Biomodulation for male-pattern baldness

Androgenetic alopecia, or also known as male-pattern baldness, is a common disorder affecting 50% of men over the age of 40 and 75% of women over the age of 65 worldwide. Baldness is a stressful experience for both sexes, but substantially more distressing for women.

Biomodulation is often offered as a possible solution to androgenetic alopecia. But, is it really effective and how does it work?

Low energy light therapy has been used for this type of treatments and various medical studies are available on the subject. The efficiency has been demonstrated repeatedly over many years.

The question now is, how does it work?

From a paper published in 2013, Low-Level Laser (Light) Therapy (LLLT) for Treatment of Hair Loss; Pinar Avci, MD, Gaurav K. Gupta, MD, PhD, et al. We learn that:

“Laser phototherapy is assumed to stimulate anagen re-entry in telogen hair follicles, prolong duration of anagen phase, increase rates of proliferation in active anagen hair follicles and to prevent premature catagen development. The exact mechanism of action of LLLT in hair growth is not known; however, several mechanisms have been proposed. Evidence suggests that LLLT acts on the mitochondria and may alter cell metabolism through photodissociation of inhibitory nitric oxide (NO) from cytochrome c oxidase (CCO) (Unit IV in the respiratory chain of mitochondria), causing increased ATP production, modulation of reactive oxygen species, and induction of transcription factors such as nuclear factor kappa B, and hypoxia-inducible factor-1. These transcription factors in return cause protein synthesis that triggers further effects down-stream, such as increased cell proliferation and migration, alteration in the levels of cytokines, growth factors and inflammatory mediators, and increased tissue oxygenation. Moreover, NO is known to be a potent vasodilator via its effect on cyclic guanine monophosphate production and it can be speculated that LLLT may cause photodissociation of NO not only from CCO but also from intracellular stores such as nitrosylated forms of both hemoglobin and myoglobin leading to vasodilation and increased blood flow which was reported in several studies. Yamazaki and coworkers observed an upregulation of hepatocyte growth factor (HGF) and HGF activator expression following irradiation of the backs of Sprague Dawley rats with linear polarized infrared laser.”

In more digestible English, it means that biomodulation extend the active growth phase and prevents premature activation of the resting phase. It is also possible to cause terminalization of vellus hairs, producing terminal hair growth.

The key here is to start treatment as early as possible when increased hair loss and thinning is noticed and keep with it over an extended period. It can take up to 3 months of regular treatment before visible results appear.

Most studies on hair growth used lasers or LED’s in the visible red spectrum ranging between 620 nm to 660 nm. Using fluence ranging between 5 mW/cm2 to 100 mW/cm2.

Treatments are usually well tolerated and are often described as relaxing. A treatment course can be started with three treatments per week and then reduced as results become visible. A continues maintenance of one treatment per week is recommended.

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