Category: Hair Products

Dr. Rassman

It is not my intention to be a “naysayer” or to engage in a continued point-counterpoint debate regarding the Lasercomb. I don’t have any ax to grind. But, in your wonderful site, your readers may not have the background to fully appreciate unusual statements in the Lasercomb response.

As a physician who is an experienced clinical trialist (I negotiated and presented clinical data resulting in drug approvals at the FDA for two major biotechnology companies over a period of 15 years) and a balding patient, the Lexington statement is not entirely forthright for your readers and does not fully address major concerns. It comes across to me as if it’s written by marketing folks rather than scientists involved in analysis and presentation of clinical data. Specifically,

It’s wonderful that “GCP”, “IRB approval”, etc was part of their clinical trial. For your readers, that means that the data was “real” (i.e., not fake or compromised), which of course is important when submitting data to regulatory agencies (FDA). But, the compelling question and real issue is presentation of data and accurate statements. For example,

1. Great that the single pivotal study is being written up for publication. This should have taken 1 week and been done a long time ago. It is highly atypical that a device or drug is approved without the study being published (before approval) in a peer-reviewed, scientific journal. This is truly the only way for physicians and patients to understand the effectiveness and safety profile, and make an educated decision. It is so atypical not to publish such data that the absence creates skepticism, whether deserved or not.
2. It is misleading for those not privy to drug/device approval processes to say that approval was based on the same statistical scrutiny as minoxidil and finasteride. What they mean is that statistical superiority had to be shown over a placebo control. The number of patients used, number of studies conducted, and duration of treatment, follow-up, and extent of the number of patients exposed paled in comparison to the aforementioned drugs. There is nothing wrong with this per se as a medical device should not be held to the same standards as a drug with potential systemic toxicity. But, again, it speaks to the clarity by which the company attempts to educate readers.
3. In the absence of publication of data in a peer-reviewed journal, the company gives only “partial data” on their web site and omits critical information (number of patients in the study, mean compliance, etc) that raises suspicion (even when no suspicion may be warranted). The presentation of clinical data on their web site is so poor that it appears to have been done by those not experienced in how to present data (and thus does not allow readers to be fully educated).
4. LaserComb may be the best thing in the world. The “real issue” is not, as the company states, that “people are not willing to move away from the “status quo.” That is ridiculous. The issue is that, in this age where data is often manipulated, spun, and marketed, companies touting products have an ethical and scientific obligation to provide detailed data of their clinical trials in public forums so that physicians and patients can make informed choices. When such data is not presented (or “in preparation”), a proper evaluation of risk/benefit can not be made, and skepticism abounds. Ironicaly if data is in a form for submission for regulatory approval, a few “cut and pastes” of several sections of the submission document should be all that is required to write up a small study.
5. The Lexington statement notes that “the hair growth, quality, condition, tensile strength, and manageability of hair” is enhanced by their laser. Data???? The company also makes statements based on their “extensive anecdotal experience over 20 years”. While anecdotal experience is not as valuable as placebo-controlled trials, it is still helpful. Let us hope that the company is also writing a manuscript “in preparation” summarizing this experience.
6. One P.S. The company needs to stops saying it “offers a money back guarantee.” As with presentation of their clinical data (so far), a half-truth. The company offers (beyond a month) a 60% refund if the comb is returned within 5 months. Their statement implies that those who find it not effective can return it, which is not the criteria. Again, nothing wrong with their policy. The issue is one of clarity of communication, which is missing for their clinical data.

We appreciate your excellent observations and input into such a controversial subject. I would hope that our readers take the time to reread your comments carefully, for in those comments there are many insights into the research process and when it is credible.

For more from this thread of critical back and forth, see:

• Critical of the LaserComb’s Claims and FDA’s Rulings
• Response from Lexington International (Makers of LaserComb) Regarding Critical Statements

And to read previous posts on the LaserComb, please see the list here.

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Greetings Dr. Rassman,

We’d like to thank you for taking the time to acknowledge the HairMax LaserComb on your Web site. We take this opportunity to respond to some of your comments and attempt to put to rest much of the ongoing debate over the HairMax LaserComb on your site.

In January of 2007, the HairMax LaserComb was Cleared by the FDA for the “Promotion of Hair Growth” in males with certain classes of Androgenetic Alopecia. This Clearance was based, not solely on a predicate device (as you’ve stated in your blog), but also on solid clinical data from our multi-centered double blind sham controlled study which followed all Good Clinical Practices.

For your readers reference, there are two processes for medical device approvals from the FDA, one being PMA (Pre-Market Approval) and the other is a 510K. Since our laser is considered a NSR (Non Significant Risk) device as defined by international laser safety standards, we appealed to the FDA to submit a 510K based on the safety of predicate devices.

Our clinical study, device labeling, GMP (Good Manufacturing Practices) and ISO (Quality) accreditation was the basis of receiving the FDA 510k Clearance.

The study took place at 5 sites throughout the United States. We are currently drafting a medical review of the study to be submitted to a peer-reviewed journal. We have every intention of publishing the study and making the full results available for public scrutiny.

Our statistical data, along with macro analyses of trial participants’ before and after images were proven to be medically significant. Our clinical protocol was IRB approved, followed GCP (Good Clinical Practices) and we utilized clinical trial monitors to verify all source data and case report forms. Please understand that we had to prove to the FDA, under the same statistical scrutiny as both Propecia and Minoxidil, that the HairMax was effective in increasing ‘Hair Counts’ in men with Androgenetic Alopecia.

In addition, we have just completed a clinical study for female Androgenetic Alopecia and have filed a new FDA 510K submission for females. We are cautiously optimistic that it will receive Clearance for females suffering from hair loss.

As for statements on your site concerning the difference between FDA approval and FDA clearance, here is the rule of thumb for submissions cleared by the FDA: In general, Drugs are ‘Approved’ for sale, and Medical Devices are ‘Cleared’ for an ‘Indication of Use’.

In your ongoing critique of the HairMax LaserComb, you also compare the technology to that of the laser hood. Here, again, you are not taking in to account the differences between the two devices. Yes, the HairMax LaserComb and the laser hood both use red lasers, but the HairMax uses a patented special array of hair parting teeth which allow for an unobstructed path of the laser to the scalp. We believe this direct laser path to the hair follicle is a critical design feature which makes the HairMax LaserComb standout from the laser hood and provides greater efficacy. Simple reasoning would indicate that an individual’s hair will block some of the laser energy from the laser hood and they would simply not see comparable results because the laser energy would not reach the scalp.

We have conducted an experiment aimed at assessing the delivery of our laser to the scalp with a specific emphasis on the efficacy of the HairMax LaserComb’s patented hair parting teeth. The results showed that 92% of the laser energy emitted from the HairMax is delivered precisely and accurately due simply to the movement of the hair away from the scalp by the hair parting teeth. The efficacy of laser therapy reaching the scalp of non-parted hair amounted to only 9-24%. Obviously this design feature is only valid for someone with hair.

Finally, your critique of the HairMax always seems to point to an alleged lack of clinical data and a clear mechanism of action.

Similar to Rogaine, how the HairMax LaserComb works is debatable and evolving. It is our hypothesis that the HairMax LaserComb, in some way, stimulates the dermal papilla leading to increased cell proliferation of the hair matrix. We believe this process causes increased production of the hair fiber. Supporting this hypothesis are user reports of faster growing hair.

We further hypothesize that the HairMax is an anagen inductor, and support this hypothesis by user reports of increased shedding at the onset of treatment. To us, this indicates an increase in telogen fallout leading to healthier anagen growth.

A few of your prominent colleagues suggest that the HairMax LaserComb may also have some effect on cell apoptosis, but we will not comment further as we know it will spark debate and we do not have any scientific premise to support this theory, yet.

We are about to conduct further research with histologic biopsies to document some of the changes which occur after HairMax LaserComb usage.

Please understand that when we went public with the fact that we were proceeding with clinical trials, naysayers complained that it was just a farce for us to attempt to increase business. Now that we have proven, through our FDA clearance, that clinical trials were conducted, some people still continue to be skeptics…The real issue seems to be that people are not willing to move away from the status quo. Rogaine and Propecia are approved; we are Cleared; all three of us have been proven as effective treatments for Androgenetic Alopecia.

We don’t guarantee that everyone will see results. From our extensive anecdotal experience spanning over 20 years, we have seen that 45% of users see benefits quickly, 45% of users see benefits over time, and 10% of people will see little results. Keep in mind, compliance is a major factor in the realization of benefits. In reality, treatments for any condition are never a sure bet, and we do not contend that our product is a miracle for hair loss sufferers. It does, however, offer well founded hope and quantifiable results, and that’s what we’re about.

To conclude, we have been collaborating with leading hair researchers and clinics across the world. What we’ve found is that the experts who actively use the HairMax LaserComb accept its efficacy; those who do not remain skeptical.

This seems to be the same issue we encounter with non-users of the HairMax LaserComb who are quick to complain that it is ineffective, but are unwilling to give it a chance to work. The HairMax LaserComb has been on the market since 2001, and one of the key factors in marketing a medical device is user experiences. We believe the HairMax LaserComb has one of the highest levels of customer satisfaction of any hair treatments. In addition to positive changes in hair growth, the quality, condition, tensile strength and manageability of the hair is enhanced. We offer a money back guarantee to our direct customers; if the HairMax LaserComb was not an efficacious treatment we would have been in the archives of a ‘hair loss snake oil’ schemes by now. Instead, we have achieved FDA accreditation and gained acceptance from hair experts and have satisfied users worldwide.

We hope that this clears up any misunderstandings you or your readers may have about our medical device.

Sincerely,
Lexington International LLC

I would love to believe that the technology works, but as yet, I can not become a supporter. I will look forward to your new publication and will read it with interest. I try to give controversial issues space on this blog to give a balanced view, so your response is appreciated.

have you had any positive results from silica complex vitamins?

There are herbal supplements which have various claims to stop hair loss, but when I research them (particularly on the internet), I can find no credible science. Your question was whether I’ve seen any positive results from silica complex vitamins — and assuming that you’re asking about this for treating hair loss, the answer is no. I can not seem to find any information about it actually treating hair loss in any way, aside from a single author on a weight loss site.

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Hi again, Dr. Rassman. The blog is great and useful as always! Congratualtions. My question is in regards to Procyanidin. After all the stories and comments since October, 2006 it now looks like the promises did not become anything solid and real, correct? I suppose more research would have been done if this really showed true potential, correct? Thanks!

I have no further insight than the last time I wrote about procyanidin B-2. That does not necessarily mean nothing has happened with it, but any new information hasn’t been brought to my attention. For those that want to read my past blog entries about procyanidin, see here.

If anyone has any new information, please don’t hesitate to send it.

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