Critical of the LaserComb’s Claims and FDA’s Rulings – Hair Loss Information by Dr. William Rassman

Dr Rassman

Thanks for your excellent blog. Much has been written in your blog about the LaserComb, with various degrees of advocates (and distracters). As a physician, I’d like to amplify on a previous blog, which emphasized that detailed data on the benefits of the LaserComb is not available and thus makes it difficult to evaluate its benefit beyond anecdotal experiences. In addition, the manufacturer makes claims likely to be criticized as unsupportable if similar claims were made for a drug and, to me, employs classic marketing techniques designed to give as little information as possible.

The data supplied to the FDA in support of the LaserComb, which is publicly available at FDA.gov (PDF File) is scant for 4 main reasons: (a) approval was based on use as a device rather than a drug, (b) the threshold of evidence was not the usual superiority of controls required of drugs but “equivalence” to “predicate” devices, (c) a single, controlled study involving a small number of patients was conducted (rather than the usual minimum of 3 studies required of drugs), and (d) unlike studies supporting drug approval, detailed data for the LaserComb is not shown on the aforementioned FDA site. Basic information, such as patient entry criteria, number of patients participating, participating centers and investigators, statistical analysis, etc is absent.

When the manufacturers of the LaserComb report their claims in peer-reviewed, scientific journals where the data can be evaluated by the public, it will allow me to better evaluate the risk/benefit is. In addition, claims made by the manufacturer (“greater than 90% user satisfaction reported!”) are the type of marketing statements that are impossible to evaluate without context. The site also speaks to the single study used to approve the device but fails to mention the number of patients used (likely very small), duration of baldness of patients, or what the placebo response is. Photos of successes are also shown on the manufacturer’s site, with no timeframe to let the reader appreciate how long the patient used the device.

Finally, a previous blog noted the 20-week return policy, which gave readers an impression that money will be refunded if the device does not work. This policy, as stated in the manufacturer’s site, is that a partial refund (60%) will be given if the device is returned within 20 weeks. As the site suggests using the device for more than 20 weeks if no growth is seen, (“many of our users report that even in this time frame, with continued use, they slowly start to notice a thickening of their hair, and even show signs of re-growth”), one wonders how many patients with no growth truly send the device in before the 20-week cut-off.

You make many great points and perhaps the manufacturer of the LaserComb (and other manufacturers of similar products) will see your post and address the points you brought up. I know they’ve read this site in the past, as I’ve received correspondence from them when I disputed claims made on their site over a year and a half ago. We’ll see.

Whatever the case may be, thank you for your comments!

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Doctor Warned Me Not to Pop Scalp Pimples After Hair Transplant – Hair Loss Information by Dr. William Rassman

hello doctor

i’m three months post a hair transplant operation, i started to note a scalp pimples appeared stating from the second month after the operation, i had told by the doctor who did the operation to me don’t burst these pimples as this could lead to follicular death!, but sometimes i got to burst the white head of the pimples spontaneously. is it true what he told me about damaging the FUE???? this could happen when combing or whatever i do actions to my scalp by mistake.

also i read on the internet that this is normal and a very good sign to hair regrowth underneath the scalp.

another question please, now and after the third month hair density is very thin, is it normal ? and what is going to happen in the next 3 months, can i really got 5 or 6 times the hairs which i got now ? or it depends on something i don’t know it ?

thank you so much

Many of your questions should be asked of your surgeon. I do not know enough about your case to address most of your questions. Some people do develop cysts after surgery and they tend to ‘pop’ by themselves with warm compress soaks. If you develop folliculitis, then you could lose a graft under the skin, but folliculitis needs to be treated, again by your doctor, not me over the internet.

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Existing Hair Falling Out In Transplanted Areas – Hair Loss Information by Dr. William Rassman

Hi, I’ve had 2 hair transplants to the front of my forehead where i still had a substantial amount of hair. The reason i did it was to thicken the area up. I noticed that after the surgery, my current hairs fell out next to where the implants were put, and a lot never grew back. The surgeon said that was because they were going to fall out anyway, but that was 8 years ago and it is still obvious where my hairs fell out, the other ones near them havent fallen out. My question is, Is it true that the trauma DOES make existing hairs die?

For people who do not take Propecia (finasteride 1mg), they run a higher risk of shock hair loss or an accelerated hair loss pattern after a hair transplant. Your doctor is correct, but the acceleration is usually about a few years worth, unless you are taking Propecia (by prescription and for men only).

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HairGenesis Clinical Studies – Hair Loss Information by Dr. William Rassman

Hi, I used the search and see you have only replied to 1 question with regards to the hair “Hair Genesis” product. I am quite aware of the products “claims”, but I wish to get your opinion on the studys that they have posted on their website. Links marked Clinical Study 1 and 2, and your input on the published report in The Journal of Alternative and Complementary Medicine. I’m in my mid 20’s and my hair is thinning and the front of my hairline has been receeding. So I have been researching potential products to try. Not interested in the mess associated with rogaine, and the merck drug can have those sexual side effects.

While I agree with you that anyone should be wary of a product that touts the FDA, however their website is much more proffessional than other, similiar all herbal products.

Ultimately my question is: If you could review the study’s they claim to have done, do these studies apear to have been legit? Also, since your last question/post on this product was in 2005, has anything changed since?

HairGenesisHairGenesis, like some other botanicals, may have DHT blocking effects, but why play games? Any DHT blocker has the potential to depress the sex drive, but the frequency with finasteride is defined and it is relatively low. I certainly don’t believe that these HairGenesis products are “Proven DHT Blockers! With no side effects.” If you want a DHT blocker, I’d think you’d want one with known value like finasteride (talk to your doctor about Propecia, as it is a prescription medication).

I read the studies and I am afraid they do not meet the type of criteria I find statistically valid. For starters, I can’t find any information relating to who conducted these studies (who knows if they are even independently researched). Secondly, the photos presented in the studies are very poor quality with bad lighting. It is also worth noting that a professional website may give an appearance of a professional company, but it isn’t too difficult to find a good designer to make a great site nowadays. I don’t see their site as looking all that great, but beauty is in the eye of the beholder. You probably shouldn’t base your opinions simply on the look of their website, though.

In the News – Love Cured Complete Alopecia in Young Woman – Hair Loss Information by Dr. William Rassman

Perhaps I’m just an old romantic, but I really enjoyed this story. Maybe balding people should look for love to cure their hair loss? Likely not, but the story is entertaining for sure.

Hayley BurtonSnippet from the article –

Love has been a hairraising experience for Hayley Burton – in the nicest possible way.

The pretty 20-year-old student had been TOTALLY BALD for seven years before meeting and falling in love with boyfriend Don Timson.

But now her locks are growing back despite her extreme form of hair-loss disease alopecia.

Full text — People.co.uk – The Lock of Love!

In Hayley’s own words — Pick Me Up Magazine – Love made me hairy!

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Psoriasis – Balding Blog

Hi Dr. Rassman. When I was younger I had what I think was diagnosed as a form of psoriasis which was mostly on my scalp. I would have quarter size patches of dry flakey skin and if i tried removing the patches large clumps of hair would also come out. Although I’m sure I was experiencing MPB as well, I feel like this was something that increased the amount and rate of hair which was being lost. I had visited the dermotologist and Nizoral was prescribed at the time.

Just wondering if this is a condition you’re familiar with?

Thanks

I am more than just familiar with it, as I have a very aggressive form of psoriasis myself. When I was young, it impacted my scalp along the ears and frontal area and looked awful and felt painful as well. Psoriasis will not cause hair loss unless you pick at it enough to develop traction alopecia. If your dermatologist has his/her hand on it, then there is nothing to do unless you are not in control of it. If you have male pattern loss at this time then probably you should be on Propecia (finasteride 1mg).


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In the News – Stress from Being Bullied Causes Teen Girl to Go Bald – Hair Loss Information – Balding Blog

From the article:

A teenage girl who was the victim of disgraceful bullying for three years has been left so traumatised that her hair has fallen out.

Faith Hawley, 14, said she was verbally abused, punched and even had her hair set on fire after starting at secondary school.

After three years Faith was diagnosed with alopecia, which doctors say was down to stress.

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Bullied girl - before and after

 

Wow. This is a horrible case of stress, and for a 14 year old girl to lose all of her hair, it must’ve been quite extreme. Read the full article at the UK’s Daily Mail — ‘I was so badly bullied my hair fell out’: Girl, 14, reveals ordeal at hands of school yobs

If I’m in My 30s And Have Early Hair Loss… – Hair Loss Information – Balding Blog

In a recent response you wrote: “It is in the 20s (pretty much from age 20-29) that men are most likely to see most of their hair loss.” What does that mean? I am 33 and I started to notice some minor thinning in the last year and a half. My derm has said it may be “very early MPB” or the result of inflammation I had – and he would not prescribe propecia as he said “You’re not there yet”. If most men see most of their hair loss in the 20s, and my dad and older brother (38) have no thinning, should I assume since I am older than 20s and dont have that pattern in my family, that the thinning will be mild or stabilize soon or is caused by something else(though it is on the vertex)? Again, I was not prescribed propecia because “I’m not there yet” – but I thought it was best early. Just wondering about my age, and what it means if most see most loss in the 20s and my family has none.

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The hair loss in the 20s is a statistical thing. Some men start balding in their 30s, less in their 40s, and some even in their 50s and 60s. There is no hard rule, but whenever you start balding, the drug finasteride is effective at slowing and/or stopping it. I do not agree with your dermatologist, as once you know you have genetic balding, the earlier you start the drug the better it is.

Hair Spray and Female Hair Loss – Hair Loss Information by Dr. William Rassman

(female) I am getting bald on top. Does cheap hair spray cause this cause I do use a lot of it? I am only on medicine liptor and zetia . Can this medicine cause hair loss. It is getting worse. What can I do? I am 67 years old

Although not a known side effect, the medication you are on may cause hair loss — or you may be experiencing genetic female hair loss, which is present in half of post menopausal women. You need to be examined by a good doctor and tested for a variety of medical conditions which can cause hair loss.

I highly doubt that it is caused by your hair spray.

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PCOS and Hair Loss – Hair Loss Information by Dr. William Rassman

I am a 27y/o female I have been dealing with hair loss for about 3yrs now. I have been diagnosed with pcos. I am being treated for that with birthconrol pills. the last time i checked my hormone levels were close to normal as well as my thyroid levels. so why is my hair still falling out? my family have no signs of baldness mother and father,grandparents, both have full hair. everybody but me. please help have you ever heard of thymu skin does it work? I also seem to have a lot of grity white stuff on my scalp my hair if very thin on top. please help

To answer your questions about the management of your PCOS and hair loss, I would need to examine you as I would anyone I was treating. PCOS tends to act like male patterned hair loss and I would want to know if that was you situation. I’d first map out your hair for miniaturization and then get a diagnosis.

See previous posts for more:

ThymuSkin is a shampoo. The science is weak and I have no working experience with it.

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