptions in or around water, such devices are considered safe, though they are contraindicated for those with cancer of the scalp due to the potential for stimulatory effects.
Please consider volunteering to help out on the site.
- Gupta AK, Mays RR, Dotzert MS, Versteeg SG, Shear NH, Piguet V. Efficacy of non-surgical treatments for androgenetic alopecia: a systematic review and network meta-analysis. J Eur Acad Dermatol Venereol. 2018;32(12):2112-2125.
- Lotti T, Goren A, Verner I, D’Alessio PA, Franca K. Platelet rich plasma in androgenetic alopecia: A systematic review. Dermatol Ther. 2019;32(3):e12837.
- Wang Y, Zhang H, Zheng Q, Tang K, Fang R, Sun Q. Botulinum toxin as a double-edged sword in alopecia: A systematic review. J Cosmet Dermatol. 2020;19(10):2560-2565.
- Carloni R, Pechevy L, Postel F, Zielinski M, Gandolfi S. Is there a therapeutic effect of botulinum toxin on scalp alopecia? Physiopathology and reported cases: A systematic review of the literature. J Plast Reconstr Aesthet Surg. 2020;73(12):2210-2216.
- Dodd EM, Winter MA, Hordinsky MK, Sadick NS, Farah RS. Photobiomodulation therapy for androgenetic alopecia: A clinician’s guide to home-use devices cleared by the Federal Drug Administration. J Cosmet Laser Ther. 2018;20(3):159-167.
- Ashique S, Sandhu NK, Haque SN, Koley K. A systemic review on topical marketed formulations, natural products, and oral supplements to prevent androgenic alopecia: a review. Nat Prod Bioprospect. 2020;10(6):345-365.
- Delaney SW, Zhang P. Systematic review of low-level laser therapy for adult androgenic alopecia. J Cosmet Laser Ther. 2018;20(4):229-236.
- Simunovic Z, Trobonjaca T, Trobonjaca Z. Treatment of medial and lateral epicondylitis--tennis and golfer’s elbow--with low level laser therapy: a multicenter double blind, placebo-controlled clinical study on 324 patients. J Clin Laser Med Surg. 1998;16(3):145-151.
- Cohen PR. A case report of scrotal rejuvenation: laser treatment of angiokeratomas of the scrotum. Dermatol Ther (Heidelb). 2019;9(1):185-192.
- Egger A, Resnik SR, Aickara D, et al. Examining the safety and efficacy of low-level laser therapy for male and female pattern hair loss: a review of the literature. Skin Appendage Disord. 2020;6(5):259-267.
- Gupta AK, Quinlan EM, Williams KL. The shifting preferences of patients and physicians in nonsurgical hair loss treatment. J Cosmet Dermatol. 2021;20(3):929-936.
- Darwin E, Heyes A, Hirt PA, Wikramanayake TC, Jimenez JJ. Low-level laser therapy for the treatment of androgenic alopecia: a review. Lasers Med Sci. 2018;33(2):425-434.
- Gupta AK, Foley KA. A critical assessment of the evidence for low-level laser therapy in the treatment of hair loss. Dermatol Surg. 2017;43(2):188-197.
- Avram MR, Rogers NE. The use of low-level light for hair growth: part I. J Cosmet Laser Ther. 2009;11(2):110-117.
- Kim H, Choi JW, Kim JY, Shin JW, Lee SJ, Huh CH. Low-level light therapy for androgenetic alopecia: a 24-week, randomized, double-blind, sham device-controlled multicenter trial. Dermatol Surg. 2013;39(8):1177-1183.
- Yoon JS, Ku WY, Lee JH, Ahn HC. Low-level light therapy using a helmet-type device for the treatment of androgenetic alopecia: A 16-week, multicenter, randomized, double-blind, sham device-controlled trial. Medicine (Baltimore). 2020;99(29):e21181.
- van Zuuren EJ, Fedorowicz Z, Schoones J. Interventions for female pattern hair loss. Cochrane Database Syst Rev. 2016;2016(5):CD007628.
- Gupta AK, Carviel JL. Meta-analysis of photobiomodulation for the treatment of androgenetic alopecia. J Dermatolog Treat. 2021;32(6):643-647.
Motion graphics by Avo Media
Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.
In my book How Not to Age, I discuss all the drugs, foods, supplements, and surgeries that can treat age-related hair loss. But what about non-dietary, non-drug, non-surgical interventions? Autologous platelet‐rich plasma, where concentrated portions of your own blood is repeatedly injected into your scalp, appears to have an efficacy similar to the available drugs, though the available evidence is considered insufficient to recommend it, and so remains unapproved in the U.S. or Europe for hair restoration purposes. Scalp Botox is also not recommended. The thought was that relaxing scalp muscles might improve blood flow, but when actually put to the test, actually caused hair loss in some pilot study participants. Then, there are lasers.
In the 1960’s, a Hungarian physician published the paper “The effect of laser beams on the growth of hair in mice,” detailing a serendipitous discovery that a low-powered ruby laser increased the hair growth on the shaved backs of mice. The mechanism appears to be increased blood flow. The floodgates opened when the FDA cleared the first low-level laser therapy device for age-related pattern hair loss in 2007, and now, there are clinics advertising lasers for everything from tennis elbow to “scrotal rejuvenation.”
There have been at least ten randomized, controlled trials of low-level laser therapy devices for hair loss, and the efficacy has been found comparable or even superior to the drugs. They are noninvasive, and appear to be relatively safe. Mild side effects include itching, acne, and scalp tenderness that usually resolve within two weeks. Reviews typically conclude that laser therapy may be a promising alternative to drugs and scalpels, but there remains considerable skepticism within the dermatology community, and for good reason.
Most of the laser therapy trials were funded by the manufacturers of the tested products themselves. This is true of hair loss treatments across the board, but laser studies appear particularly reticent to provide visual evidence or inquire about perhaps the most important outcome of all: patient satisfaction. When the first independent study was performed, blinded evaluations of before-and-after photographs could not detect a difference in hair density or caliber. In two studies that compared subjective satisfaction between laser and sham placebo devices, no significant difference could be found either. In other words, from the patient’s perspective, they just plain don’t work. So, while there are statistically significant improvements in hair density and thickness, there may be little clinically significant improvement.
If you want to give them a try anyway, there are at least 29 FDA-cleared devices currently on the market. There have been no head-to-head studies between them, but based on measured outcomes, there appear to be no difference between comb-style and hat-style devices––though those containing laser diodes exclusively may have an edge over devices that include a mix of both laser diodes and LED. Do not look into the light, as prolonged retinal exposure could be damaging. Thankfully, at least most cap designs have a built-in safety shut off to avoid accidental eye exposure. Otherwise, besides general safety caveats about using electrical contraptions in or around water, such devices are considered safe, though they are contraindicated for those with cancer of the scalp due to the potential for stimulatory effects.
Please consider volunteering to help out on the site.
- Gupta AK, Mays RR, Dotzert MS, Versteeg SG, Shear NH, Piguet V. Efficacy of non-surgical treatments for androgenetic alopecia: a systematic review and network meta-analysis. J Eur Acad Dermatol Venereol. 2018;32(12):2112-2125.
- Lotti T, Goren A, Verner I, D’Alessio PA, Franca K. Platelet rich plasma in androgenetic alopecia: A systematic review. Dermatol Ther. 2019;32(3):e12837.
- Wang Y, Zhang H, Zheng Q, Tang K, Fang R, Sun Q. Botulinum toxin as a double-edged sword in alopecia: A systematic review. J Cosmet Dermatol. 2020;19(10):2560-2565.
- Carloni R, Pechevy L, Postel F, Zielinski M, Gandolfi S. Is there a therapeutic effect of botulinum toxin on scalp alopecia? Physiopathology and reported cases: A systematic review of the literature. J Plast Reconstr Aesthet Surg. 2020;73(12):2210-2216.
- Dodd EM, Winter MA, Hordinsky MK, Sadick NS, Farah RS. Photobiomodulation therapy for androgenetic alopecia: A clinician’s guide to home-use devices cleared by the Federal Drug Administration. J Cosmet Laser Ther. 2018;20(3):159-167.
- Ashique S, Sandhu NK, Haque SN, Koley K. A systemic review on topical marketed formulations, natural products, and oral supplements to prevent androgenic alopecia: a review. Nat Prod Bioprospect. 2020;10(6):345-365.
- Delaney SW, Zhang P. Systematic review of low-level laser therapy for adult androgenic alopecia. J Cosmet Laser Ther. 2018;20(4):229-236.
- Simunovic Z, Trobonjaca T, Trobonjaca Z. Treatment of medial and lateral epicondylitis--tennis and golfer’s elbow--with low level laser therapy: a multicenter double blind, placebo-controlled clinical study on 324 patients. J Clin Laser Med Surg. 1998;16(3):145-151.
- Cohen PR. A case report of scrotal rejuvenation: laser treatment of angiokeratomas of the scrotum. Dermatol Ther (Heidelb). 2019;9(1):185-192.
- Egger A, Resnik SR, Aickara D, et al. Examining the safety and efficacy of low-level laser therapy for male and female pattern hair loss: a review of the literature. Skin Appendage Disord. 2020;6(5):259-267.
- Gupta AK, Quinlan EM, Williams KL. The shifting preferences of patients and physicians in nonsurgical hair loss treatment. J Cosmet Dermatol. 2021;20(3):929-936.
- Darwin E, Heyes A, Hirt PA, Wikramanayake TC, Jimenez JJ. Low-level laser therapy for the treatment of androgenic alopecia: a review. Lasers Med Sci. 2018;33(2):425-434.
- Gupta AK, Foley KA. A critical assessment of the evidence for low-level laser therapy in the treatment of hair loss. Dermatol Surg. 2017;43(2):188-197.
- Avram MR, Rogers NE. The use of low-level light for hair growth: part I. J Cosmet Laser Ther. 2009;11(2):110-117.
- Kim H, Choi JW, Kim JY, Shin JW, Lee SJ, Huh CH. Low-level light therapy for androgenetic alopecia: a 24-week, randomized, double-blind, sham device-controlled multicenter trial. Dermatol Surg. 2013;39(8):1177-1183.
- Yoon JS, Ku WY, Lee JH, Ahn HC. Low-level light therapy using a helmet-type device for the treatment of androgenetic alopecia: A 16-week, multicenter, randomized, double-blind, sham device-controlled trial. Medicine (Baltimore). 2020;99(29):e21181.
- van Zuuren EJ, Fedorowicz Z, Schoones J. Interventions for female pattern hair loss. Cochrane Database Syst Rev. 2016;2016(5):CD007628.
- Gupta AK, Carviel JL. Meta-analysis of photobiomodulation for the treatment of androgenetic alopecia. J Dermatolog Treat. 2021;32(6):643-647.
Motion graphics by Avo Media
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Do Low-Level Laser Therapy Devices Work for Hair Loss?
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Content URLDoctor's Note
Check out some of my other videos on hair loss and growth:
- Supplements for Hair Growth
- Pills for Hair Growth
- Food for Hair Growth
- Caffeine Shampoo and Rosemary Oil for Hair Growth
For more on preserving your hair, check out my book How Not to Age from your local public library, or listen to me read it on audiobook. (All proceeds I receive from the sales of all my books go to charity.)
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