Low-level laser (light) therapy (LLLT) for treatment of hair loss

Comparative efficacy of minoxidil alone versus minoxidil combined with low-level laser therapy in the treatment of androgenic alopecia: a systematic review and meta-analysis

OBJECTIVE

This systematic review evaluates the efficacy of minoxidil alone versus minoxidil with low-level laser therapy (LLLT) for androgenic alopecia.

STUDY DESIGN

systematic review and meta-analysis.

METHODS

An online search of PubMed, Web of Science, and MEDLINE was conducted. Randomized clinical trials comparing minoxidil monotherapy with minoxidil and LLLT combination therapy were included based on predefined criteria. The Risk of Bias 2.0 (RoB 2.0) tool was used for quality assessment.

RESULTS

From 38 identified studies, 34 remained after excluding 4 duplicates. Further exclusions left 4 eligible studies comparing minoxidil alone with minoxidil and LLLT. The meta-analysis found no statistically significant differences in hair counts between the two groups at baseline, 12 weeks, and 8 weeks post-treatment [mean difference = -0.04, 95% CI -1.22 to 1.14, p = .95, I² = 0%]. Similarly, hair diameter showed no significant differences at the same time points [mean difference = 0.00, 95% CI -0.00 to 0.00, p = .98, I² = 38%].

CONCLUSION

The combination of minoxidil and LLLT does not significantly improve outcomes compared to minoxidil alone for treating androgenic alopecia.

Flexible, surface-lighting MicroLED skin patch for multiple human skincare

As the global population ages, concerns regarding aesthetic appearance have increased. Wearable light-emitting diode (LED) devices have received significant attention in the cosmetic fields due to their non-invasive, non-thermal, home-use characteristics. However, conventional bulk LED chips have limitations in flexibility and uniform irradiation, hindering efficient light penetration into the skin. Here, we introduce a flexible, surface-lighting microLED (FSLED) patch with uniform light-emission for various skincare applications. The FSLED was fabricated using a pick-and-place transfer technique, which allows for high-density irradiation over the large area, while maintaining outstanding mechanical flexibility. In addition, the FSLED was designed to deliver light efficiently and emit light evenly by conforming to the skin. Finally, we prove the effect of the FSLED for pore tightening and skin rejuvenation through clinical trials.

Hyperbranched polymer dots enhance hair follicle regeneration via Wnt/β-catenin activation: A drug-free nanozyme-based approach to hair growth therapy

BACKGROUND

Hair loss affects millions worldwide, yet current pharmacological treatments remain limited in efficacy and long-term sustainability. The Wnt/β-catenin pathway plays a crucial role in hair follicle regeneration, providing a promising target for novel therapeutic interventions.

METHODS

This study investigates the potential of Hyperbranched Polymer Dots (HPD) as a novel nanotherapeutic for hair follicle regeneration. Using a C57BL/6 mouse model, we assessed the effects of topically applied HPD on hair growth, follicular proliferation, and key molecular markers of follicular activation. Optical coherence tomography (OCT), histological analysis, and immunofluorescence staining for Ki67 and β-catenin were performed to evaluate follicular activity at multiple time points.

RESULTS

HPD treatment significantly accelerated hair regrowth (p < 0.05) and enhanced follicular density compared to minoxidil-treated controls. Immunofluorescence analysis revealed upregulation of Ki67 and β-catenin, indicating enhanced follicular stem cell proliferation and activation of the Wnt/β-catenin pathway. Furthermore, HPD-treated mice exhibited increased melanin deposition, suggesting early follicular entry into the anagen phase.

CONCLUSION

Our findings demonstrate that HPD serves as a potent activator of hair follicle regeneration, surpassing the efficacy of conventional minoxidil treatment. By modulating Wnt/β-catenin signaling and enhancing follicular proliferation, HPD presents a promising nanomedicine-based approach for non-invasive hair restoration therapies. Future studies should focus on optimizing HPD formulations for clinical translation in treating androgenetic alopecia and related hair disorders.

Clinical Trial Comparing Three Wavelengths in Photobiomodulation Therapy for Hair Loss

Background: Commercial lasers and light combs have limitations such as restricted wavelengths, inconsistent energy delivery, and variable results. While photobiomodulation therapy (PBMT) at 650 nm has been extensively studied for hair growth, research on PBMT at 1550 nm and 14,000 nm (far infrared radiation, FIR) remains limited. Objective: This study aims to evaluate and compare the effectiveness of PBMT, including 650 nm, 1550 nm, and 14,000 nm, in promoting hair growth and improving scalp health. Method: A controlled study with 68 participants (18-60 years old) assigned them to either PBMT 650 nm, 1550 nm, 14,000 nm, or a control group. Treatment lasts 3 months, with maintenance treatments every 4-6 weeks for up to 9 months. Hair density, scalp condition, and loss were assessed at baseline 3, 6, and 9 months. Results: PBMT at 650 nm, 1550 nm, and 14,000 all improved hair growth over 9 months. Hair density increased in the PBMT groups (100→114 hairs/cm2, 99→115 hairs/cm2, and 101→107 hairs/cm2), while the control group declined (100→98 hairs/cm2). Among the 68 participants, 42 had oily scalps initially. This condition improved in all treatment groups, with oily scalp cases nearly halved in each treatment group. Conclusion: PBMT (650 nm, 1550 nm, and 14,000 nm) effectively promotes hair growth and reduces hair loss. Further research is needed to refine protocols, explore combinations, and extend follow-up periods.

Alterations in scalp microorganisms after Er: YAG laser treatment for Shanghai androgenetic alopecia patients

Androgenetic alopecia (AGA) is associated with the scalp microbiota, but the role of microflora during hair loss has not been fully characterized. Erbium: yttrium aluminum garnet (Er: Yag) is a microablative laser treatment for hair regeneration that can cause minimal damage to the skin surface. This investigation aimed to evaluate the effects of microtrauma caused by the Er: Yag laser of AGA on scalp microorganisms. Thirteen AGA patients in this study received Er: Yag laser treatment (3.3 Hz frequency and 7.00 J/cm2 pulse fluence). Scanning electron microscope (SEM) was used to observe the scalp bacteria. Before treatment, microflora samples were collected 2 hours and 48 hours after shampooing. Samples were also collected on the third, seventh, and fourteenth days following laser treatment. Scalp microorganisms coding the 16S ribosomal RNA V3/V4 region were analysed by high-throughput DNA sequencing. Globular bacteria were detected through the SEM images on the epidermis at the junction of the hair shaft and hair follicle. The results of the 16S sequencing revealed that the most abundant genera observed across all samples prior to laser treatment were Cutibacterium species (spp.) (53%) and Staphylococcus spp. (13%) in 13 AGA patients. Three days after laser treatment, Firmicutes, Staphylococcus spp., and Staphylococcus capitis were significantly more abundant at the phylum, genus, and species levels than before, respectively. These data suggest that the presence of Staphylococcus spp. significantly increased after microtrauma caused by Er: Yag laser treatment, indicating that the Er: Yag laser might play an essential role in modulating and restoring the balance of scalp microbiota.

Enhanced Hair Regrowth Through Dual-Wavelength Low-Level Laser Therapy: A Comparative Study on Mice

Low-level laser therapy (LLLT) is a non-invasive treatment that uses low-power lasers or light sources to stimulate biological responses. Previous studies focused on single-wavelength effects on hair growth in mice. In this study, we investigated dual-wavelength combinations to enhance hair regrowth. Using light-emitting diodes (LEDs) at 670, 680, 780, and 880 nm, we assessed the correlation between different wavelength pairs and hair regrowth after shaving in mice. Phototherapy was conducted over 14 days, with results analyzed through surface image analysis and histological examination. Our findings indicate that dual-wavelength therapy is superior to single-wavelength treatment and significantly more effective than the untreated control, demonstrating its potential for improved hair regrowth.

Human-Centric, Three Dimensional Micro Light-Emitting Diodes for Cosmetic and Medical Phototherapy

Phototherapy based on micro light-emitting diodes (µLEDs) has gained enormous attention in the medical field as a patient-friendly therapeutic method due to its advantages of minimal invasiveness, fewer side effects, and versatile device form factors with high stability in biological environment. Effective cosmetic and medical phototherapy depends on deep light penetration, precise irradiation, and simultaneous multi-site stimulation, facilitated by three-dimensional (3D) optoelectronics specifically designed for complex human matters, defined here as 3D µLEDs. This perspective article aims to present the functionalities and strategies of 3D µLEDs for human-centric phototherapy. This study investigates the effectiveness of phototherapy enabled by three key functionalities such as shape morphing, self-adaptation, and multilayered spatiotemporal mapping of 3D µLEDs. Finally, this article provides future insights of 3D µLEDs for human-centric phototherapy applications.

Lasers for treatment of androgenetic alopecia: an in-depth analysis

With recent developments in laser technologies and growing demand for alternative treatments, laser therapy has been increasingly studied as a treatment for androgenetic alopecia (AGA). Low-level laser therapy (LLLT) and fractional laser therapies have been marketed as safe and effective options for treating AGA in comparison with traditional drug therapies, which are associated with unwanted side effects. We discuss the history of development and implementation of laser devices for treatment of hair loss and outline the proposed mechanism of action for LLLT and fractional lasers. Additionally, we summarize the evidence of efficacy for LLLT and fractional laser monotherapies in the treatment of AGA and assess potential risk of bias in available clinical studies. While evidence is still mounting, there exists some congruency in proposed mechanisms for the stimulation of hair follicles by laser therapy. Laser light is believed to foster a supportive microenvironment for the hair follicle, through improved vascularization and modulation of inflammation, and directly stimulate growth signaling in the follicle. As for evidence of clinical efficacy, studies of LLLT and fractional laser monotherapies have reported improvement in AGA markers from baseline values. However, these studies have a relatively small sample size and our risk of bias assessment suggests some concerns in procedural design. Although laser therapy represents a safe alternative treatment option for AGA, its evidence of efficacy is hindered by a lack of large-scale, high-quality clinical trials, susceptibility to bias, and a wide range of devices, treatment protocols and parameters.

Exploring the potential of the emerging 675 nm laser across diverse skin pathologies: a comprehensive review

BACKGROUND

Low-level laser therapy (LLLT) at 675 nm, within the red light spectrum, has emerged as a noninvasive therapeutic option for various dermatological conditions, including aging-related skin changes, melasma, acne vulgaris, and striae distensae.

AIMS

This review aims to elucidate the therapeutic potential of the 675 nm laser in dermatology by synthesizing existing research evidence and clinical outcomes.

METHODS

A literature search was conducted on PubMed to include studies investigating the efficacy of the 675 nm laser in diverse dermatological conditions. Parameters such as treatment protocols, patient demographics, and outcome measures were analyzed to assess the laser's therapeutic associations. The literature search composed of clinical trials or review articles. Studies were additionally identified by searching reference lists of included articles. Only articles in English were utilized for this review.

RESULTS

The 675 nm laser demonstrates efficacy in addressing aging-related skin changes, including facial rejuvenation and wrinkle reduction, with significant improvement observed in skin texture and collagen remodeling. Additionally, the laser exhibits promising outcomes in treating melasma and hyperpigmentation disorders, acne vulgaris, and striae distensae, offering selective damage to target tissues with minimal adverse effects.

CONCLUSIONS

The 675 nm laser presents a versatile and innovative therapeutic option in dermatology, offering noninvasive treatment modalities for various health and cosmetic concerns. Further research and clinical trials are warranted to optimize treatment protocols and fully elucidate its therapeutic potential in diverse patient populations.

Dual Wavelength LEDs Induce Reactive Oxygen Species and Nitric Oxide That Inhibit the Production of Dihydrotestosterone by 5-α Reductase

Androgenetic alopecia (AGA) causes balding in approximately 50% of adults. One primary cause of AGA is synthesis of dihydrotestosterone from testosterone by 5-α reductase. Systemic pharmaceutical interventions have potentially serious side effects, necessitating development of localized interventions. One such approach is administration of red light via low level light therapy (LLLT), which has promising clinical data. However, the LLLT mechanism of action remains unclear. We investigated the ability of LLLT to stimulate nitric oxide (NO) and the role of NO in inhibition of DHT synthesis. Our results show that red and red-orange light induce NO release in a cell-free platform. In A549 and HEK293T cells, we demonstrate 620 and 660 nm LED-emitted light stimulates the production of NO, reactive oxygen species (ROS), and decreases DHT synthesis. These results provide a plausible mechanism of action for LLLT employing LED-emitted red and red-orange wavelengths of light to treat AGA.

Impact of short and long-term application of low-level laser therapy on mandibular alveolar process of osteoporotic rats - a Histological and Molecular Study

This study aims to investigate and compare the effects of short and long-term application of low-level laser therapy on the mandibular alveolar process of osteoporotic rats. Forty adult male albino rats were included in this study. After animal grouping, the experimental group received dexamethasone (0.1 mg/kg b.wt./day for 60 days) for the induction of osteoporosis, then the rats were treated using LLLT (830 nm, 100 mW, at 60 J/cm2). The lower jaw specimens were collected and processed for histological, molecular, and histomorphometric assessments. The osteoporotic group exhibited alveolar bone resorption, accompanied by significantly upregulated RANKL and downregulated OPG mRNA expression. The short-term application of laser group showed alveolar bone partial improvement with slightly downregulated RANKL and slightly upregulated OPG levels. The long-term application of laser group showed dramatic positive changes in the alveolar bone, with markedly downregulated RANKL and upregulated OPG levels. LLLT shows potential as a low-risk and impactful local management for osteoporosis, with long-term laser application demonstrably improving bone quality, quantity, and organization compared to short-term application.

Combination Therapy With CGF and Microneedling-Assisted Compound Betamethasone for Resistant Alopecia Areata: A Pilot Study

BACKGROUND

Alopecia areata (AA), an autoimmune disorder characterized by hair loss, can be particularly difficult to manage when patients do not respond to standard therapeutic approaches such as topical or injectable corticosteroids, contact immunotherapy, and systemic treatments. In instances where these conventional therapies prove ineffective, alternative or adjunctive treatments are sought. Concentrated growth factor (CGF) and microneedling (MN)-assisted drug delivery are promising methods for the treatment of different dermatological diseases.

OBJECTIVE

This study aimed to assess the practical benefits and the safety aspects of utilizing a dual treatment approach involving CGF and MN-assisted compound betamethasone for patients suffering from resistant AA that are unresponsive to conventional medical interventions.

MATERIAL AND METHODS

This retrospective study was based on evaluations of seven patients with refractory AA treated with CGF and MN-assisted compound betamethasone from July 2021 to December 2023. The efficacy of treatment was assessed by extents of hair regrowth percentages of involved areas.

RESULTS

Among the seven enrolled patients with refractory AA, a notable outcome was observed where one patient (14.3%) achieved a regrowth of hair by over 50%, while six patients (85.7%) exhibited complete recovery without any systemic or local adverse effects. Furthermore, the difference in SALT scores between baseline, and the final visit for all patients was found to be statistically significant, substantiating the therapeutic efficacy of the intervention employed.

CONCLUSION

The present study demonstrated that the synergistic application of CGF in conjunction with MN-assisted compound betamethasone may constitute a promising and well-tolerated therapeutic modality for refractory AA, offering a potentially efficacious and safe treatment alternative.

MitoQ enhances CYP19A1 expression to stimulate WNT/β-catenin signaling pathway for promoting hair growth in androgenetic alopecia

Increased sensitivity to androgens and androgen receptors is the underlying cause of androgenetic alopecia (AGA), a hereditary disease. Our study investigated the preventive effects of MitoQ on dihydrotestosterone (DHT)-induced mitochondrial dysfunction and subsequent hair loss from three perspectives: in vivo, in vitro, and network pharmacology. A mouse model of AGA was used to assess the effectiveness of MitoQ intervention. Seventy-five drug targets and 367 disease targets were identified through network pharmacology analysis. Molecular docking analysis revealed that the androgen receptor (AR) and CYP19A1, which are key targets of MitoQ, may play a role in AGA treatment. CYP19A1 expression was downregulated in lesions from patients with AGA compared to healthy scalp tissue, while AR expression was upregulated. Cellular tests of human dermal papilla cells (DPCs) treated with MitoQ revealed that the mRNA and protein expression of AR remained unchanged, but the mRNA expression of CYP19A1 was upregulated. Our experiments also confirmed that CYP19A1 overexpression prevented DHT-induced apoptosis and upregulated the expression levels of WNT3A and β-catenin, whereas increased apoptosis levels and the downregulation of WNT3A and β-catenin due to CYP19A1 knockdown were reduced by MitoQ. We verified that MitoQ enhanced hair growth in DHT-induced hair loss model mice and reversed DHT-induced apoptosis by enhancing the expression of CYP19A1 in DPCs and that MitoQ may act by mediating the WNT/β-catenin pathway. These findings indicate that MitoQ could be a promising intervention for AGA and that CYP19A1 may serve as a valuable therapeutic target for AGA.

In vitro hair growth-promoting effects of araliadiol via the p38/PPAR-γ signaling pathway in human hair follicle stem cells and dermal papilla cells

Background

Scalp hair plays a crucial role in social communication by expressing personal appearance and self-identity. Consequently, hair loss often leads to a perception of unattractiveness, negatively impacting an individual's life and mental health. Currently, the use of Food and Drug Administration (FDA)-approved drugs for hair loss is associated with several side effects, highlighting the need for identifying new drug candidates, such as plant-derived phytochemicals, to overcome these issues.

Objective

This study investigated the hair growth-promoting effects of araliadiol, a polyacetylene compound found in plants such as Centella asiatica.

Methods

We employed an in vitro model comprising human hair follicle stem cells (HHFSCs) and human dermal papilla cells (HDPCs) to evaluate the hair growth-promoting effects of araliadiol. The proliferation-stimulating effects of araliadiol were assessed using water-soluble tetrazolium salt assay, adenosine triphosphate content assay, and crystal violet staining assay. In addition, we performed luciferase reporter assay, polymerase chain reaction analysis, cell fractionation, Western blot analysis, and enzyme-linked immunosorbent assay (ELISA) to elucidate the mechanism underlying the hair growth-inductive effects of araliadiol.

Results

Araliadiol exhibited both proliferation- and hair growth-promoting effects in HHFSCs and HDPCs. Specifically, it increased the protein expression of cyclin B1 and Ki67. In HHFSCs, it elevated the expression of hair growth-promoting factors, including CD34, vascular endothelial growth factor (VEGF), and angiopoietin-like 4. Similarly, araliadiol increased the expression of hair growth-inductive proteins such as fibroblast growth factor 7, VEGF, noggin, and insulin-like growth factor 1 in HDPCs. Subsequent Western blot analysis and ELISA using inhibitors such as GW9662 and SB202190 confirmed that these hair growth-promoting effects were dependent on the p38/PPAR-γ signaling in both HHFSCs and HDPCs.

Conclusion

Araliadiol promotes hair growth through the p38/PPAR-γ signaling pathway in human hair follicle cells. Therefore, araliadiol can be considered a novel drug candidate for the treatment of alopecia.

Chemotherapy-Induced Alopecia by Docetaxel: Prevalence, Treatment and Prevention

Docetaxel is a commonly used taxane chemotherapeutic agent in the treatment of a variety of cancers, including breast cancer, ovarian cancer, prostate cancer, non-small cell lung cancer, gastric cancer, and head and neck cancer. Docetaxel exerts its anti-cancer effects through inhibition of the cell cycle and induction of proapoptotic activity. However, docetaxel also impacts rapidly proliferating normal cells in the scalp hair follicles (HFs), rendering the HFs vulnerable to docetaxel-induced cell death and leading to chemotherapy-induced alopecia (CIA). In severe cases, docetaxel causes persistent or permanent CIA (pCIA) when hair does not grow back completely six months after chemotherapy cessation. Hair loss has severe negative impacts on patients' quality of life and may even compromise their compliance with treatment. This review discusses the notable prevalence of docetaxel-induced CIA and pCIA, as well as their prevention and management. At this moment, scalp cooling is the standard of care to prevent CIA. Treatment options to promote hair regrowth include but are not limited to minoxidil, photobiomodulation (PBMT), and platelet-rich plasma (PRP). In addition, a handful of current clinical trials are exploring additional agents to treat or prevent CIA. Research models of CIA, particularly ex vivo human scalp HF organ culture and in vivo mouse models with human scalp xenografts, will help expedite the translation of bench findings of CIA prevention and/or amelioration to the clinic.

Effectiveness of 675-nm Wavelength Laser Therapy in the Treatment of Androgenetic Alopecia Among Indian Patients: Clinical Experimental Study

BACKGROUND

Androgenetic alopecia (AGA) is the most prevalent cause of hair loss around the world.

OBJECTIVE

The purpose of this study was to evaluate the efficacy of laser stimulation with a 675-nm wavelength for the treatment of AGA in male and female Indian patients.

METHODS

A total of 20 Indian healthy patients aged 23-57 years who presented a grade of alopecia stage I to stage V underwent one single pass with a 675-nm laser to the scalp area twice a week for a total of 8 sessions, followed by once a week for 4 sessions and once in 2 weeks for 2 sessions. There are 14 laser treatments in total. Macro- and dermatoscopic images have been acquired at T0 (baseline) and T1 (4 months). The vertex, frontal, and parietal areas of the scalp were evaluated. Many parameters were analyzed including hair count and hair density of terminal; mean thickness; vellus follicles; total follicular units; units with 1 hair, 2 hairs, 3 hairs, 4 hairs, and >4 hairs; unit density; and average hair/unit.

RESULTS

The macroimages and dermatoscopic evaluations showed good improvement over the entire treated area, with a clear increase in the number of hairs and hair thickness. General parameters such as hair count and hair density showed a percentage increase of around 17%. The hair mean thickness parameters showed a significant (P<.001) percentage increase of 13.91%. Similar results were obtained for terminal and vellus hair: terminal hair count and hair density significantly (P=.04 and P=.01, respectively) increased by 17.45%, vellus hair count increased by 16.67% (P=.06), and the density of vellus hair increased by 16.61% (P=.06).

CONCLUSIONS

The study findings demonstrate that the 675-nm laser system improved AGA in Indian patients, facilitating the anagen phase and improving hair density and other positive hair parameters.

High-powered 675-nm laser: Safety and efficacy in clinical evaluation and in vitro evidence for different skin disorders

BACKGROUND

Laser technology is a viable therapeutic option for treating a number of skin pathologic conditions, including pigmented lesions, vascular lesions and acne scars.

AIM

In this work, through in vitro and clinical investigations we test the efficacy, the safety and the speed of treatment of high-powered laser system emitting a 675-nm in the management of various skin condition.

MATERIALS AND METHODS

In vitro experiments were performed irradiating adult human dermal fibroblasts cells (HDFa) with 675-nm laser for 24, 48 and 72 h with different fluences and Ki-67+ cells were counted. The confocal microscopy images of control and treated samples were acquired. Clinical skin rejuvenation/diseases treatments with 675 nm laser device were performed with different laser parameters in 11 patients with pigmented lesions, 5 patients with acne scars and 23 patients for skin rejuvenation. Data were evaluated with the validated global score using 5-point scales (GAIS) and patient's satisfaction scale.

RESULTS

The application of the high-power 675 nm laser has proven effective in stimulating cell proliferation in in vitro experiments and it led to good results for all skin pathologies. GAIS showed values between 3 and 4 points for all treated pathologies, all scores between '75%-good improvements' and '100%-excellent improvements'. The treatment time was reduced by 50% compared to the old parameters setting, resulting in a faster and good patient's satisfying technique. No serious adverse effects were recorded.

CONCLUSION

the preclinical and clinical data confirm the efficacy and safety of this high-powered 675 nm laser for several skin condition.

Hybrid hair follicle stem cell extracellular vesicles co-delivering finasteride and gold nanoparticles for androgenetic alopecia treatment

Androgenetic alopecia (AGA) is a non-fatal disease prevalent worldwide. However, mixed efficacy has been observed among different therapies for hair regrowth in AGA patients. Thus, a nano-platform with synergistic treatments based on a hybrid extracellular vesicle encapsulating gold nanoparticles (AuNPs) and finasteride (Hybrid/Au@Fi) was constructed through membrane fusion between hair follicle stem cell (HFSC)-derived extracellular vesicles and liposomes. These hybrid vesicles (HVs) not only fuel hair regrowth by providing cellular signals in extracellular vesicles, but also improve storage stability, follicle retention, and drug encapsulation efficiency (EE%) for finasteride inhibiting 5α-reductase, and nano-size AuNPs that simulate low-level laser therapy (LLLT) with similar photothermal effects in vitro. The EE% of finasteride in these HVs reached 45.33%. The dual administration of these extracellular vesicles and finasteride showed a strong synergistic effect on HFSCs in vitro. In an AGA mouse model, once-daily topical Hybrid/Au@Fi (115.07 ± 0.32 nm, -7.50 ± 1.68 mV) gel led to a faster transition of hair follicles (HFs) from the catagen to the anagen, increased hair regrowth coverage, and higher quality of regrowth hair, compared to once-daily 5% minoxidil treatment. Compared to topical minoxidil, the multifaceted synergistic therapy of Hybrid/Au@Fi through topical administration offers a new option for intractable AGA patients with low side effects.

Clinical and preclinical approach in AGA treatment: a review of current and new therapies in the regenerative field

Androgenetic alopecia (AGA) is the most prevalent type of hair loss. Its morbility is mainly psychological although an increased incidence in melanoma has also been observed in affected subjects. Current drug based therapies and physical treatments are either unsuccessful in the long term or have relevant side effects that limit their application. Therefore, a new therapeutic approach is needed to promote regenerative enhancement alternatives. These treatment options, focused on the cellular niche restoration, could be the solution to the impact of dihydrotestosterone in the hair follicle microenvironment. In this context emerging regenerative therapies such as Platelet-rich plasma or Platelet-rich fibrine as well as hair follicle stem cells and mesenchymal stem cell based therapies and their derivatives (conditioned medium CM or exoxomes) are highlighting in the evolving landscape of hair restoration. Nanotechnology is also leading the way in AGA treatment through the design of bioinks and nanobiomaterials whose structures are being configuring in a huge range of cases by means of 3D bioprinting. Due to the increasing number and the rapid creation of new advanced therapies alternatives in the AGA field, an extended review of the current state of art is needed. In addition this review provides a general insight in current and emerging AGA therapies which is intented to be a guidance for researchers highlighting the cutting edge treatments which are recently gaining ground.

Impact of Photobiomodulation on the Quality of Life of Men and Women With Androgenetic Alopecia

OBJECTIVES

Androgenetic alopecia (AGA) is the most common cause of hair loss in men and women, and it can affect the psychological and social activities of individuals, thus reducing their quality of life. Photobiomodulation (PBM) is a recent adjuvant treatment for this condition with promising results for hair regrowth. We aimed to assess the health-related quality of life of men and women with AGA before and after PBM sessions.

METHODS

This is a single-center prospective observational study conducted with 42 men and 43 women with AGA. All participants answered a sociodemographic questionnaire in an interview and individually answered the Brazilian version of Skindex-29 (self-application). After 24 PBM sessions, two 20-minute sessions per week, with 48 to 72 hours of interval between sessions, participants answered the Skindex-29 again.

RESULTS

Women had a large reduction in Skindex-29 total score after PBM (p<0.01; d=0.82) and lower scores in the emotions (p<0.01; d=0.89), psychosocial functioning (p<0.01; d=0.60), and symptoms domains (p=0.03; d=0.38). Men presented a moderate reduction in Skindex-29 total score after PBM (p<0.01; d=0.68), largely lower scores in the emotions domain (p<0.01; d=0.82) and a small reduction in the psychosocial functioning domain (p<0.01; d=0.47).

CONCLUSIONS

The use of PBM in AGA is associated with improving the quality of life of men and women. This enhancement was higher regarding emotions, the major domain affected in the AGA population. Women had larger impacts on all domains of Skindex-29 after the use of PBM.

Efficacy of probiotics in hair growth and dandruff control: A systematic review and meta-analysis

Background

Probiotics are intellectually rewarding for the discovery of their potential as a source of functional food. Investigating the economic and beauty sector dynamics, this study conducted a comprehensive review of scholarly articles to evaluate the capacity of probiotics to promote hair growth and manage dandruff.

Methods

We used the PRISMA 2020 with Embase, Pubmed, ClinicalTrials.gov, Scopus, and ICTRP databases to investigate studies till May 2023. Meta-analyses utilizing the random effects model were used with odds ratios (OR) and standardized mean differences (SMD).

Result

Meta-analysis comprised eight randomized clinical trials and preclinical studies. Hair growth analysis found a non-significant improvement in hair count (SMD = 0.32, 95 % CI -0.10 to 0.75) and a significant effect on thickness (SMD = 0.92, 95 % CI 0.47 to 1.36). In preclinical studies, probiotics significantly induced hair follicle count (SMD = 3.24, 95 % CI 0.65 to 5.82) and skin thickness (SMD = 2.32, 95 % CI 0.47 to 4.17). VEGF levels increased significantly (SMD = 2.97, 95 % CI 0.80 to 5.13), while IGF-1 showed a non-significant inducement (SMD = 0.53, 95 % CI -4.40 to 5.45). For dandruff control, two studies demonstrated non-significant improvement in adherent dandruff (OR = 1.31, 95 % CI 0.13-13.65) and a significant increase in free dandruff (OR = 5.39, 95 % CI 1.50-19.43). Hair follicle count, VEGF, IGF-1, and adherent dandruff parameters were recorded with high heterogeneity. For the systematic review, probiotics have shown potential in improving hair growth and controlling dandruff through modulation of the immune pathway and gut-hair axis. The Wnt/β-catenin pathway, IGF-1 pathway, and VEGF are key molecular pathways in regulating hair follicle growth and maintenance.

Conclusions

This review found significant aspects exemplified by the properties of probiotics related to promoting hair growth and anti-dandruff effect, which serve as a roadmap for further in-depth studies to make it into pilot scales.

Enhancement of skin rejuvenation and hair growth through novel near-infrared light emitting diode (nNIR) lighting: in vitro and in vivo study

The study aimed to explore the impact of a novel near-infrared LED (nNIR) with an extended spectrum on skin enhancement and hair growth. Various LED sources, including White and nNIRs, were compared across multiple parameters: cytotoxicity, adenosine triphosphate (ATP) synthesis, reactive oxygen species (ROS) reduction, skin thickness, collagen synthesis, collagenase expression, and hair follicle growth. Experiments were conducted on human skin cells and animal models. Cytotoxicity, ATP synthesis, and ROS reduction were evaluated in human skin cells exposed to nNIRs and Whites. LED irradiation effects were also studied on a UV-induced photoaging mouse model, analyzing skin thickness, collagen synthesis, and collagenase expression. Hair growth promotion was examined as well. Results revealed both White and nNIR were non-cytotoxic to human skin cells. nNIR enhanced ATP and collagen synthesis while reducing ROS levels, outperforming the commonly used 2chip LEDs. In the UV-induced photoaging mouse model, nNIR irradiation led to reduced skin thickness, increased collagen synthesis, and lowered collagenase expression. Additionally, nNIR irradiation stimulated hair growth, augmented skin thickness, and increased hair follicle count. In conclusion, the study highlighted positive effects of White and nNIR irradiation on skin and hair growth. However, nNIR exhibited superior outcomes compared to White. Its advancements in ATP content, collagen synthesis, collagenase inhibition, and hair growth promotion imply increased ATP synthesis activity. These findings underscore nNIR therapy's potential as an innovative and effective approach for enhancing skin and promoting hair growth.

The Frontal Fibrosing Alopecia Treatment Dilemma

Frontal fibrosing alopecia (FFA) is a type of cicatricial alopecia predominantly observed in postmenopausal women, with the incidence rising since its initial description in 1994. The exact etiopathogenesis of the disease has not been completely elucidated. FFA is characterized by an inflammatory process affecting the hair follicles of the fronto-temporal hairline, leading to its gradual recession. Eyebrows, particularly the lateral parts, may also be affected. Early diagnosis and an implementation of effective therapy to limit the inflammatory process are crucial in halting disease progression. Various treatment possibilities have been reported, including anti-inflammatory and immunosuppressive agents, as well as 5-alpha-reductase inhibitors, retinoids, and antimalarial agents. The use of phototherapy and surgical procedures has also been described. However, most available data have been obtained retrospectively, frequently consisting of descriptions of case reports or small case series, and not from randomized controlled trials. In addition, the etiopathogenesis of FFA remains unclear and its course unpredictable, occasionally being linked with spontaneous stabilization. Hence, no precise guidelines exist regarding treatment modalities. Therefore, the aims of this study were to provide a comprehensive review of the efficacy of existing therapeutic modalities for FFA and to highlight novel therapeutic options.

Gynostemma pentaphyllum Hydrodistillate and Its Major Component Damulin B Promote Hair Growth-Inducing Properties In Vivo and In Vitro via the Wnt/β-Catenin Pathway in Dermal Papilla Cells

Alopecia, a prevalent yet challenging condition with limited FDA-approved treatments which is accompanied by notable side effects, necessitates the exploration of natural alternatives. This study elucidated the hair growth properties of Gynostemma pentaphyllum leaf hydrodistillate (GPHD) both in vitro and in vivo. Furthermore, damulin B, a major component of GPHD, demonstrated hair growth-promoting properties in vitro. Beyond its established anti-diabetic, anti-obesity, and anti-inflammatory attributes, GPHD exhibited hair growth induction in mice parallel to minoxidil. Moreover, it upregulated the expression of autocrine factors associated with hair growth, including VEGF, IGF-1, KGF, and HGF. Biochemical assays revealed that minoxidil, GPHD, and damulin B induced hair growth via the Wnt/β-catenin pathway through AKT signaling, aligning with in vivo experiments demonstrating improved expression of growth factors. These findings suggest that GPHD and damulin B contribute to the hair growth-inducing properties of dermal papilla cells through the AKT/β-catenin signaling pathway.

Deciphering the molecular mechanisms of stem cell dynamics in hair follicle regeneration

Hair follicles, which are connected to sebaceous glands in the skin, undergo cyclic periods of regeneration, degeneration, and rest throughout adult life in mammals. The crucial function of hair follicle stem cells is to maintain these hair growth cycles. Another vital aspect is the activity of melanocyte stem cells, which differentiate into melanin-producing melanocytes, contributing to skin and hair pigmentation. Sebaceous gland stem cells also have a pivotal role in maintaining the skin barrier by regenerating mature sebocytes. These stem cells are maintained in a specialized microenvironment or niche and are regulated by internal and external signals, determining their dynamic behaviors in homeostasis and hair follicle regeneration. The activity of these stem cells is tightly controlled by various factors secreted by the niche components around the hair follicles, as well as immune-mediated damage signals, aging, metabolic status, and stress. In this study, we review these diverse stem cell regulatory and related molecular mechanisms of hair regeneration and disease conditions. Molecular insights would provide new perspectives on the disease mechanisms as well as hair and skin disorder treatment.

The effect of a helmet type, home-use low-level light therapy device for chemotherapy-induced alopecia: study protocol for a randomized controlled trial

BACKGROUND

Alopecia is one of the most common adverse effects of chemotherapy. It reduces the patient's self-esteem and quality of life and the effect of therapy. Scalp cooling is the only verified current method for prevention but success is not guaranteed, particularly after receiving anthracycline-based combinations. Low-level light therapy has been clinically proven to inhibit the progress of androgenic alopecia. A previous study using human subjects shows limited benefits for low-level light therapy for patients who suffer chemotherapy-induced alopecia but an increase in the number of probes and the optimization of light sources may improve the efficacy. This study determines the efficacy of low-level light therapy for the prevention of chemotherapy-induced hair loss for patients with breast cancer using a randomized controlled trial.

METHODS

One hundred six eligible breast cancer patients were randomly distributed into a low-level light therapy group and a control group, after receiving chemotherapy. Subjects in the low-level light therapy group received 12 courses of intervention within 4 weeks. Subjects in the control group received no intervention but were closely monitored. The primary outcome is measured as the difference in the hair count in a target area between the baseline and at the end of week 4, as measured using a phototrichogram (Sentra scalp analyzer). The secondary outcomes include the change in hair count at the end of week 1, week 2, and week 3 and hair width at the end of week 1, week 2, week 3, and week 4, as measured using a phototrichogram, and the change in distress, the quality of life, and self-esteem due to chemotherapy-induced alopecia, at the end of week 4, as measured using a questionnaire.

DISCUSSION

This study improves cancer patients' quality of life and provides clinical evidence.

TRIAL REGISTRATION

Registered at ClinicalTrials.gov- NCT05397457 on 1 June 2022.

Nanotechnology-based techniques for hair follicle regeneration

The hair follicle (HF) is a multicellular complex structure of the skin that contains a reservoir of multipotent stem cells. Traditional hair repair methods such as drug therapies, hair transplantation, and stem cell therapy have limitations. Advances in nanotechnology offer new approaches for HF regeneration, including controlled drug release and HF-specific targeting. Until recently, embryogenesis was thought to be the only mechanism for forming hair follicles. However, in recent years, the phenomenon of wound-induced hair neogenesis (WIHN) or de novo HF regeneration has gained attention as it can occur under certain conditions in wound beds. This review covers HF-specific targeting strategies, with particular emphasis on currently used nanotechnology-based strategies for both hair loss-related diseases and HF regeneration. HF regeneration is discussed in several modalities: modulation of the hair cycle, stimulation of progenitor cells and signaling pathways, tissue engineering, WIHN, and gene therapy. The HF has been identified as an ideal target for nanotechnology-based strategies for hair regeneration. However, some regulatory challenges may delay the development of HF regeneration nanotechnology based-strategies, which will be lastly discussed.

Effects of photobiomodulation at various irradiances on normal and dihydrotestosterone-treated human hair dermal papilla cells in vitro

Androgenetic alopecia (AGA) is the most common type of hair loss caused by dihydrotestosterone (DHT) binding to androgen receptors in dermal papilla cells (DPCs). Photobiomodulation (PBM) is a promising treatment for AGA but suffers from inconsistent outcomes and inconsistent effective light parameters. This study investigated the impact of red light at various irradiances on normal and DHT-treated DPCs. Our results suggested that red light at 8 mW/cm2 was most effective in promoting DPCs growth. Furthermore, a range of irradiances from 2 to 64 mW/cm2 modulated key signaling pathways, including Wnt, FGF, and TGF, in normal and DHT-treated DPCs. Interestingly, 8 mW/cm2 had a greater impact on these pathways in DHT-treated DPCs and altered the Shh pathway, suggesting that the effect of PBM varies with the cellular environment. This study highlights specific factors that influence PBM effectiveness and provides insight into the need for personalized PBM treatment approaches.

The Mechanisms and Efficacy of Photobiomodulation Therapy for Arthritis: A Comprehensive Review

Rheumatoid arthritis (RA) and osteoarthritis (OA) have a significant impact on the quality of life of patients around the world, causing significant pain and disability. Furthermore, the drugs used to treat these conditions frequently have side effects that add to the patient's burden. Photobiomodulation (PBM) has emerged as a promising treatment approach in recent years. PBM effectively reduces inflammation by utilizing near-infrared light emitted by lasers or LEDs. In contrast to photothermal effects, PBM causes a photobiological response in cells, which regulates their functional response to light and reduces inflammation. PBM's anti-inflammatory properties and beneficial effects in arthritis treatment have been reported in numerous studies, including animal experiments and clinical trials. PBM's effectiveness in arthritis treatment has been extensively researched in arthritis-specific cells. Despite the positive results of PBM treatment, questions about specific parameters such as wavelength, dose, power density, irradiation time, and treatment site remain. The goal of this comprehensive review is to systematically summarize the mechanisms of PBM in arthritis treatment, the development of animal arthritis models, and the anti-inflammatory and joint function recovery effects seen in these models. The review also goes over the evaluation methods used in clinical trials. Overall, this review provides valuable insights for researchers investigating PBM treatment for arthritis, providing important references for parameters, model techniques, and evaluation methods in future studies.

Photobiomodulation With a Continuous Wave Red Laser (660 nm) as Monotherapy for Adult Alopecia Areata: A Case Presentation

Introduction: Alopecia areata (AA) is an autoimmune, inflammatory, non-scarring hair loss in which T-cells target hair follicles. Given that the available therapeutic options generally do not induce and sustain remission of AA effectively and many adverse effects may occur, monochromatic light sources have been recently gaining attention from clinicians. Therefore, the present paper aimed to report the first case in which photobiomodulation therapy (PBMT) with a continuous wave red laser (660 nm) was used as monotherapy for AA. Case Presentation: An isolated round area of complete hair loss was subjected to daily PBMT sessions, resulting in significant regrowth (hair of normal coloration and thickness) within 7 days. On the 21st day, the patient's aesthetic concern was completely resolved. Conclusion: PBMT with a continuous wave red laser seems to be a promising therapeutic option for the treatment of AA; however, additional studies are necessary to obtain more robust evidence.

Treatment of Androgenetic Alopecia: Current Guidance and Unmet Needs

Androgenetic alopecia (AGA) is the most common cause of hair loss in men and women. Traditionally, topical minoxidil and oral finasteride have been the standard of care yielding mixed results. New treatments such as Low-Level Laser Therapy (LLLT), microneedling, platelet-rich plasma (PRP), and others have been extensively studied in the literature, and the purpose of this review is to provide a comprehensive discussion of the latest treatment methods and their efficacy in treating AGA. Novel therapies such as oral minoxidil, topical finasteride, topical spironolactone, botulinum toxin, and stem cell therapy offer interesting alternatives to standard of care therapies for patients. In this review, we present data from recent studies on the clinical efficacy of these treatments. Furthermore, as new treatments have emerged, clinicians have tested combination therapies to assess whether there may be a synergistic relationship between multiple modalities. While there has been a great increase in the treatments available for AGA, the quality of evidence varies greatly and there is still a great need for randomized double blinded clinical trials to adequately assess the clinical efficacy of some treatments. While PRP and LLLT have demonstrated encouraging results, standardized treatment protocols are needed to adequately inform clinicians on how to use such therapies. Given the abundance of new therapeutic options, clinicians and patients must weigh the benefits and risks of each treatment option for AGA.

The bactericidal effects of 632.8 nm He-Ne laser on Staphylococcus aureus colonies

The bactericidal effect of 632.8 nm low level laser has been studied in order to point out both the effective power and laser exposure time on Staphylococcus aureus, which is reported to be involved in several dermatology problems. Low level laser has been reported to be useful for infected wounds, tissue necrosis, nerve injury, osteoarthritis or other chronic pain syndromes. Numerous studies have been conducted to quantify the effective laser parameters, i.e. dose, power, and exposure time, which ultimately leads toward clinical implementation. Staphylococcus aureus bacteria colonies were exposed to laser doses with powers of both 1 and 3 mW at different exposure times varies between 3 to 30 minutes. The bacterial colonies were isolated from a patient with inflamed wounds. Two sets of bacterial colonies were prepared to be exposed to laser beam. Next, the bacterial colonies were compared before and after exposing them to laser doses. The results showed that laser sessions have reduced the number of the bacterial colonies for both doses; 1 and 3 mw at the different exposure times and concentrations. The results revealed significant dose dependent bactericidal effects of He-Ne laser on Staphylococcus aureus at 3 mW for 30 minutes, which was found to be more effective in reducing the amount of bacteria to the less than 2% of its initial count. The results exhibited the reduction of the number of colonies as a function of exposure time. Appropriate doses of 632.8 nm can kill Staphylococcus aureus, suggesting that a similar effect may be used in clinical cases of bacterial infection.

Combination and Rotational Therapy in Androgenetic Alopecia

Management of androgenetic alopecia is a challenge because of its long course, need for continuous treatment, and potential adverse effects of the therapies. In order to enhance efficacy, minimize side effects, and ensure patient compliance, the authors propose a scheme for using combination treatments with a rotational scheme, based on current evidence for efficacy, pharmacokinetic properties, convenience of administration over long term, side effect profile, and patient acceptance.

Prevention and Treatment of Chemotherapy-Induced Alopecia: What Is Available and What Is Coming?

Millions of new cancer patients receive chemotherapy each year. In addition to killing cancer cells, chemotherapy is likely to damage rapidly proliferating healthy cells, including the hair follicle keratinocytes. Chemotherapy causes substantial thinning or loss of hair, termed chemotherapy-induced alopecia (CIA), in approximately 65% of patients. CIA is often ranked as one of the most distressing adverse effects of chemotherapy, but interventional options have been limited. To date, only scalp cooling has been cleared by the US Food and Drug Administration (FDA) to prevent CIA. However, several factors, including the high costs not always covered by insurance, preclude its broader use. Here we review the current options for CIA prevention and treatment and discuss new approaches being tested. CIA interventions include scalp cooling systems (both non-portable and portable) and topical agents to prevent hair loss, versus topical and oral minoxidil, photobiomodulation therapy (PBMT), and platelet-rich plasma (PRP) injections, among others, to stimulate hair regrowth after hair loss. Evidence-based studies are needed to develop and validate methods to prevent hair loss and/or accelerate hair regrowth in cancer patients receiving chemotherapy, which could significantly improve cancer patients’ quality of life and may help improve compliance and consequently the outcome of cancer treatment.

The efficacy and safety of the combination of photobiomodulation therapy and pulsed electromagnetic field therapy on androgenetic alopecia

BACKGROUND

Photobiomodulation therapy (PBMT) appears to be safe and effective for hair loss. Pulsed electromagnetic field therapy (PEMF) also has a positive biological effect on hair re-growth.

OBJECTIVES

We evaluated the efficacy and safety of both PBMT and PEMF for the treatment of androgenetic alopecia (AGA).

MATERIALS AND METHODS

This study was a 24-week, randomized, double-blind, sham device-controlled trial. We recruited 80 subjects with androgenetic alopecia. The subjects got treatment every week for the 1st 12 weeks, every other week for the next 8 weeks. PBMT entails 15-min therapy, and PEMF was carried out for 10 min.

RESULTS

The baseline hair density was 114.57 (±28.75)/cm² and 113.31 (±30.07)/cm² in both treatment and control groups. After 24 weeks of treatment, the mean hair density increased to 139.37 (±31.4)/cm² in the treatment group but only to 119.78 (±31.92)/cm² in the control group. The difference between two groups was statistically significant (p < 0.05). Based on the global assessment of independent experts, the score was 0.41 (±0.62) in the treatment group and 0.07 (±0.45) in the control group. Only very mild erythema or irritation was reported, and no serious adverse reactions were reported.

CONCLUSIONS

A combination of PBMT and PEMF is a valid and safe treatment option for AGA.

Low-Level Light Therapy and Minoxidil Combination Treatment in Androgenetic Alopecia: A Review of the Literature

Introduction

We analyzed randomized clinical trials (RCTs) evaluating the efficacy of combined therapy with low-level light therapy (LLLT) and topical minoxidil for treatment of androgenetic alopecia (AGA).

Methods

A literature search within PubMed identified RCTs evaluating hair regrowth following LLLT and minoxidil. Selection criteria were 600-1,100 nm wavelengths, treatment time ≥16 weeks, and objective evaluation for hair regrowth.

Results

Five RCTs compared LLLT with minoxidil (2% or 5%) to 5% minoxidil treatment or LLLT treatment. One study showed combination therapy of LLLT, and 5% minoxidil improved hair density more than monotherapy. Another found combination LLLT with 2% minoxidil induced hair regrowth equivalent to 5% minoxidil. Similarly, another study described LLLT with 5% minoxidil versus minoxidil monotherapy to increase the number of hairs with no statistical difference between groups. One trial found that combination group increased hair regrowth in the first 2 months. The last study found a statistically significant increase in hair density with combined therapy compared to monotherapy.

Conclusion

The studies describe either superiority or equivalence of combination therapy to minoxidil monotherapy for AGA. Early outcomes appear to support the superiority of combination therapy, but this advantage wanes at the end of the study periods.

Integrative and Mechanistic Approach to the Hair Growth Cycle and Hair Loss

The hair cycle is composed of four primary phases: anagen, catagen, telogen, and exogen. Anagen is a highly mitotic phase characterized by the production of a hair shaft from the hair follicle, whereas catagen and telogen describe regression and the resting phase of the follicle, respectively, ultimately resulting in hair shedding. While 9% of hair follicles reside in telogen at any time, a variety of factors promote anagen to telogen transition, including inflammation, hormones, stress, nutritional deficiency, poor sleep quality, and cellular division inhibiting medication. Conversely, increased blood flow, direct stimulation of the hair follicle, and growth factors promote telogen to anagen transition and subsequent hair growth. This review seeks to comprehensively describe the hair cycle, anagen and telogen balance, factors that promote anagen to telogen transition and vice versa, and the clinical utility of a variety of lab testing and evaluations. Ultimately, a variety of factors impact the hair cycle, necessitating a holistic approach to hair loss.

Can transcranial photobiomodulation improve cognitive function? A systematic review of human studies

BACKGROUND

Transcranial photobiomodulation (tPBM) has been studied for over a decade as a possible cognitive intervention.

OBJECTIVE

To evaluate the effect of tPBM for enhancing human cognitive function in healthy adults and remediating impaired cognitive function in adults with cognitive disorders.

METHODS

A systematic literature search from three electronic databases (PubMed, Scopus, Web of Science) was conducted from 1987 to May 2022. The cognitive function being evaluated included learning and memory, attention, executive function, language, and global cognitive function.

RESULTS

Of the 35 studies identified, 29 (82.9 %) studies reported positive improvement in cognitive functions after tPBM. All nine studies on participants with subjective memory complaints, mild cognitive impairment, and dementia, showed positive outcomes. Seven (87.5 %) studies on traumatic brain injury (TBI) patients also showed positive results. A series of clinical trials on stroke patients showed positive trends on improved neurological deficit at first, but was prematurely terminated later at phase III due to the lack of statistical significance. One of the most common protocols for clinical populations employed devices delivering near-infrared light (810 nm), the irradiance of 20-25 mW/cm², and fluence of 1-10 J/cm². While this was common, the reviewed protocols also included other wavelengths of light ranging from visible, red (630-635 nm) to invisible near-infrared maximum wavelengths of 1060-1068 nm.

CONCLUSIONS

tPBM seems to improve cognitive function. However, only half of the reviewed clinical trials were randomized control trials, further investigation is warranted.

[Alopecia and COVID-19: possible etiopathogenetic variants and therapeutic approach]

Sudden hair thinning, phantom trichalgia in the early and late rehabilitation period after novel coronavirus infection (COVID-19) are the most common complaints of patients, that can be considered by both dermatocosmetologist and medical rehabilitation specialist. A telogen hair loss was found in 19.8% of patients, whereby 27.3% of patients suffering from hair loss during disease and 72.7% - at 3rd-6th month after recovery. Most commonly, hair loss is non-structural and associated with an abnormal ovulatory cycle shift and diffuse asynchronous loss of hair follicles in telogen phase, as well as with an increase of total predisposed to loss hair follicles number. Nevertheless, the analysis of clinical observations of patients with post-COVID hair loss has shown that this disorder is registered not only in telogen phase. There is a rapid disease progression up to the final stages in the presence of verified androgenetic alopecia diagnosis. The cases of alopecia areata and cicatricial alopecia, associated with previous COVID-19, also were registered. Androgenetic alopecia is the first (30.7%) and diffuse alopecia is the second (19.8%) by degree of incidence. The relapses or much less frequently the onsets of alopecia areata and the unexplained pronounced pain at the hair roots in parietal region (7.8%) are in the third place. The article presents in detail the possible reasons and mechanisms of hair loss associated with COVID-19, determines necessary examinations with consideration to the scientific analysis of domestic and foreign literature sources.

Efficacy of Low-Level Laser Therapy in Androgenetic Alopecia - A Randomized Controlled Trial

Background

Androgenetic alopecia (AGA) is caused by the susceptibility of hair follicles to androgenic miniaturization, which leads to hair loss. The most common modalities for the treatment of AGA include the use of topical minoxidil and oral finasteride. Low-level laser therapy (LLLT) is a newer modality of treatment for AGA. We tried to evaluate the added benefit of LLLT in AGA compared with topical minoxidil 5% alone.

Aim

The aim of this study was to compare the efficacy of LLLT combined with topical 5% minoxidil in AGA versus topical 5% minoxidil used alone.

Materials and Methods

After ethics committee approval, 54 patients of AGA were randomly divided into two groups. Group A participants received LLLT therapy twice a week plus topical 5% minoxidil and Group B participants received only minoxidil 5% solution. Both the groups were followed up for 16 weeks and evaluated with gross photographs, TrichoScan analysis, and dermoscopy to look for any improvement in hair density.

Results

After 16 weeks, improvement in hair density of 14.78% ± 10.93% in Group A was recorded compared to 11.43% ± 6.43% in Group B. However, while comparing both means, P value was 0.45 which was not significant. The physician global assessment and patient satisfaction score revealed no significant difference between both the groups.

Conclusion

Although LLLT appears to be safe and effective in the treatment of male pattern hair loss, we did not observe any significant difference in terms of improvement in hair density between both the groups.

Enhanced hair growth effects through low-level vortex beams radiation: An experimental animal study

Photobiomodulation therapy (PBMT) is a non-invasive and pain-less treatment for hair loss. Researches on PBMT rarely considered the impact of different light structures. In this study, we irradiated shaven rats with both 650 nm, m = 32 vortex beams and ordinary Gaussian beams. The laser treatment was performed at 24-hour intervals for 20 days. The energy density was set to 4.25 J/cm² . The results indicated that low-level vortex beam irradiation led to better stimulation of hair growth than the Gaussian beams, which might be related to deeper penetration. The underlying biological mechanisms are discussed in terms of the activation of Wnt/β-catenin/sonic hedgehog pathway. Our results suggest that low-level vortex beam irradiation is advantageous to the treatment of hair loss because it is technically feasible, convenient and effective.

The efficacy of LED microneedle patch on hair growth in mice

Light penetration depth in the scalp is a key limitation of low-level light therapy for the treatment of androgenetic alopecia (AGA). A novel light emitting diode (LED) microneedle patch was designed to achieve greater efficacy by enhancing the percutaneous light delivery. The study aimed to investigate the efficacy and safety of this device on hair growth in mice. Thirty-five male C57BL/6 mice which their dorsal skin was split into upper and lower parts to receive either LED irradiation alone or LED irradiation with a microneedle patch. Red (629 nm), green (513 nm), and blue light (465 nm) at an energy dose of 0.2 J/cm² were applied once daily for 28 days. Outcomes were evaluated weekly using digital photographs. Histopathological findings were assessed using a 6 mm punch biopsy. A significant increase in hair growth was observed in the green light, moderate in the red light, and the lowest in the blue light group. The addition of the microneedle patch to LED irradiation enhanced greater and faster anagen entry in all the groups. Histopathology showed an apparent increase in the number of hair follicles, collagen bundles in the dermis, angiogenesis, and mononuclear cell infiltration after treatment with the green-light LED microneedle patches. No serious adverse effects were observed during the experiment. Our study provides evidence that the newly developed green-light LED microneedle patch caused the optimal telogen-to-anagen transition and could lead to new approaches for AGA. Microneedle stimulation may aid percutaneous light delivery to the target hair follicle stem cells.

Hair Growth Booster Effects of Micro-Needling with Low-Level Led Therapy and Growth Factors on Subjects Treated with Finasteride®

A procedure based on Microneedling (MND) with Low-Level Led Therapy (LLLT) and Growth Factors (GFs) could be a booster for hair re-growth (HRG) in patients assuming Finasteride®. The study examined the clinical outcomes of a multicentric, observational, retrospective, case-series investigation in which MND with LLLT and GFs was applied to patients suffering from androgenic alopecia (AGA) who were prescribed Finasteride®. Twenty-one patients were initially enrolled, of which seventeen males were classified in stage II–VI by the Norwood–Hamilton scale, and four females were classified in stage II–III by the Ludwig scale. One male patient was excluded after screening (exclusion and inclusion criteria evaluation). Twenty patients were analyzed, of which ten patients’ hair growth has stalled after taking Finasteride®, and ten patients did not achieve good results from Finasteride®. HRG assessment was evaluated with photography, physician’s, and patient’s global assessment scale, in addition to standardized phototrichograms during a short follow-up: T0—baseline, T1—20 weeks (wks). A statistically significant improvement in HRG (p = 0.0822) and an increase in hair density of 19 ± 2 hairs/cm2 at T1 after 20 wks (20 wks vs. 0 wks) in the targeted area over baseline (74 ± 2 hairs/cm2 at T1 versus 55 ± 2 hairs/cm2 at baseline) were reported and described as encouraging results. The effectiveness of MND with LLLT and GFs use was demonstrated in patients whose hair growth stalled after taking Finasteride® and in patients who did not achieve good results from Finasteride®.

Patient Satisfaction and Clinical Effects of Platelet-Rich Plasma on Pattern Hair Loss in Male and Female Patients

Introduction

Hair loss is a widespread condition in both genders. Over the past decade, platelet-rich plasma (PRP) has become a common treatment for hair loss. Our goal was to analyze patient satisfaction and the clinical effects of PRP on male and female pattern hair loss.

Methods

Over a period of 12 months, we treated a total of 56 patients for androgenetic alopecia with PRP. All of these patients were included in this study; 15 cc of whole blood was spun in an ACP double syringe (Arthrex Inc., Naples, Forida) for five minutes. The yielded 5 to 6 cc of PRP were then injected into the scalp. Forty-nine patients were treated with a series of three injections at monthly intervals, three patients with a series of four injections, two patients with a series of five injections, one patient was treated with a series of seven injections, and one patient with a series of eight injections. Follow-ups were conducted one month after the last treatment. A self-drawn questionnaire was used to assess the satisfaction and clinical results from the patient's and the clinician's perspectives.

Results

The average age was 41 years (20-68 years). Fifty-seven percent of all patients were male and 43% female. In total, the patients were satisfied with the treatment results. The average score was 7.29 on a scale from 0 to 10. The clinician's rating was similar (6.46). Moreover, with an average score of 8 on a scale from 0 to 10, it is very likely that the patients will recommend PRP treatments to friends. The probability of occurrence of clinical effects among the entire study population was reported as follows: improvement in hair density (patient‘s rating: 64%; clinician's rating: 46%), thickness (38%; 45%), quality (46%; 54%), sheen/lustre (27%; 21%), new hair growth (57%; 68%), less hair loss (48%; 20%), other positive effects (5%, 2%), no effects (4%; 4%), negative effects (0%; 0%).

Conclusion

Our study revealed encouraging results for the treatment of male and female pattern hair loss with PRP. The autologous treatment was rated with high satisfaction scores and can be considered a safe and effective treatment modality.

Stimulatory effects of wavelength-dependent photobiomodulation on proliferation and angiogenesis of colorectal cancer

In recent decades, the laser treatment of cancer has been introduced as a promising treatment option. Because of the maldistribution of optical energy and an ambiguous boundary between the normal and tumor tissues, laser irradiation can stimulate residual cancer cells, leading to a cancer regrowth. As photobiomodulation (PBM) is involved in an extensive range of cellular responses, profound comprehension of photo-stimulated mechanisms against the cancer cells is required to establish a safety margin for PBM. Therefore, we aimed to identify the stimulant effects of PBM at various wavelengths against the tumor cells to establish a safety margin for the laser treatment. CT26 murine colon cancer cells were exposed to either 405 (BL), 635 (VIS), or 808 (NIR) nm laser lights at the fluences of 0, 10, 30, and 50 J/cm². In addition, CT26 tumor-bearing mice were irradiated with BL, VIS, or NIR at a fluence of 30 J/cm². Both the proliferation and angiogenesis potential of the CT26 cells and tumors were evaluated using the MTT assay, western blot, and immunohistochemistry (IHC) staining analyses. Although cell viability was not statistically significant, BL significantly induced p-ERK upregulation in the CT26 cells, indicating that PBM with BL can stimulate proliferation. In vivo tests showed that the NIR group exhibited the maximum relative tumor volume, and BL yielded a slight increase compared to the control. In the IHC staining and western blot analyses, both BL and NIR increased the expression of EGFR, VEGF, MMP-9, and HIF-1α, which are related to the proliferation and angiogenesis-related factors. Further investigations will be pursued to clarify the molecular pathways that depend on the cancer cell types and laser wavelengths for the establishment of safety guidelines in clinical environments.

Single-cell transcriptome analysis of fractional CO2 laser efficiency in treating a mouse model of alopecia

OBJECTIVES

Hair loss, including alopecia, is a common dermatological issue worldwide. At present, the application of fractional carbon dioxide (CO₂ ) laser in the treatment of alopecia has been documented; however, the results vary between reports. These varying results may be due to the limited knowledge of cellular action in laser-irradiated skin. The objective of this study was to investigate the molecular and cellular mechanisms of laser treatment under effective conditions for hair cycle initiation.

METHODS

A fractional CO₂ laser was applied and optimized to initiate the hair cycle in a mouse model of alopecia. Several cellular markers were analyzed in the irradiated skin using immunofluorescence staining. Cellular populations and their comprehensive gene expression were analyzed using single-cell RNA sequencing and bioinformatics.

RESULTS

The effective irradiation condition for initiating the hair cycle was found to be 15 mJ energy/spot, which generates approximately 500 μm depth columns, but does not penetrate the dermis, only reaching approximately 1 spot/mm² . The proportion of macrophage clusters significantly increased upon irradiation, whereas the proportion of fibroblast clusters decreased. The macrophages strongly expressed C-C chemokine receptor type 2 (Ccr2), which is known to be a key signal for injury-induced hair growth.

CONCLUSIONS

We found that fractional CO₂ laser irradiation recruited Ccr2 positive macrophages, and induced hair regrowth in a mouse alopecia model. These findings may contribute to the development of stable and effective fractional laser irradiation conditions for human alopecia treatment.