quote:

Originally posted by the B spot:
the general public is under the impression that laser therapy possesses the same level of success as finasteride/minox.

I don't think it is reasonable to expect the general public to really understand exactly what to expect from ANY type of therapy (minox, fin, transplants, laser, etc.) until they've spoken with a physician who can evaluate their current situation and goals.

It's kind of like the average guy going to the gym and thinking he's just a couple of sit-ups away from six-pack abs. His personal trainer will let him know it's going to take more than just sit-ups and that it's going to take months, not weeks. The analogy works becasue a good personal trainer (or hair doc) will help his clients (patients) set appropriate goals, realistic expectations and time-frames.

When Propecia was first approved 10 years ago, and the studies were published, most of us hair docs didn't really know exactly what to expect from the therapy. We knew it was beneficial, but by how much? Certainly, I learned what kind of reversal of miniaturization I could expect to see from prescribing it a few hundred times and following the patients' results.

Some patients surprise us by how much they respond to the non-invasive therapies, some because they don't realize how much they've responded, and some because they don't respond, period.

--Dr. B.

bezane,

Thanks for the response...

First let me say, that generally speaking, I don't disagree with you. I have not seen anything from posters over the years on this, or other forums, or even back when I was researching alternative methods 5+ years ago, state that they have had any benefit from laser therapy, whether a hand-held device or from a clinic. I have never tried it first hand, nor do intend to, especially after having 3 transplants.

You said...

quote:

I'm just miffed that this board has enough clout to make new readers believe whatever is posted on it

I can certainly understand why you are miffed especially because you were duped once into trying something that didn't work for you and wasted your money...but please understand ...this board is not MAKING new readers BELIEVE anything. All the arguments are thrown out on the table and readers make a choice as to what to believe.

I must state this: EVERYONE, including Dr. Bauman is in AGREEMENT that laser therapy is NOT a cure for hair loss. There is no false advocacy being made here from gimic companies that laser therapy will help ANYONE regrow a full head of hair. Making a statement like that is preposterous. That conversation is not happening here. The converstion that IS taking place here is whether or not laser therapy will help anyone at all regarding hair loss. But even Dr. Bauman who is stating that laser therapy has merit is stating that there are many limitations.

I'm simply stating straight out that if I have not made a full conclusion one way or the other. I tend to agree with Dr. Feller on his stand and don't actually see how lasers could do anything to stimulate any new growth, even if it is minimal. Yet on the other hand, Dr. Bauman's claim to have seen it first-hand knowing he is a respectable doctor in his field does peek my interest a bit.

If you read Dr. Bauman's posts, you can see he is not advocating it like those commercialized scam companies that promise the world and deliver nothing. BUT, he is stating that in some patients there might be some benefit. So is it possible? Maybe...maybe not.

As I said...I will not advocate laser therapy until I see evidence that it works...BUT, I will not close my eyes to REAL research.

Heck...if everyone closed their eyes to new possibilities, there will NEVER be new developments in hair loss treatment nor will there ever be a cure. So I'm not quick to scoff at reputable doctors who are making REAL efforts to understand potential treatments, no matter what they are.

Falc

Hey Falc....yeah....very reasonable. All your points valid and valuable. Just don't want anyone to think that the LASER COMB is a new product that is waiting on results. For most of us it is old news, nothing good in the way of results and some shady past practices to get in the public eye.

My final point on the matter is on to bigger and better things, alternatives and maybe just good old fashioned skilled labor.

quote:

Just don't want anyone to think that the LASER COMB is a new product that is waiting on results.

I agree...the lasercomb has been around for a long time. To be honest, IMO, I'm very uncomfortable with the fact that something that's been around for so long has only NOW just become FDA approved. JoTronic, another member of our community and employee of Hasson and Wong posted a very educational (and alarming) thread about FDA approval for medical devices. The link can be found here: http://hair-restoration-info.com/eve/forums/a/tpc/f/1466060861/m/8701040113.

Thanks for the debate

Falc

I would question the opinion of some doctors on their take on the lasers to some extent. One doctor who promotes lasers is a paid consultant and apparently charges over 1000 dollars per hour to speak with the companies etc.People should be asking how much money these docs are being paid? Is there a conflict of interest?
The fact is that the 510K approval is based on a previous device and to my knowledge no new claims were made compared to the previous device. According to Dr Walter Unger the previous device was allowed to state that it "promoted hair growth'
My understanding is that the lasers MAY be as effective as Rogaine
Low level light lasers have been shown to have some effect on wound healing but the data on hair growth is scant to some extent. At the same time I am impressed by the commitment of the Hair Max comb company to try to ascertain the possible biologic mechanism of action.I believe that Michael who own Lexington is sincere in his belief in the laser.
Hypotheses that affects on ATP seem questionable. How can 15 minutes of therapy cause a long lasting effect?. I believe that the mechanism is more likely associated with apoptosis (controlled cell death, if the lasers really work.
Also we need to be sure we are comparing apples to apples etc. Are the frequencies the same? Is the power generated the same?
We need to know if the longterm results hold up.
Studies of massage to the scalp show a TEMPORARY response in terms of hair growth.
Our approach needs to be open and scientific.

Be fair to Dr. Unger. He unequivocally states on his website that he is in no way affiliated with laser comb. And that has been on his site well before FDA approval. And has told me personally many times that it was something he considers to be unproven and lacked any significant results. They tried to use a small portion of his review in an out of context manner as though he said it worked. Very unethical.

Paul Rose presents the best perspective on this debate- and that is, we clearly have a device that has, at best, some marginal efficacy. There is no debating that it is not the cure for hair loss. Furthermore, I find there to be a paucity of photos or patient testimonials adequately proving the efficacy of what is an expensive therapy.
There is a difference, a definite difference, between minoxidil and lasers, and that is the financial incentive for proprietors- whether physicians or non-medical hair clinics- to sell this technology. I have heard too many patients report that they were sold laser therapy as an additonal $1000 plus adjuvant therapy to their hair transplant. According to a patient who consulted with me, the clinic with whom he had his hair transplant told him that the reason he did not get full growth from a hair transplant was because he did not comply with the post-procedure laser therapy regime that cost somewhere around $1000. In addition, these lasers are promoted to physicans and hair clinics as "profit centers"- making me question the motives of those who provide them to patients. I am not saying the device doesn't work- only that we need more evidence before we elevate the expectations of our patients who pay all this money.

Science commands objective analysis- which all too often is thwarted by financial incentives. Almost all reputable scientific meetings and journals require authors/presenters to reveal any financial incentive he/she has with a specific technology. This allows the listener/reader to put the information provided in perspective. This is not to accuse any doctor of being disreputable - only that it puts the entire situation in focus.

I can provide my financial relationships with companies: none.

Case closed.

Dr Epstien, can I copy your post and post it elsewhere?

This debate is going on in several forums.

Thanks,
J

Dr. Epstein,

I appreciate your take on LLLT. I, too, share a similar stance: it could work, but it is sold at a great mark-up (as it is basically a bunch of laser pointers focused on your scalp or one laser pointer and a bunch of plastic mirrors attached to a comb).

What I have said and continue to say is that I believe that LLLT COULD have some benefit, but I want a LOT more information and studies to be done and I think it is horrible to sell this unproven therapy at this kind of mark-up.

I guess I am saying that I believe all things are possible, but I will question all things.

To the doctors and board members that try to post with a polite and even tone I do commend you for your tolerance. But I also don't have the patience for hucksters. Bald is bald. You either cure it or you don't. I advocate for people to either get a top shelf transplant from one of the masters or deal with your baldness with dignity. No checking the mirror to see if a single hair sprouted from some wacky tonic. I wish the board were more about crucifying those that prey on the desperate. Whether intentional or not.

Lasers have not done anything for hair transplantation or regrowth. Even the cutting by laser method was silly.

Dr Bauman.

This is really quite sad. Everyone knows lazer therapy is a hoax. There is no evidence supporting the claims that lazer regrows hair.
And the only tests ever made were made in conjunction with minoxidil. It was only proved that the lazer - minoxidil combination regrew hair. For something not to work with minoixidil it has to be direcly harmful to your scalp.
And that is why lazer was approved by the FDA.

I can smear pigeon feaces on my head and use minoxidil as well and the results would be the same. Bottled pigeon faces would also pass FDA, given it is not somehow dangerous.

Lazer does not work. You are just shining light on your scalp. May as well use a torch, it is definately cheaper.
And then you can spend the money you saved on bottled pigeon shit.

el guapo, keep your powder dry and your pecker hard. : )

Hi all

If you look at the facts, there are 2 very credible doctors on here ( and mine who is not posting) who claimLaser therapy does not gernerate results ..

That speaks for itself

Lastly, the FDA approval does not mean it grows hair rather it is safe to use. This is my take on it

Well said El Guapo and Jobi!

Aquarius, I have trouble understanding your lingo sometimes - but you crack me up anyway. You bring it strong my brother.

It is certainly very exciting to see such a lively discussion regarding laser therapy on this forum. A healthy skepticism is certainly understandable. In fact I, too, was a skeptic back in 1999 before I acquired my first in-office phototherapy unit from Sweden. For those of you who may not know, for over a year we did not charge patients for this treatment and we tracked patients using laser therapy (ALONE, without other treatments). At that point in time, I essentially set out to DISPROVE that the therapy worked--not only to myself, but also to the local distributor. Now, I can say that certainly it was NO MIRACLE CURE, and some patients simply DID NOT achieve any measurable results. However, many of those patients did see a reversal of minaturization and an improvement in hair texture. Those were the patients that encouraged me to continue offering the therapy. In the nearly EIGHT years since, we've treated hundreds of patients with laser therapy and it has been an integral part of my hair restoration practice. I am happy to provide my patients with a non-chemical, non-invasive treatment that is effective.
Certainly, improving hair quality or simply achieving minor improvements in coverage of certain areas of the scalp is not going to satisfy all patients.
For those who are, as yet, not familiar with the science of phototherapy (which has been around for around 25 yrs or so), including its cellular effects, I would direct them to the medical and scientific literature, like that found at http://www.laser.nu for example.
When it comes to hair loss, it's true, the studies are just starting to come to the forefront, but the anecdotal reports appeared in text books from years ago.

One study in particular was presented two years ago at a medical conference is summarized below. It suggests that light-energy can have a cellular effect that mimicks that of minoxidil. This may be a clue to the mechanism of Low Level Laser Therapy and its effect on the dermal papilla cells of the human hair follicle...



ABSTRACT:
LED PHOTOMODULATION INDUCED HAIR GROWTH STIMULATION

Robert Weiss, David H. McDaniel, Roy G. Geronemus, Margaret Weiss

Maryland Laser Skin & Vein Institute, Hunt Valley, MD
Laser Skin & Vein Center of Virginia, Virginia Beach, VA
Laser & Skin Surgery Center of New York, New York, NY

Background & Objective: The ability to stimulate human scalp hair growth is well established. Oral finasteride inhibits 5-alpha reductase (5-AR). Topical minoxidil stimulates vascular endothelial growth factor (VEGF), hepatocyte growth factor (HGF), and matrix metalloproteinase (MMP-2). LED photomodulation modulates the activity of genes in human skin. This study investigates the effects of LED photomodulation on human dermal papillae cells (HDP) in culture and in clinical trials.

Study Design/Materials & Methods: Male and female HDP cells were exposed to LED arrays. Variables included wavelength, energy, and pulse duration. Gene expression of 5-AR, HGF, MMP-2 and others were measured using RT-PCR and microarrays.

Results: Different protocols produced significant distinctive effects on gene expression. Relative expression of 5-AR by RT-PCR ranged from -3.6 to +2.0 depending on the LED parameters. For example, one LED array produced VEGF (+1.8), HGF (+2.0), MMP-2 (+2.7) and 5-AR (0). This pattern resembled minoxidil rather than finasteride and was selected for a pilot clinical trial. Hair growth stimulation was observed.

Conclusions: LED photomodulation using visible light can alter the expression of genes associated with stimulation of hair growth. This effect is dependant upon treatment parameters

Published online in Wiley InterScience
(www.interscience.wiley.com).
DOI 10.1002/lsm.20164

Presented at American Society for Laser Medicine and Surgery
Annual Meeting—Orlando, April 2005.


I appreciate all of your questions and comments.

Sincerely,
Dr. B.

Oh boy. Here we go. Just when I thought I was out......they pull me back in.

This post is not directed at Dr. Bauman. My patience are all but obliterated by his posts. This is simply to shed what I think is important points regarding this last post and to further encourage to boycott and slam those doctors that don't get it. It's not like recommending a car. This crap hurts people emotionally and physically.

THE LASER THING IS WHACK!!!!! Period. Thge guy posts an abstract. WHat a joke. An abstract is to inform other medical professionals about research. This abstract shows that Laser Therapy should stay in the research area and leave us consumers the hell alone.

No one in the world can post photos of significant results using only lasers. And if the point is just to throw everything at it like creams, lotions and drugs, then just admit money falling out of pockets like the hair off a bald man is what these shysters are after.

I really think the kind tone of some of our more educated posters allows for this to masquerade as a "possibility." Yet not one guy on here with a nice HT would do this therapy themselves.

If a doctor wants to devote himself to cures then do it. When they find that cure let us know and charge us. But don't make false promises of hair when this thing might on a good day produce some angel hair fuzz.

Like I said. The pool of qualified surgeons will shrink. Hard work. Not so great cash. But if the Laser comb or Laser treatments can throw another 150K into the practice....why not? A sucker is born every minute.

So your saying my dream of opening a Laser Hair Clinic is no-go?

You mean I can't purchase a 8,000 machine and charge patients 500,1000, 1500 for 4,6,8 week programs?

What if I sold local patients the "Ultra Package" where the patient got a hair transplant, and then half-off laser therapy for 6 months?

Dammit Bezane, your ruining my dreams here man!!!!

[QUOTE]Originally posted by DrBauman:

"For those of you who may not know, for over a year we did not charge patients for this treatment and we tracked patients using laser therapy (ALONE, without other treatments)".

** Any real photo evidence????


At that point in time, I essentially set out to DISPROVE that the therapy worked--not only to myself, but also to the local distributor. Now, I can say that certainly it was NO MIRACLE CURE, and some patients simply DID NOT achieve any measurable results. However, many of those patients did see a reversal of minaturization and an improvement in hair texture.

"Those were the patients that encouraged me to continue offering the therapy".

*** Still free of charge???



In the nearly EIGHT years since, we've treated hundreds of patients with laser therapy and it has been an integral part of my hair restoration practice.

*** And profitable$$$$$$


I am happy to provide my patients with a non-chemical, non-invasive treatment that is effective.

*** Effective??? really, you stated earlier that it is no miracle cure and some patients did not achieve any measurable results. Hardly a convincing argument Dr.

nobuzz, to be fair, I have to say that some people do not achieve any measurable results from finasteride, either - which doesn't disprove its effectiveness.