INTRODUCTION
Low Level Laser Beam Therapy (LLLT) is an internationally recognized name for biostimulation with low energy lasers to achieve the desired unwanted effects. Traditionally, LLLT falls under the scope of physical medicine, which uses stimulation therapy to activate the body's natural defense mechanisms. When LLLT is a stimulus, the treatment method is known as PHOTOBIOSTIMULATION.
LLLT has been indicated in sports medicine, physics / manual medicine, dermatology and neuroendocrine disorders in humans and animals. The anti-inflammatory and analgesic properties of LLLT, as well as its effect on the formation of collagen, are good indicators for LLLT in the field of traumatology, surgery and dentistry, especially after major surgeries.
LASER
The word "Laser" is actually an acronym, which means "Light Enhancement" by stimulated emission. The laser generates extremely pure light, that is. Light is one wavelength, and not an infinite spectrum, like a light bulb. The emitted light is highly organized in the stream (this may help to think of the laser as the only malted scotch, and not the "mixture" of different wavelengths of light). The laser can be any wavelength of light, visible or invisible, high energy or low energy.
In 1917, Albert Einstein presented his main theory for stimulated emission of electromagnetic radiation. This theory was tested by Landberg in 1928, but at that time there were no practical possibilities for creating a functional laser. In 1951, physicist-physicist Fabrikant filed an application for a patent and allegedly published an article about a laser in 1959.
Mester, a Hungarian scientist, was the first to publish a series of articles in 1960 about the biostimulating effect of LLLT on cell cultures. In 1963, he published the results of experiments on animals, which showed that the repeated growth of the epithelium over skin lesions was faster if the irradiation was irradiated with a Joule per square centimeter. Higher doses had no effect. In fact, if the dose was increased many times, the result was the opposite. Wound healing was suppressed.
In 1965, Laor and his team discovered that laser irradiation (LLLT) stimulates the healing rate of burns and mechanically induced wounds.
PHYSICS 101
A laser is a device that produces electromagnetic radiation in the light range. Electromagnetic radiation is a form of energy flow, which has the properties of both waves and particles. These wave particles are called PHOTONS.
Photons have a certain amount of energy (E), which combine these two properties of waves and particles. The energy (E) is proportional to the photon mass (m) in accordance with the well-known Einstein equation:
E = mc2
Energy (E) is also proportional to the frequency (f) of the photon in accordance with the equation:
E = hf
Since the wavelength fx is equal to (the speed of light), then f = c / wavelength. Substituting above, E is proportional to 1 / wavelength, or the photon energy is INVERSLEY PROPRTIONAL with a wavelength.
Thus, the BIG PHOTON WOLF, SMALL IS ENERGY.
When a PHOTON hits an object, what happens to its energy? If a photon (light) is reflected from the surface of an object, the photon retains its energy. If the photon is transmitted further (outside the object), it also saves its energy. However, if a photon is absorbed by an object, its energy is delivered to the atoms and molecules of the object.
Depending on the wavelength (and, therefore, energy) of the absorbed photon, several scenarios can occur. This absorbed energy can cause heat fluctuations, i.e. Atoms / molecules become hot if the energy is low. If the absorbed energy is higher, the atoms and molecules of the object can be excited and / or ionized. If the absorbed energy is large, it can lead to the breaking of chemical bonds in the atoms / molecules of the object and lead to the formation of new compounds.
Laser light then consists of photons of a certain wavelength, that is, PURE LIGHT and, therefore, a certain level of energy that can interact with a given object. The results of this interaction depend on this particular wavelength (energy level).
MEDICAL LASERS
There are many different types of medical lasers, but they can be divided into two main groups:
HIGH POWER LASERS cut through coagulation and evaporate tissue. They are also known as surgical lasers because they replace the surgeon’s scalpel. These lasers produce high energy photons (light).
Low-level lasers stimulate cellular function. The effect is not thermal, as in the case of surgical lasers. These non-surgical therapeutic lasers are FDA-certified 3A grade. The energy generated by the photons of these lasers is low and has no thermal component, which can cause injury to users and / or operators. This low level energy does not alter the molecular structures, but INCENTIVES the mechanisms of the body for REPAIR and HEALTH itself.
Low-level (energy) laser light photons are absorbed by chromophores inside cells. This causes an increase in the production of cellular energy in the form of ATP, which leads to normalization of cell function, pain relief and healing. These effects are especially striking in areas of the body where cells are under stress.
The photo-energy of these low-level lasers is low and remains far below the levels necessary for ionizing the atoms and molecules of the cells. Thus, the induction of cancer growth is not associated with these lasers. The risk of eye damage is almost non-existent, but glasses are recommended.
LLLT FOT HAIR LOSS (ANDROGENETIC ALOPETIA)
What type of laser device will benefit patients with androgenetic alopecia? Advanced devices must be safe to use. They must be effective to meet the requirements of the manufacturer. The consumer should know that he / she is buying, and the device should not expose the consumer to the elimination of risks.
The therapeutic factors for choosing a laser are as follows:
(a) The wavelength of light is important because it determines the depth of penetration into the target tissue. For example, red light at 670 nm penetrates more than other lasers, which are close to the red spectrum. Since wavelengths of 670–690 nm support oxidation processes, it is believed that a wavelength of 670 nanometers demonstrates better efficacy in therapy than lasers with a lower wavelength.
(b) For use in hair, the first and most significant condition when choosing a laser wavelength is deep penetration, which should be sufficient to target the hair follicles, usually resting on a depth of 5-6 mm.
(c) Visible red light at a wavelength of 660 nanometers penetrates the tissue to a depth of 8-10 mm, so that the entire organ of the hair will be covered to the depth directly behind the hair follicle. Visible red light can theoretically be effective on the entire scalp and can include wounds, cuts, scars, folliculitis, etc.
(d) The question of a continuous wave against a pulsed laser operation arises. It is shown that impulse surgery stimulates tissue regeneration and regeneration to a greater extent than continuous wave surgery. Impulses have been shown to stimulate cellular activity. Pulses can regulate biological rhythms or cycles. Finally, impulse surgery exhibits a greater anti-inflammatory effect than continuous mode.
GOAL LLLT is to increase blood circulation in the follicle area and stimulate the hair organs (nerves, muscles and follicle growth centers). The effects of LLLT on stimulation, the increase or acceleration of the normal life cycle and the production cycle of open hair follicles are studied and quickly become the science through which this technology will be evaluated:
In 1996, Pontien published a study of microcirculation with a laser hair care device and showed an increase in blood flow.
In 2005, Weiss and McDaniel showed that photo-modulation using visible light can alter the expression of genes associated with hair growth stimulation. They described this as a more “minoxidil-like” effect.
EFFECTS LLLT
The physics of laser radiation, along with its well-known properties, led to the practical application of low-energy lasers in medicine. Various studies have confirmed these properties of a living organism. Taken together, the data indicate the following effects of low level laser radiation on the scalp:
(1) Increased blood flow to the scalp and microcirculation by 20-30%
(2) Increases nutrient intake to improve hair growth.
(3) Stimulates and accelerates hair growth.
(4) Stop hair loss progress
(5) Repair and improve the quality of hair rods
(6) Reduces excess levels of 5 alpha reductase of the skin and DHT, which contribute to genetic thinning
(7) Relieves scalp conditions such as psoriasis, seborrheic dermatitis, itchy / scaling scalp (anti-inflammatory properties)
(8) Normalizes sebum production (also increases production in conditions of activity and dryness and reduces production in case of excessive activity or fat content)
[9] Reduces dense, delicate scalp
These effects also make LLLT an excellent adjuvant therapy for pre-operative and postoperative hair restoration procedures.
TREATMENT PROGRAMS
When developing treatment programs using LLLT, you must first consider whether the treatment will be applied with a laser machine of class 3A with a handheld laser device or with both.
The larger class 3A laser machine is a patented cold laser that creates a soft halo of light around the scalp. Light comes from several rotating laser positions designed to increase blood flow to the scalp. There are 30 diode lasers rotating in half of the sphere around the head, supplying a low-laser pulse energy to the scalp. This requires twice a week or more visits to the clinic. It is recommended to use ancillary products, including vasodilators. An FDA approval for the use of this laser for hair loss is pending.
A handheld laser comb is a hand-held rod instrument with laser light holes located across its surface like the teeth of a comb. It is used at home 3-4 times a week for 10-15 minutes per use. It is easy to use and convenient for the patient, therefore, compliance with high rates. An FDA approval for its use for hair loss is pending. It is adopted as a medical device in Canada. This allows advertising to make therapeutic claims about a handheld laser device, such as its ability to increase the power of hair on the head in men and women, its ability to prevent hair loss in men and women, and its ability to cause hair growth in men and women.
Studies conducted using a handheld laser comb confirmed these statements:
In 2003, Martin Unger showed that LLLT was found to have a biomodulatory effect on human hair and hair follicles. 97% of the studied patients had a certain benefit in improving the characteristics of the hair, stabilizing hair loss or re-growing hair (defined by Unger as an increase in the number of hairs by 11% or more from the initial level).
Santino and Marku in 2003 studied 35 patients (28 men, 7 women) with androgenetic alopecia on the LaserMax comb. The treatment regimen was carried out every 6-10 minutes for 6-10 minutes. The results showed that, in the opinion of all patients, 93.5% of patients had an increase in the number of hairs, and 78.9% increased the tensile strength of the hair.
There are current FDA tests for men and women with thinning hair. These individuals undergo two treatments per week using a hand-held laser comb for 6 months. All the details of the tests are missing, but preliminary results show that in men, 10% had stabilized frontal and apical hair loss, 84.6% had re-growth of some hair in the frontal area and 82.8% had re-growth of some hair at the top. In women, 100% stabilization of hair loss was observed at the top, 87.5% had stabilization of hair loss in the frontal region, 75% experienced repeated growth of some hair in the frontal region, and 96.4% had repeated growth of some hair to the top. So far, no side effects or eye damage have been reported.
CANDIDATES FOR LLLT
Based on information that is far away and on various clinical trials in progress, a potential list of candidates for LLLT for hair loss is as follows:
Men and women aged 18 to 65 years
Thinning hair loss
Patients not eligible for hair restoration surgery due to early stages of hair loss
Women experience diffuse or general thinning, including the sides and back.
Pre and postoperative hair restoration.
There are three general categories of users with LLLT regarding hair loss. 45% of patients will receive positive results after 8 weeks of treatment, 45% will receive positive results after 10-16 weeks of treatment, and 10% will improve after 16 weeks.
Finally, to give an idea of the types of existing laser programs, the hair restoration group has three different programs. Patients choose a program based on specific needs.
IN-CLINIC PROGRAM consists of 46 LLLT sessions for 12 months with three capillary readings for measuring hair density. AT HOME AND IN CLINIC PROGRAM PROGRAM uses a handheld laser comb three times a week for ten minutes at home with 12 monthly LLLT sessions at the clinic. Finally, there is the LLLT POST-OPERATING PROGRAM, comprising 2 20-minute LLLT sessions per week for 8 weeks. Patients undergoing postoperative LLLT note accelerated healing, smoothing of scars (especially in the area of donors), the growth of vaccination accelerates, the appearance of the graft improves and postoperative swelling does not occur.
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All rights, including copyright, in the content of this article.
Richard P. Giannotto, MD, owned or
controlled by Transitions International Group.
