Email Response from Managing Director of HairMax LaserComb – Hair Loss Information – Balding Blog

Earlier this month, I posted an entry titled Analyzing the Results of the HairMax Laser Comb. The extensive email that I received (posted below) shows the great care that the HairMax folks went through to try to be objective. I do not doubt that objectivity was the intent, but upon reviewing the images that were presented, my counts came up differently than the counts of the researcher(s). I know how to count, and since densitometry was my invention (so to speak), I think that my expertise in counting hairs stands for itself. The conclusions of my previous writing still stand (see link above). Nothing written below changes that. The scientific study was put together properly, but it failed on the simplest level, counting hairs. All is wasted if the counts (which our readership can do) failed to be what the researchers counted. I will present the impressive piece written by David Michaels of Lexington International (makers of HairMax LaserComb), because it is fair to do so. Remember, there is no substitute for good marketing, but the success of a product should not infer that the product does as represented, nor does it make counting numbers different than what they are.

Greetings Dr. Rassman,

Firstly, I would like to thank you for taking interest in low-level laser therapy and fielding questions on your blog about our device, the “HairMax LaserComb.” Open discussions like this one can only help to further the advancement of LLLT. I spoke to our chief medical advisor, Dr. Matt Leavitt, about your remarks regarding the LaserComb on your blog and Dr. Leavitt spoke very highly of your professionalism, commenting especially about your intellectual brilliance.

We reviewed your blog page that contains comments about our clinical study’s macro photos and we encourage you to post this message as a follow up to your comments.

We would like to outline some of the background about the clinical study we concluded.

Our experience with using low-level laser therapy for hair dates back to the mid-80’s in Sydney, Australia. Our founder operated a laser clinic where he successfully treated thousands of people. I was one of these laser patients and had significant results. We then worked closely together to develop a hand held laser device for the international market that can assist individuals suffering from problem hair. The HairMax LaserComb has been on the market for five years and is in use in over 74 countries.

In 2005, we concluded a clinical study protocol entitled “A RANDOMIZED, DOUBLE-BLIND CLINICAL TRIAL TO EVALUATE THE SAFETY AND EFFICACY OF THE HAIRMAX LASERCOMB FOR THE TREATMENT OF ANDROGENETIC ALOPECIA IN MALES”. The primary efficacy endpoint was: Change in terminal hair counts, which are non-vellus hairs, in the target region between baseline and endpoint, utilizing macro images.

This is our second clinical study; unfortunately, we had bad professional direction for our first study as it was only a single site without a control. Despite this, we used the results of this initial research as a pilot study to help develop our new protocol.

Our goal was to conduct this study scientifically and in accordance to Good Clinical Practices (GCP). We utilized four clinical research facilities, three of which participated in many of the Minoxidil studies. Each facility had a primary investigator with extensive experience in Androgenetic Alopecia. All study protocols were approved by an IRB. Professional independent site monitors were employed to verify all case report forms and data managers were used to ensure that all recorded data complied with the protocol and with all applicable section of 21 CFR as required by the FDA. A biostatistician was retained to independently analyze the resulting dataset.

The equipment in use was a Fuji S2 6 megapixel digital camera with a Canfield epilume attachment. The same location was photographed every time, marked by a tattoo and the hair counts, centered around this tattoo, are well documented using Canfield Mirror DPS 6.0 software which stores a image on each individual hair counted over the original macro image for verification.

While conducting our study, we sought to show that the HairMax LaserComb had an effect on the number of non-vellus hairs present on the scalp. In an effort to eliminate any potential bias, independent medical professionals were commissioned to perform the hair counts. These professionals were blinded to the treatment assignments thus removing any bias towards the subjects’ treatment. The data from these medical professionals was then monitored and sent directly to the data management team removing and potential for us to review the data or interact with it.

All terminal hairs were marked and registered in Canfield’s Mirror DPS software using a 19 inch computer monitor. They were evaluated and counted by two independent hair professional reviewers. We are sure you can appreciate that counting many hundred macro images is a laborious task and can be very tiring on the eye. For this reason, we ensured that all hair counts were not performed consecutively. The counts were split up over a reasonable period of time in an effort to eliminate any uncertainty introduced from reviewer fatigue. Although the reviewers may have missed one or two hairs, we are confident that our macro counts represent a fair and accurate assessment of our study.

Our macro images were carefully reviewed by numerous professionals including many of your peers; all have complemented us on our fair evaluation of the data and our methods used in the study. We are unaware of what standard Dr. Rollins and you used in reviewing these images and where the difference exists in our hair counts. However, all the hairs that were counted are marked and we consider these counts to be an objective evaluation.

We will be bringing our clinical images with us to the ISHRS conference in San Diego; we invite you and Dr. Rollins to further review our images up close and hopefully once you see the standard of the images and documented counts you may have a different assessment of our macro images.

Kind regards,

David Michaels, Managing Director
Lexington Int LLC
Developers and Manufacturers of the HairMax LaserComb

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Tribulus Supplement and Hair Loss – Hair Loss Information – Balding Blog

I am 41 year old with a history of succesful treatment of MPB with Propecia. Over the past 6 months I was taking a supplement (tribulus) to help with working out and muscle gains. It is a herb which is reputed to increase testosterone. It seems to me that my hair is losing some weight and thickness during the past 3 months or so. I am wondering if you think that such a supplement could negatively impact on hair?

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TribulusIt is difficult for me, as a physician who understands the classic drugs, to comment upon such substances which are not reflected or reported in standard PDRs (Physician Desk References are used for full disclosures of all FDA approved drugs). Based upon what I read in BodybuildingForYou.com, there is a clear suggestion that this botanical is stimulating hormone modification, some of it steroid like. That would mean that this supplement could caused hair loss.

I did not feel good after looking at USDA – Tribulus terrestris. Maybe I am just old fashioned. I try not to take anything that has such varied and powerful effects. I always point out that arsenic (another herbal) is very toxic. A single bubble of arsine (the hydride gas) can be fatal and it is this herbal that was promoted as the cure of syphilis by doctors some 100+ years ago (may have also killed some of the patients). It was a classic poison in many classic writings, and at the least, entertained thousands of readers of great literature.

1mg vs 5mg Finasteride for Hair Growth – Hair Loss Information – Balding Blog

Has there been any studies that have shown any increased hair growth taking proscar 5mg daily vs propecia 1 mg daily.

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The 1mg dose is just as good as the 5mg dose for treating hair loss. This was determined when the drug company (Merck) did effectiveness testing. I am sure you can get it from the FDA. For urological problems, the 5mg dose is more effective. The question is really about how much finasteride binds to the hair follicles themselves. We know for prostate problems, that there is different binding dynamics than with hair follicles. I am not familiar with any study that directly compares the 5mg dose to the 1mg dose, but I would suspect that like any bell curve, the 1mg recommendation applies to those individuals in the center of the bell curve and that some people most certainly would be better with a higher dose, possibly worth trying if the 1mg dose is not adequate to meet the needs of the patient’s problem. See Pattern-Baldness.com for more.

Using Rogaine Without Seeing a Doctor First – Hair Loss Information – Balding Blog

Hello,
If a woman suspects she may have thinning hair, is it safe to use female rogaine without seeing a doctor first?

I am 33 years old and noticed after having my daughter my hair is not as thick (child is 3 now),and it seems like my hairline is thinner. The hairline has always been a little thin but nothing that is noticeable. I just noticed lately that the hair seems sparse, but of course, I am told otherwise by my husband. I am healthy, not on any medication, no crash diets, don’t dye my hair, etc. I am a vegetarian and good about getting the protein I need. Just concerned as I don’t want to lose my hair!

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Rogaine is an over-the-counter medication, which means that the FDA feels that decisions on using the drug can be made safely by the patient. Try it, you might find it helps.

After a Long Night Out, I Woke Up With a Bald Spot! – Hair Loss Information – Balding Blog

FightHi, i am 25 years old female. After one of the “Nights out” i got up and realized that i have bald spot on the back oh my head. It is about 1 inch long and 1/2 wide. My head is hurt all around that spot. I am not sure if it got pulled out or they just fall out on there own.

I do not know what to do. I have to put my hair up, so nobody can see it. Please, tell me if it will ever grow back…

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I would assume that you may have had a little too much to drink and got your hair pulled out. I have seen this many times before. It will come back!

Shedding from Highlighting Hair Months Ago – Hair Loss Information – Balding Blog

Black female 36: Hair is thinning from shedding due to highlights put in months ago. What can be done to help this?

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Don’t assume that your thinning is from the highlighting. It sounds doubtful. I can not blindly stab at an answer to your questions without access to you, get your correct history, examine you, etc. You should see a dermatologist if the hair does not regrow. Not much I can do online at this point.

Cowlick Gives a Bald Spot Appearance – Hair Loss Information – Balding Blog

Hi, I have a cowlick on the back top of my head (crown). The hair grows outward in a circular, flattened pattern giving teh appearance of a thin/bald spot. I usually attempt to cover it with longer hair combed over it and sometimes actually succeed in getting the hair to appear to go in the correct direction.

Is there anything I can do about this, it is very annoying and hard to cover since I am very blonde. It will just not grow out straight. Will short layers make this harder to cover or easier to fill in with the use of hair wax. THanks.

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Cowlicks are common. The swirl in the crown is present on 100% of people, and some folks even have two of them. It is in your nature to have them. Although it can be annoying, styling adjuncts are the best way to manage them.

The below photo is of a natural swirl in the crown of a young man. The way the hair sits may appear that there is a bald spot present, but there is actually no miniaturization here, and thus, no genetic balding. What appears to be a hole, is really the point where the hair diverges from a center point. This divergence, the radial direction of hair that covers the full 360 degrees of a circle, is the point where I say “the hair changes direction“. Only when a cowlick is present, will the hair point to what appears to be a bare section of scalp. Click the photo to enlarge.


Hair Loss InformationHair Restoration Society Credentialing – Hair Loss Information – Balding Blog

I read on a doctor’s resume that he is a member of the International Society of Follicular Unit Extraction Surgery. Can you shed light on the value of this society on the doctor’s resume?

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In the past, to develop expertise that is unearned, a doctor would create a society and possibly become its only member. That could make him/her the founder of the society, president of it, director or it, or whatever he/she chooses to be. For the less than knowledgeable buyer, the name of the society implies, as is here, some international expertise, some special training and certification, some special recognition by peers in the industry (like an Academy Award Society). The International Society of Hair Restoration Surgery (with hundreds of member physicians) has looked at creative societies with disdain and so should the buyer. There is a suggestion of a ‘slight of hand’ when one invents expertise for themselves or a group of like physicians. As the inventor of the follicular unit extraction technology and the doctor who published the authoritative article in the field, I was never invited to join that society, speak before it, or review contributions by its members in the field. I would find that strange if it were a legitimate society.

Expertise should be earned. Inventiveness is something that should be published or proven. Put the doctor and his society to that test and you will see if it meets this criteria.