Author: Dr. William Rassman

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Laser Treatment (LLLT) for Hair Loss (with Photos)

Update: We are constantly asked about the effects of Low Laser Light Therapy (LLLT) for hair loss. A man who used the laser on our office showed me the impact of the laser on his hair with before and after pictures. He went to a company called Laser Hair Solutions, which uses a proprietary laser (we have one in our Los Angeles office) and a series of solutions which are religiously applied to the scalp. Minoxidil is one of the agents in the solutions that are applied to the scalp. I would like to say that I can tell which of the treatment solutions worked to increase the evident thickness shown in the photographs, but knowing that minoxidil alone could do it (a 3-15% chance of good growth with minoxidil alone), I can not attribute the benefits completely to the laser or to the minoxidil. I have reviewed a substantial number of publications (mostly European) on LLLT, and there is a good basis to show that LLLT does increase blood supply. Possibly when LLLT is added to Minoxidil, there is an additive effect. With that said, the results on this one patient are quite remarkable in just 90 days of using the combined treatment. Again one might ask, would the same effect have occurred with either the laser or minoxidil alone? This man was thrilled and only noted that ‘the’ treatment worked.

The below 1st set of photos were taken on October 10, 2005 before laser treatment. Click the photos to enlarge.

The below 2nd set of photos were taken on January 9, 2006 after laser treatment. Although I did not take these photos, a comparable set of photos were taken by me which essentially show the same effect as those taken on January 9th. I am comfortable that the photographs show what this man saw and is not a trick of the camera or lighting. Click the photos to enlarge.

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LaserComb Versus Bigger Laser Machines

Dr. I bought the hair max laser comb, i cant tell if it is producing results or not, my hair is still pretty thick, my question is, is there a difference in the hair max laser comb compared with the machine that you sit under, is there a difference in quality or the results you can expect?

Unless you have a camera that takes pictures at the exact and repeatable spot on your scalp, it is almost impossible to tell. One researcher (see: Analyzing the Results of the HairMax Laser Comb) used a small tattooed dot on an area of interest and took serial photographs at regular intervals to see if there is a change in hair count. I reviewed that particular study, as you can see in the above unfavorable reference. To my knowledge, no comparable study has been done so far for the lasers that you sit under.

With respect to your question asking if laser comb and the ‘bigger’ laser machines differ, well, the size comparison is obvious — one is a comb and the other is a big hood that you sit under. If you are asking if one is better than the other, I have no way of telling, but based upon the study of the laser comb, which was most unimpressive, I might think that the comb has very limited value. The subjective feedback of patients who have experienced the larger system seems positive, but there are no objective criteria for me to endorse. If you are asking for the results, I have no way of telling at this time.


2006-10-27 14:26:54LaserComb Versus Bigger Laser Machines

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Late 20s, want a hair transplant and need to know how many grafts I would need (photo)

I am in my late 20s and have been balding since 22. I started taking finasteride over a year ago, and while it reversed the balding a little bid (about 20% hair grew back in the bald spot), it’s been stuck at this level for a while. I am trying to figure out how many FUE grafts I will need if I am going to do a hair transplant surgery to cover this up, and whether I can get this done under $10k in the US/California. If not, I am debating making a trip to Turkey for a cheaper all inclusive surgery. I didn’t include a picture of the front, because my hair somehow hasn’t receded in the front.

Thanks in advance

You need a Master Plan to determine not only what you need now, but what is likely to happen to you in the near or long term future as hair loss is a progressive process. As you are in your late 20s, I could transplant the crown (depending upon your hair being fine, medium or coarse) the range of grafts would be between 1800-3000 (more for fine hair.

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Lateral Slits

Thank you for answering all our questions. This site is a great help!
Can you address the below paragraph pulled of Hasson & Wong’s (Canada) website?

“Hasson & Wong have pioneered the revolutionary Lateral Slit Technique. This technique of creating recipient site incisions allows for far more accurate control of hair graft angulation and direction. In addition, the coverage of bald scalp is increased on average by two hundred percent…Hair transplant surgery utilizing the Hasson & Wong Lateral Slit Technique is the only technique that is able to duplicate the alignment and distribution of hair as it occurs in nature. The result of this amazing technique is the complete absence of plugginess seen in other techniques including standard follicular unit transplantation.”

Hasson and Wong do very nice work. I have nothing but admiration for them both. With regard to lateral slits, I have been doing them on all my cases for three years, but I have never been convinced that they are superior to vertical slits. The written studies done by different doctors throughout the world have not proven that lateral slits are any better. Patients who have had lateral slits on one side and vertical slits on the other side, are split on which side is better. So while there may not be any scientific proof that lateral slits are superior or inferior, it becomes a matter of physician preference, and my choice is to use lateral slits.

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Late 50s, Noticing Acceleration in Hair Loss

I am 57 years old and have maintained a good head of hair (albeit grey these days) throughout my adult life. I did notice in my late teens and early 20’s some recession at the temples, but overall I have what is considered to be good “coverage” when compared to others in my age group.

I have been on Flomax for a urinary flow issue (high bladder neck) and Androgel for hormone replacement for 5 years now. Recently, I added Plavix, Enalapril, 81mg aspirin and Vytorin to the regimen because of an angioplasty and to lower my lipids.

In addition, I take Fish Oil, Folic Acid (5mg) Saw Palmetto and CoQ10 (200mg) although these are not prescribed, only suggested.

Recently, I have noticed some acceleration in hair loss at the crown and frontal area, although it’s progressing slowly and mildly.

I am wondering if the new combination of drugs might be the reason, or if this is simply the natural progression of MBP. I imagine at this point a minaturization study would be a good idea instead of speculating on the impact of my drug cocktail.

Please advise, and thanks for your excellent site as well as your candid, well-researched and scientific approach to this problem.

Yes, I believe a miniaturization study may be of benefit. Genetic male pattern balding (MPB) may be a cause of your hair loss, but is rare (although not unheard of) to occur so late in life. Of note, taking Androgel may contribute to the MPB due to its androgenic properties. However, you should always consult with your physician before starting or stopping any medication. It is unusual that hair loss starts in a person of your age, so I would look to the medications that you use as a possible cause.

If your hair loss is related to MPB, there are medications (such a Propecia) that MAY offset it.


2007-08-03 13:35:10Late 50s, Noticing Acceleration in Hair Loss

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Latisse MPB Trials?

Dr.Rassman,

I just came across Allegran starting trials with Latisse on patients with moderate MPB.. [article].

What was interesting to note was, some doctors prescribe Latisse as an off-label treatment for hairloss? What do you think of that regimen? Have you given it a try? Would it be acceptable to try that on patients who are on Finasteride and are not too bald (say NW 5)?

I am aware of Latisse (bimatoprost), which is currently FDA approved for growing eyelashes, and I’ve seen one patient who took it upon himself to try it on the scalp with no success. The dose is quite small for eyelashes and it’s quite expensive for treating the scalp, and I’m not sure what dose would even be necessary for the scalp.

I am also aware that there’s a formal trial to find out if it works for scalp hair growth, but at this time the question of how effective it is remains. I guess we’ll have some sort of idea once they release their phase 1 results next year (which is a study of 28 patients).


2010-12-16 14:13:51Latisse MPB Trials?

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Laws appear to block discrimination against hair styles (from CNN)

In just 1 week, 3 states considered bills to ban discrimination based on hair texture or style

Harmeet Kaur

By Harmeet Kaur, CNN

Updated 7:24 AM ET, Sun February 16, 2020

A national effort known as the CROWN Act seeks to ensure protection against discrimination based on hair texture and protective styles.

A national effort known as the CROWN Act seeks to ensure protection against discrimination based on hair texture and protective styles.

(CNN)In just one week, three states around the nation introduced or advanced bills that would ban hair discrimination.

The bills are part of a national effort known as the CROWN Act, which stands for “Creating a Respectful and Open World for Natural Hair” and seeks to ensure protection against discrimination based on hair texture and protective styles.
The Colorado state House passed the CROWN Act on Wednesday, and the state Senate introduced the bill on Thursday.

If this Texas student doesn't cut his dreadlocks, he won't get to walk at graduation. It's another example of hair discrimination, some say

If this Texas student doesn’t cut his dreadlocks, he won’t get to walk at graduation. It’s another example of hair discrimination, some say
The same day, Washington state House passed a bill that would prohibit employers and schools from discriminating against people over hairstyles and textures including afros, braids, locks and twists. The bill was introduced in the state Senate on Friday.
The Minnesota bill introduced similar legislation earlier in the week.

The recent bills come after ‘Hair Love’s’ Oscar

The flurry of activity around these bills come as director Matthew A. Cherry won an Oscar for the short film “Hair Love,” a story about a black father trying to do his daughter’s hair.

Matthew A. Cherry won an Academy Award for best animated short for the film "Hair Love."

Matthew A. Cherry won an Academy Award for best animated short for the film “Hair Love.”
In his acceptance speech, Cherry pushed for the CROWN Act to be passed around the nation.
“‘Hair Love’ was done because we wanted to see more representation in animation, we wanted to normalize black hair and there’s a very important issue out there, the CROWN Act. If we can help get this passed in all 50 states it will help stories like Deandre Arnold’s … stop to happen,” Cherry said.

Nearly two dozen states are considering action

The CROWN Act is already law in California, New York and New Jersey. At least 22 states are considering the legislation, and local jurisdictions like Cincinnati, Ohio, and Montgomery County, Maryland, have passed it too.
This week Texas lawmakers said they would consider the issue too. Members of the state’s Legislative Black Caucus announced this week that they were working on a bill for the 2021 legislative session, after an 18-year-old in the state was told to cut his dreadlocks or he wouldn’t be able to walk at graduation.
The legislation has also been introduced in Congress.
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2020-02-17 11:03:46Laws appear to block discrimination against hair styles (from CNN)