Full text of DOI:10.1089/153082003769591209

INTERNATIONAL JOURNAL OF COSMETIC SURGERY and AESTHETIC DERMATOLOGY
Volume 5, Number 2, 2003
© Mary Ann Liebert, Inc.
Hair Regrowth and Increased Hair Tensile Strength
Using the HairMax LaserComb for
Low-Level Laser Therapy
JOHN L. SATINO and MICHAEL MARKOU, D.O.
ABSTRACT
The authors wished to confirm the efficacy of low level laser therapy (LLLT) using a Hair-
Max LaserComb for the stimulation of hair growth and also to determine what effect LLLT
with this device had on the tensile strength of hair. Thirty-five patients, 28 males and 7 fe-
males, with androgenetic alopecia (AGA) underwent treatment for a six-month period. Both
the hair counts and tensile strength of the hair were affected very beneficially in both sexes
in the temporal and vertex regions, with the males and vertex areas showing the most im-
provement.
INTRODUCTION
publication in 1983 which reported favorable
results with LLLT in the treatment of Alopecia
areata.(4) The authors heard about Dr. Martin
Unger’s paper in Puerto Vallarta, Mexico, dis-
cussing the use of LLLT for hair biostimula-
tion,(5) and around this same time period, the
fall of 2001, became interested in the HairMax
LaserComb (Lexington International, Boca Ra-
ton, FL), secondary to several anecdotal reports
that they had heard about this device. It was at
this time that the authors decided to carry out
their own study to determine whether the Hair-
Max LaserComb was effective with regard to
stimulating hair growth. The authors also
wished to determine what affect LLLT had on
the tensile strength of hair and undertook to
determine this during the same study.
LTHOUGH LOW-LEVEL LASER THERAPY (LLLT),
the therapeutic application of low-energy
A
lasers to medicine, has been used for photo-
biostimulation for more than thirty years now,
in the past it has primarily been used to accel-
erate the healing of burns or wounds, or alter-
natively, to ease or relieve pain. Furthermore,
LLLT has gained credibility and common us-
age in some parts of the world, such as Japan,
the Scandinavian countries, and Australia,
while in other parts of the world, such as North
America, a lack of recognition of its efficacy has
remained.
Even though there are more than 2,500 pa-
pers related to LLLT in the scientific litera-
ture,(1) only one printed reference, Professor
Pekka Pontinen’s text, was found which actu-
ally discussed the use of LLLT “to stimulate
hair growth.”(2) Even in this source, the infor-
mation was limited to one paragraph, which
MATERIALS AND METHODS
The HairMax LaserComb (Figs. 1, 2) was se-
refers to one paper given in Sorrento in 1982 lected as the LLLT device for many important
which reported increased hair growth after reasons. As noted above, the authors had heard
LLLT in animals,(3) and a foreign language several favorable anecdotal reports about its ef-
113

114
SATINO AND MARKOU
Dorsal view of the HairMax LaserComb and its
Lateral view of the HairMax LaserComb,
demonstrating the nine laser beams on the case and the
comblike teeth extending from its ventral surface.
FIG. 1.
FIG. 2.
leather storage case.
ficacy. Secondly, the cost of the device was af- allowing the patients to see for themselves that
fordable ( ), and thirdly, the the device is operating.
www.lasercomb.net
device was simple enough for the patient to use
In total, 35 patients with androgenetic alope-
at home, avoiding repeated visits to the clinic. cia (AGA) were involved in the study, of which
The facts that the device was completely safe, 28 were males, aged 28 to 72, and 7 were fe-
and that no adverse side effects had ever oc- males, aged 46 to 76. Each patient was given a
curred, were also important considerations. In HairMax LaserComb to use at home for six full
addition, the comblike teeth of the device sep- months and was instructed to comb his/her en-
arates the hair so that the nine laser beams emit- tire scalp hair slowly (advancing one-quarter of
ted can easily reach the scalp without absorp- an inch per second) for five to ten minutes
tion or interference from existing hair, and the every other day. The treatment was to be car-
laser beams themselves are visible light energy ried out when the hair and scalp were clean
and the hair was dry. A hair count in the great-
est area of alopecia and a determination of the
tensile strength of the hair was carried out be-
fore treatment was started and again after six
months of treatment.
As each patient was troubled by AGA to start
with, the authors did not want to clip additional
Clear acrylic head mold with the one-square-cen-
A frontal view of the VIP HairOScope used for
FIG. 3.
FIG. 4.
timeter opening noted in the vertex area, and outlined in red. measuring the hair tensile strength.

115
HAIR REGROWTH AND INCREASED HAIR TENSILE STRENGTH
hair for the hair counts. Accordingly, they cre- hook and a lens with five times magnification.
ated a clear acrylic mold of each patient’s head, Hair counts were carried out by both authors to
with the front of the mold positioned at the hair- confirm the accuracy of the data.
line, and a one-centimeter square removed from
To test the tensile strength of the hair before
the mold in the area of greatest alopecia in ei- treatment and after six months of treatment,
ther the temporal or vertex region (Fig. 3). For three typical terminal hairs were removed from
the hair count, the hairs within the one square the one square centimeter area and a VIP
centimeter space were pulled through the open- HairOScope (Belson Imports, Hialeah, FL) used
ing, and then counted using a surgical skin to determine the tensile strength (Fig. 4).
TABLE 1. HAIRMAX LASERCOMB HAIR COUNT DATA
Hair Count
Number
Patient
Age
Sex
Area
Baseline
6 months after
Difference
Change(%)
1
RC
CP
DL
SH
WG
JC
TM
JH
LM
JT
AT
470.
340.
280.
560.
350.
290.
340.
510.
630.
290.
360.
M
M
M
M
M
M
M
M
M
M
M
T
T
T
T
T
T
T
T
T
T
T
23
33
45
51
22
18
95.7
54.5
2
3
22
31
09
40.9
4
06
11
05
83.3
5
16
28
12
75.0
6
38
56
18
47.4
7
12
46
34
283.30
50.0
8
18
27
09
9
16
16
00
00.0
10
11
15
23
08
53.3
28
37
09
32.1
Average (T) 40.2
0.20.6
08
0.33.7
22
0.13.1
14
74.1
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
DB
RK
PP
EL
JI
BG
SA
DB
EW
JS
MB
PL
JL
CR
PH
RH
JB
550.
370.
290.
340.
510.
480.
590.
290.
380.
560.
350.
460.
720.
420.
600.
420.
300.
M
M
M
M
M
M
M
M
M
M
M
M
M
M
M
M
M
V
V
V
V
V
V
V
V
V
V
V
V
V
V
V
V
V
175.00
13.9
36
41
05
22
61
39
177.30
89.5
50.0
19
36
17
18
27
09
14
64
50
357.10
91.7
12
23
11
18
26
08
44.4
22
28
06
27.3
18
31
13
72.2
22
39
17
77.3
12
23
11
91.7
12
33
21
175.00
91.7
12
23
11
12
27
15
125.00
58.3
24
38
14
04
17
13
325.00
120.10
102.70
59.4
Average (V) 44.9
0.16.8
0.18.2
32
0.32.9
0.33.2
51
0.16.1
0.15.0
019
08
Average (V T) 43.1
1
29
30
31
32
JL
560.
660.
710.
460.
F
F
F
F
T
T
T
T
FP
EL
LW
19
27
42.1
22
29
07
07
0.10.3
10
18
08
0.12.0
0.10.3
0.12.3
0.15.5
0.14.1
31.8
08
15
87.5
Average (T) 59.8
0.20.3
19
0.30.5
29
55.2
33
34
35
NC
PJ
RM
640.
760.
490.
F
F
F
V
V
V
52.6
18
19
0.18.7
0.20.3
0.20.5
0.17.1
0.18.5
36
27
0.30.7
0.30.5
0.32.9
0.32.6
0.32.7
100.00
42.1
Average (V) 63.0
64.9
Average (T V) 59.8
55.2
1
1
1
1
Average (T, M F) 45.4
69.1
Average (V, M F) 47.6
111.90
93.5
Average (T V, M F) 46.7
1
M, male; F, female; T, temporal; V, vertex.

116
SATINO AND MARKOU
RESULTS
counts increased in the temporal area an aver-
age of 55.2% in women, 74.1% in men, and
69.1% for all patients. In the vertex area, the
corresponding percentages were 64.9% for
women, 120.1% for men, and 111.9% for all pa-
tients. There was a hair count increase of 93.5%
when all temporal and vertex patients were
combined. In general, males and the vertex area
did the best, but both sexes and all areas did
demonstrate significant improvement.
The scientific data for the hair counts is dem-
onstrated in Table 1, and the data for the ten-
sile strength of the hair recorded in Table 2.
One-third of the patients did report some tem-
porary slightly increased hair shedding during
the first one or two months of treatment, but
after two months, this no longer occurred.
In summary, Table 1 shows that the hair
TABLE 2. HAIRMAX LASERCOMB HAIR TENSILE STRENGTH DATA
Hair tensile
6 months after
Number
Patient
Age
Sex
Area
Baseline
Difference
Change(%)
1
RC
CP
DL
SH
WG
JC
TM
JH
LM
JT
AT
470.
340.
280.
560.
350.
290.
340.
510.
630.
290.
360.
M
M
M
M
M
M
M
M
M
M
M
T
T
T
T
T
T
T
T
T
T
T
4.5
3.8
3.7
2.1
2.3
2.4
1.2
5.5
2.4
4.2
4.6
3.3
1.6
4.0
2.9
4.1
1.9
3.5
2.3
too short
2.9
1.1
0.8
1.7
2.9
2.8
2.4
1.3
3.8
2.5
2.8
2.0
3.2
2.2
2.7
2.5
1.7
2.1
2.1
2.0
2.5
3.1
2.4
2.7
5.9
6.1
4.2
3.5
3.6
4.1
5.2
6.3
2.9
4.9
5.7
4.8
3.7
5.8
5.8
5.4
3.1
4.7
5.0
1.4
2.3
0.5
1.4
1.3
1.7
4.0
0.8
0.5
0.7
1.1
1.4
2.1
1.8
2.9
1.3
1.2
1.2
2.7
N/A
0.2
2.0
1.5
2.3
1.7
1.5
1.9
2.2
1.3
1.7
1.6
2.6
0.6
1.8
2.7
1.9
1.2
1.3
1.7
1.4
1.9
1.6
1.7
1.6
031.1
060.5
013.5
066.7
056.5
070.8
333.3
014.5
020.8
016.7
023.9
064.4
131.3
045.0
100.0
031.7
063.2
034.3
117.4
N/A
006.9
181.8
187.5
135.3
058.6
053.6
079.2
169.2
034.2
089.3
079.5
130.0
018.8
081.8
100.0
082.6
070.6
061.9
081.0
071.1
082.6
069.3
086.4
078.9
2
3
4
5
6
7
8
9
10
11
Average (T) 40.2
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
DB
RK
PP
EL
JI
BG
SA
DB
EW
JS
MB
PL
JL
CR
PH
RH
JB
550.
370.
290.
340.
510.
480.
590.
290.
380.
560.
350.
460.
720.
420.
600.
420.
300.
M
M
M
M
M
M
M
M
M
M
M
M
M
M
M
M
M
V
V
V
V
V
V
V
V
V
V
V
V
V
V
V
V
V
3.1
3.1
2.3
4.0
4.6
4.3
4.3
3.5
5.1
4.2
4.4
4.6
3.8
4.0
5.4
4.5
2.9
3.4
3.8
3.4
4.5
4.7
4.1
4.4
Average (V) 44.9
Average (V T) 43.1
1
29
30
31
32
JL
560.
660.
710.
460.
F
F
F
F
T
T
T
T
FP
EL
LW
Average (T) 59.8
33
34
35
NC
PJ
RM
640.
760.
490.
F
F
F
V
V
V
Average (V) 63.0
Average (T V) 59.8
1
1
1
1
Average (T, M F) 45.4
Average (V, M F) 47.6
Average (T V, M F) 46.7
1
M, male; F, female; T, temporal; V, vertex.

117
HAIR REGROWTH AND INCREASED HAIR TENSILE STRENGTH
Similarly, in Table 2, the hair tensile strength to fully understand the scientific findings noted
increased in the temporal area 82.6% in women, in this paper.
64.4% in men, and 69.3% in both sexes. In the
vertex area, the percentages were 71.1% for
women, 89.3% for men, and 86.4% for both
sexes. The hair tensile strength was increased
78.9% when all temporal and vertex patients
were considered. There was greater improve-
ment in the vertex area in males, but more im-
provement in the temporal area in females. Both
sexes and all areas did benefit significantly.
CONCLUSION
LLLT with the HairMax LaserComb is an ef-
fective treatment for stimulating hair growth
and increasing the tensile
of hair in
strength
both sexes in both the temporal and vertex re-
gions. In the authors’ opinion, LLLT should be
given serious consideration as an option in the
treatment of AGA in view of its safety, ease of
patient home administration, and the benefits
documented in this study.
DISCUSSION
In general, the results far exceeded the ex-
pectations of the authors, and they were
pleased to be able to document the benefits that
LLLT with the HairMax LaserComb can
achieve for both men and women in both the
temporal and vertex regions. Although there
were four times as many men as women pa-
tients in the study, each sex did demonstrate
significant benefits from the LLLT.
The mechanism or mechanisms of action of
LLLT are unknown with regard to the stimu-
lation of hair growth or how the hair tensile
strength is increased so greatly. From wound
healing studies, it is known that LLLT causes
an increase in the microcirculation of tissue and
a reduction in inflammation.(2) The amount of
cellular energy in the form of adenosine
triphosphatase (ATP) is also increased follow-
ing LLLT.(2) Perhaps one or more of these ben-
eficial effects are responsible for the results that
we were able to achieve. The authors hypoth-
esized that the early temporary hair shedding
experienced by some patients was most likely
related to an accelerated hair cycle in general.
Obviously, more research is required if we are
REFERENCES
1. LaserWorld LLLT Internet Guide (
).
http://www.laser.nu/
2. Pontinen, P.: Low Level Laser Therapy as a Medical
Treatment Modality. Art Urpo, Ltd., Publishers, 1992,
pp 99–101.
3. Trelles, M., and Mayayo, E.: The Growth of Hair un-
der Influence of the He-Ne Laser Beam: Histological
Study. Sorrento. World Congress of Laser-Therapy,
1982.
4. Trelles, M., Mayayo, E., Schmidt, C., Igllesias, J., and
Barber, J.: Laser Para la Salud y la Estetica. Etecnes,
2nd. edition, 1983, pp 98–107.
5. Unger, M.: Low Level Laser Therapy (LLLT) for Hair
Biostimulation, 9th Annual Meeting of the International
Society of Hair Restoration Surgery, Puerto Vallarta,
Address reprint requests to:
John L. Satino
Clinic Director & Laser Safety Officer
The Laser Hair and Scalp Clinic
13555 Automobile Boulevard, No. 110
Clearwater, FL 33762
hslaser@sisna.com
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