Q: What are the pros and cons of low-level laser therapy?

Pros The treatment is noninvasive and painless. LLLT is considered safe and isn’t associated with any side effects. A growing body of research shows that it may be effective for a wide variety of conditions and concerns, including hair loss. Cons Depending on the application, a series of treatments is usually necessary to see benefits. LLLT hair loss devices like Capilus are expensive and require continued commitment to see and maintain results. Some claims for LLLT may be unsubstantiated. More rigorous research is needed to evaluate the effects of LLLT. Because of the inconsistency in studies, this remains a controversial therapy.

Question 1

What is low-level laser therapy?

Accepted Answer

Low-level laser therapy (LLLT), aka photobiomodulation, is a noninvasive, pain-free treatment that uses low-intensity light to stimulate biochemical changes in cells, helping repair tissue and reduce inflammation.

One of the most common types of LLLT treatment is the stimulation of hair regrowth in men and women with hereditary hair loss. It’s also commonly used in physical therapy, sports medicine, and chiropractic treatment.

The precise biochemical mechanism underlying the therapeutic effects of LLLT isn’t yet fully known, but it appears to have a wide range of effects at various levels. For instance, within cells, LLLT acts on the mitochondria (the cellular “power plants”) to increase energy. This stimulates regeneration and healing of damaged muscles, ligaments, nerves, bones, joints, and soft tissue. The technique is referred to as “cold” laser therapy because the low levels of light aren’t enough to heat your body’s tissues, so it produces no sensation or burning.

At low doses, LLLT has been shown to increase the proliferation of these types of cells:

Fibroblasts, the cells that produce collagen and elastin
Keratinocytes, the cells that produce the protein that makes up skin, hair, and nails
Endothelial cells, commonly found in blood vessels, lymph vessels, and the heart
Lymphocytes, a type of white blood cell that’s an important part of the immune system

Question 2

What are the pros and cons of low-level laser therapy?

Accepted Answer

Pros

The treatment is noninvasive and painless.
LLLT is considered safe and isn’t associated with any side effects.
A growing body of research shows that it may be effective for a wide variety of conditions and concerns, including hair loss.

Cons

Depending on the application, a series of treatments is usually necessary to see benefits.
LLLT hair loss devices like Capilus are expensive and require continued commitment to see and maintain results.
Some claims for LLLT may be unsubstantiated. More rigorous research is needed to evaluate the effects of LLLT. Because of the inconsistency in studies, this remains a controversial therapy.

Question 3

How much does low-level laser therapy cost?

Accepted Answer

Most health insurance carriers consider LLLT experimental and investigational, so be sure to speak to your plan provider before having treatment, to see if any of the costs for your therapy will be covered.

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Question 4

Can low-level laser therapy help with hair loss?

Accepted Answer

There is evidence that LLLT helps to stimulate hair follicles and induce regrowth of thicker, fuller hair. A meta-analysis of 11 double-blinded randomized controlled trials (the gold standard of studies) published in 2019 found that LLLT significantly increases hair growth in both men and women with hereditary hair loss, using both comb- and helmet-type devices.

Several of these devices have been FDA-cleared for the treatment of androgenetic alopecia in both men and women. One such cap-type device, Capillus, uses a six-minute daily protocol, while HairMax LaserComb needs to be used for eight minutes, three times a week.

Doctors on RealSelf don’t agree on whether LLLT works for hair loss. Dr. Justin Misko, a hair restoration surgeon in Lincoln, Nebraska, says in a RealSelf Q&A that there’s a medical synergy when laser therapy is combined with Rogaine (minoxidil). “I specifically like the Capillus and have had tremendous success with patients.”

Others aren’t impressed with the results. “Low-level laser therapy for hair does not work. I’ve offered it at my practice for free. I even gave it away as a study. I have not seen results,” says Dr. Jae Pak, a hair restoration surgeon in Los Angeles. “If it works, it is so minimal it’s not worth the effort or cost to justify a result that cannot be seen with the naked eye, for someone to say, ‘That was worth it.’”

For people who can’t use medication like finasteride (Propecia) and Rogaine, LLLT may be a good option to help improve hair quality, says Dr. Parsa Mohebi, a hair restoration surgeon in Beverly Hills, California.

Related: Everything You Need to Know About Postpartum Hair Loss—Including How to Treat It

Question 5

What other conditions can be treated by LLLT?

Accepted Answer

There’s rapidly growing interest in LLLT as an approach to stimulate healing, reduce pain, enhance athletic performance, and improve general wellness. There’s research on LLLT for a wide range of applications, including:

Back pain. In a 2016 review of 15 studies, researchers concluded that LLLT, when used by itself or in combination with other modalities, may reduce nonspecific back pain (pain that can’t be traced back to a definitive cause, like a herniated disk) for up to three months, with few adverse effects.
Plantar fasciitis. This common condition is one of the predominant causes of heel pain. If your heel hurts when you first step out of bed in the morning and then feels better once you start moving, you may have plantar fasciitis. A 2019 analysis of six studies found that LLLT significantly relieves plantar fasciitis and the benefit lasts for three months after treatment.
Cancer treatment. Although there is some evidence suggesting that LLLT can be detrimental in animal studies, according to a 2018 review article, there are also many studies that suggest the opposite—that light can directly damage the tumor, enhance other cancer therapies, and stimulate the immune system. There are even two clinical trials showing increased survival in cancer patients who received LLLT. The therapy, concluded researchers, may have benefits for cancer patients and should be further investigated.
Athletic performance. LLLT done prior to physical activity may help enhance performance. In a 2018 study on competitive cyclists, LLLT minimized muscle fatigue.
Toenail fungus. Research shows that treatment with low-level lasers like Lunula can be effective at improving toenails affected by fungal infections. Laser toenail fungus removal is quick and painless. But even when effective, it’s not uncommon for the fungus to return.

LLLT is also being investigated to treat male infertility, traumatic brain injury, weight loss, wound healing in diabetic ulcers, and psoriasis and other skin conditions.

Despite research that shows LLLT to be beneficial, it’s difficult to draw firm conclusions yet about the effect of LLLT, since some research hasn’t shown a benefit. More rigorous studies are needed before the “credibility gap,” as one researcher described it, is bridged.

LOW-LEVEL LASER THERAPY

Karyn Repinski

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Karyn Repinski

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