Efficacy of Minoxidil Combined With Photobiomodulation for the Treatment of Male Androgenetic Alopecia. A Double‐Blind Half‐Head Controlled Trial

Abstract

Background: Androgenetic alopecia (AGA) is a hair loss disorder that frequently affects the male population. Conventional treatment modalities are limited to minoxidil, 5α reductase inhibitors, and hair transplantation procedures. The efficacy of low-level laser therapy (LLLT), also known as photobiomodulation, in the treatment of AGA has been reported, yet little is known about the outcomes of combining photobiomodulation with other conventional therapies. Objective: To evaluate hair growth improvement in males with AGA, during the administration of minoxidil with and without photobiomodulation, using a half-head model. Study Design/Materials and Methods: Twenty-one men with AGA agreed to undergo 12 minutes of low-level laser irradiation (using a modified Capellux ® ), followed by topical minoxidil application (1 ml of 5% solution), to the affected scalp two times per day for 6 months. The photobiomodulation devices were modified such that the left half emitted light, and the right half did not. Efficacy was assessed by blinded analyses of clinical photos and automated phototrichograms (Trichoscan ® ) taken before treatment and after 3 and 6 months of therapy. Results: None of the study participants experienced any adverse events. All patients showed improvements in hair coverage on both sides of the scalp at 3 and 6 months. On the side with combined treatments, the number of total hairs was significantly increased after 3 (P < 0.001) and 6 months (P = 0.001). A similar increase was also observed on the minoxidil-only side, at both 3 (P < 0.001) and 6 months (P < 0.001). No statistically significant differences were detected between sides (P > 0.05). Conclusion: Additional improvement was not observed with the association of photobiomodulation to topical minoxidil in male AGA. Differences from previous studies that might have influenced our result include noncollimated light source, higher dosimetry, and a cohort with darker skin phototype and more severe alopecia. Lasers Surg. Med.

Effect of Skin Type on Efficacy of Laser Treatment for Androgenetic Alopecia: A Review of the Literature

“…However, the sample size for the specific FST was variable and low. These results do not support to hypotheses that darker skin type would have a decreased effect due to decreased penetration of light therapy [44]. Instead, they might be indicative that more melanin causes increased absorption of light therapy [49, 50].…”

“…Ten total studies were selected for analysis including 8 clinical trials and 2 pilot studies. LLLT-delivering devices included the TOPHAT655 [42, 43], HairMax LaserComb [38, 39], X5 HairLaser [36], iRestore ID-520 [37], Capellux ® [44], LDU 8024PN/8024BN [36], and a novel device [43]. Eight out of ten studies utilized wavelengths between 635 and 660 nm with 655 nm being the most common in 4 of those studies.…”

Low-level laser therapy in androgenetic alopecia: narrative review

“…Both tests were prescribed for a period of 6 months with a 5% concentration of minoxidil, but the number of LLLT treatments and wavelengths used differed. Tests that received treatment two to three times per week showed a significant increase in hair number and diameter [39], while no significant difference was ob- served in tests that received treatment twice per day [40].…”

“…A total of 11 related papers were obtained from the PubMed database, of which 9 were treatment studies using only LLLT (Table 1) [22,[30][31][32][33][34][35][36][37], and the remaining 2 were combined with minoxidil (Table 2) [38,39].…”

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

“…Ferrara et al [16] examined 21 male patients with AGA who were treated with LLLT using Capellux (wavelength 650 nm) followed by topical 5% minoxidil solution for 6 months. In this split scalp study, the LLLT device was altered such that it only emitted therapy to half the scalp region, and the other half of the device was shut off.…”