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Post-Transplant Laser Therapy : Clinically Useful or Just a Marketing Gimmick?

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Use of Laser in Post-Transplant Care : Our Clinical Perspective

Last Updated: 6 Nov 2025

Low-Level Laser Therapy ( LLLT ), also known as photobiomodulation, is one of only three FDA-cleared treatment modalities for androgenetic alopecia, alongside minoxidil and finasteride ( FDA, 2007; Avci et al., 2014 ). At our clinic, we have incorporated LLLT into post-operative care for over 15 years, primarily during the first 3–7 days following hair transplantation.

Our primary objective is not long-term hair growth stimulation, but rather to support early wound healing, reduce post-operative inflammation, and potentially improve graft survival during the critical initial phase when follicles are most vulnerable ( Gupta & Daigle, 2014; Lanzafame et al., 2014 ).

While some studies suggest LLLT may modestly enhance hair density with consistent use — typically requiring treatment every other day for at least 20 minutes per session ( as noted by laser therapy experts, including those from the UK’s Hair Restoration Advisory Group ) — the effect size is generally small compared to pharmacologic therapies ( Jimenez et al., 2014; Wikramanayake et al., 2020 ).

Importantly, sustained benefits for hair growth require ongoing, regular use. For this reason, we believe home-use LLLT devices ( e.g., FDA-cleared laser helmets or combs ) are more practical and cost-effective than in-office sessions, which are often too infrequent to produce meaningful regrowth effects.

Medical therapy should be grounded in evidence-based medicine, not promoted as a marketing-driven add-on. While many clinics now routinely offer post-transplant laser therapy, its benefits — particularly beyond the early healing phase — are modest at best and require consistent, long-term use to be meaningful. When offered solely as an in-clinic service without a clear protocol or patient commitment to ongoing treatment, it often becomes a time-consuming intervention with little tangible return. True value lies in scientifically supported, patient-centered care — not in ancillary services that prioritize profit over proven outcomes.

In summary :

Post-op ( Days 1–7 ) : LLLT may aid healing and reduce edema/swelling.
Long-term : Any hair growth benefit is minor and dose-dependent, best achieved via consistent home use, not sporadic clinic visits.
Individual results vary : LLLT is considered adjunctive — not a replacement — for medical or surgical hair restoration.

References :

FDA. (2007). Clearance of HairMax LaserComb for androgenetic alopecia. [K063427]
Avci, P., et al. ( 2014 ). Low-level laser ( light ) therapy ( LLLT ) in skin: stimulating, healing, restoring. Seminars in Cutaneous Medicine and Surgery, 33(1), 48–53.
Lanzafame, R. J., et al. ( 2014 ). Hair growth in men and women using a low-level laser therapy device: A multicenter, randomized, sham device–controlled, double-blind study. Lasers in Surgery and Medicine, 46(2), 144–151.
Jimenez, J. J., et al. ( 2014 ). Efficacy and safety of a low-level laser device in the treatment of male and female pattern hair loss: A multicenter, randomized, sham device–controlled, double-blind study. American Journal of Clinical Dermatology, 15(2), 115–127.
Wikramanayake, T. C., et al. ( 2020 ). Effects of low-level laser therapy on hair regrowth: A systematic review. Journal of Cosmetic and Laser Therapy, 22(5), 273–279.

Clinical application of Laser

For Hair Loss

Laser is able to stimulate and preserve hair follicles in patients with androgenetic alopecia and other hair loss disorders. Laser has been used over the past few years in a number of laser devices ( combs, caps, hairdryer-like ) for treatment of genetic or acquired hair loss. The Laser energy addresses hair loss at the hair follicle cellular level, rejuvenating miniaturizing hair follicles in seven major ways :

Photo-Biomodulation and a stimulation effect
Initiates protein synthesis
Mobilizes calcium ions within the hair follicle
Mobilizes cellular stimulation within the dermal papilla
Enhancement of ATP production in the cells
Significant improvement of blood microcirculation
Allows greater nutrient acquisition by follicular site

After Hair Transplant

Hair transplants can initially traumatize the scalp and can result in a temporary hair loss during the first 4 months (this is known as shock loss). Some patients may experience swelling in the transplanted area. The transplanted donor follicles can also experience difficulty adapting to their new environment. Clinical studies have demonstrated the following beneficial effects of laser when use in conjunction with hair transplant.

minimizes hair shedding ( shock loss )
strengthen hair follicles after surgery with a much higher probability of survival
reduce swelling, redness and inflammation post-surgery

Advantage 1 : Effect of Laser in Cell Energy Supply

Laser hair therapy stimulates the mitochondria in cells to increase the production of adenosine triphosphate (ATP).
ATP is the form of energy used by hair cells to grow imto follicles.
Abundant energy supply is critical when dealing with weakened and traumatized hair follicles.

Advantage 2 : Increase Success Rate after Hair Transplant

Laser hair therapy devices have been used by thousands of hair transplant centers all over the world ( such as Bosley and HairClub ).
However handheld contraptions made with cheap Light Emitting Diodes ( LEDs ) are worthless when it comes to energizing the base of hair follicles.
Technologically advanced device with the FDA-cleared is now available in our center for use after hair transplant. A 20 minutes of treatment is able to revive the mitochondria of hair cells.
This can result in stronger hair follicles with a higher probability of surviving the operation.
These extra amounts of “survivor” hair grafts will eventually grow into healthy, terminal hairs.

Promotes Wound Healing

Since the first experiments in the 1960s with laser treatment for impaired wound healing, there has been much research-both lab-based and clinically-into the use of lasers for medical treatment.
Later Nils Finsen pioneered the use of UV therapy for which he won the Nobel prize in 1904 [2]).
The use of lasers and LEDs as light sources was the next step in the technological development of light therapy, which is now applied to many thousands of people worldwide each day.
The Lasers and LEDs are applied directly to the respective areas ( e.g., wounds, sites of injuries ) or to various points on the body (acupuncture points, muscle-trigger points).
Controlled clinical trials have shown efficacy in treating stroke, stimulating wound healing, orthopedic conditions and relief of chronic inflammation.
Preclinical studies have shown effectiveness in spinal cord injuries, peripheral nerve regeneration, heart attacks, degenerative brain diseases and traumatic brain injury.

Other Applications

Sports-medicine – reduce swelling and hematoma, relieve pain, treat acute soft-tissue injuries
Rehabilitation – improve mobility
Dentistry – treat inflamed oral tissues and heal diverse ulcerations
Dermatology – treat edema, non-healing ulcers, burns, and dermatitis
Rheumatology – relieve pain and treat chronic inflammations and autoimmune diseases
Veterinary Medicine – especially in racehorse-training centers
Other specialists and general practitioners

BioMechanism of Use in Hair Loss

What is Laser Hair Therapy ?

Laser Therapy, also referred to as Low Level Laser Therapy ( LLLT ), cold laser therapy, photobiomodulation, biostimulation, and phototherapy, has been shown in thousands of peer-reviewed publications to increase cellular survival, proliferation and function. The laser light after absorbed by mitochondria in the cell produces the following actions

Photo-Biomodulation and a stimulation effect
Initiates protein synthesis
Mobilizes calcium ions
Enhancement of ATP production
Significant improvement of blood microcirculation
Allows greater nutrient acquisition
Increases cellular respiration
Induces activation of transcription factors via reactive oxygen species.

The question is no longer whether light has biological effects but rather how energy from therapeutic lasers and LEDs works at the cellular and organism levels and what the optimal light parameters are for different uses of these light sources.

Biphasic Dose Response - Kills Hair vs Promotes Hair Growth

One important point that has been demonstrated by multiple studies in cell culture, animal models and in clinical studies is the concept of a biphasic dose response with the total delivered light energy density ( fluence ).
The reason why the technique is termed Low-level is that there exists an optimal dose of light for any particular application, and dose lower than this optimum value, or more significantly, larger than the optimum value will have a diminished therapeutic outcome, or for high doses of light a negative outcome may result.

Delivering Methods

The methods for delivering the therapeutic light are diverse. The field is characterized by a variety of methodologies and uses of various light sources ( lasers, LEDs ) with different parameters ( wavelength, output power, continuous-wave or pulsed operation modes, pulse parameters, polarization state etc ).
In 2002 MicroLight Corp received 510K FDA clearance for the ML 830-nm diode laser for treatment of carpal tunnel syndrome.
There were several controlled trials reporting significant improvement in pain and some improvement in objective outcome measures.
Since then several light sources have been approved as equivalent to an infra-red heating lamp for treating a wide-range of musculoskeletal disorders with no supporting clinical studies.

Historical Development of LLLT

1967

Low Level Light therapy (LLLT ) is one of the oldest therapeutic methods used by humans ( historically as solar therapy by Egyptians ).
In 1967 a few years after the first working laser was invented, Endre Mester in Semmelweis University, Budapest, Hungary decided to test if laser radiation might cause cancer in mice.
He shaved the hair off their backs, divided them into two groups and gave a laser treatment with a low powered ruby laser ( 694-nm ) to one group.
They did not get cancer and to his surprise the hair on the treated group grew back more quickly than the untreated group.
This was the first demonstration of “laser biostimulation” to re-grow hair.

1989

Increase the number of the miniaturized follicles causes baldness. Hair follicles in hairline, midscalp, crown, and temples are most sensitive to DHT.
In men the first appearance is therefore a receding hairline and/or thinning crown.
Thinning eventually progresses into other areas.
In the more advanced AGA only a rim or “horseshoe” pattern of hair remains.
In some men even this remaining rim of hair can be affected by DHT.

1995

An analysis of five action spectra suggested that the primary photoacceptor for the red-NIR range in mammalian cells is cytochrome c oxidase [6].
It is remarkable that the action spectra that were analyzed had very close (within the confidence limits) peak positions in spite of the fact that these are seemingly different processes.
The enzyme contains two iron centres, haem a and haem a3 ( also referred to as cytochromes a and a3 ), and two copper centres, CuA and CuB [7].
Fully oxidized cytochrome c oxidase has both iron atoms in the Fe(III) oxidation state and both copper atoms in the Cu(II) oxidation state, while fully reduced cytochrome c oxidase has the iron in Fe(II) and copper in Cu(I) oxidation states.
There are many intermediate mixed-valence forms of the enzyme and other coordinate ligands such as CO, CN, and formate can be involved.
All the many individual oxidation states of the enzyme have different absorption spectra [8], thus probably accounting for slight differences in action spectra of LLLT that have been reported.

Recent Development

A recent paper from Karu’s group [9] gave the following wavelength ranges for four peaks in the LLLT action spectrum :
1) 613.5 – 623.5 nm,
2) 667.5 – 683.7 nm,
3) 750.7 – 772.3 nm,
4) 812.5 – 846.0 nm.

Absorption of photons by molecules leads to electronically excited states and consequently can lead to acceleration of electron transfer reactions [10].
More electron transport necessarily leads to increased production of ATP [11].
Light induced increase in ATP synthesis and increased proton gradient leads to an increasing activity of the Na+/H+ and Ca2+/Na+ antiporters and of all the ATP driven carriers for ions, such as Na+/K+ ATPase and Ca2+ pumps.
ATP is the substrate for adenyl cyclase, and therefore the ATP level controls the level of cAMP.
Both Ca2+ and cAMP are very important second messengers. Ca2+ especially regulates almost every process in the human body ( muscle contraction, blood coagulation, signal transfer in nerves, gene expression, etc. ).

Research

1. Early Discovery: Mester's Mouse Study

In the 1970s, Mester first reported that 694-nm ruby laser treatment stimulated hair growth in shaved mice.
Black mice showed dense hair regrowth between the 5th and 7th treatments, while white mice responded later.
After the 9th treatment, hair growth at the center stopped, but ring-shaped peripheral hair growth appeared.
In untreated control mice, hair regrew slowly or not at all.

2. Limited Clinical Observations in Humans

Despite the popularity of LLLT devices for hair regrowth, only a few clinical studies exist:

Japan : Super Lizer (600–1600 nm) improved alopecia areata lesions in 47% of patients.
Spain : HeNe laser used for androgenetic alopecia and alopecia areata.
Finland : Compared different light sources and observed increased scalp blood flow.

3. Proposed Biological Mechanisms for LLLT-Induced Hair Growth

3.1 Nerve Growth Factor (NGF) and Hair Cycle Regulation

NGF and its receptor TrkA are active during early anagen (growth phase).
NGF mRNA peaks in early anagen; NGF protein peaks in catagen (regression phase).
Commercial NGF promotes anagen in early-stage follicles but can trigger catagen if applied late.
➔ Suggests NGF/TrkA plays an anagen-supporting role.

3.2 p75 Neurotrophin Receptor (p75NTR) and Catagen Control

p75NTR promotes apoptosis in catagen (regression) phase.
Knockout mice without p75NTR showed delayed catagen, while NGF-overexpressing mice had accelerated catagen.
➔ p75NTR is a key controller of hair follicle regression.

3.3 LLLT Increases NGF Expression

HeNe laser exposure increased NGF mRNA fivefold in muscle cells.
Human keratinocytes also released more NGF after laser exposure.
➔ LLLT may stimulate hair regrowth via the NGF/p75NTR signaling pathway.

4. Other Molecules Potentially Involved in Hair Growth

4.1 Heparanase

Heparanase degrades extracellular matrix, allowing stem cell migration and hair follicle regeneration.
Overexpression in mice led to faster hair regrowth, including after chemotherapy-induced alopecia.

4.2 Thymosin Beta-4 (TB4)

TB4 promotes stem cell migration, differentiation, and extracellular matrix remodeling.
Stimulated hair growth in rats and mice by activating follicle stem cells.

4.3 Activin/Follistatin System

Activin regulates skin development and hair growth.
Overexpression of Follistatin (an activin inhibitor) delayed hair follicle development and transition to catagen.

Sara’s Comment

Although both low-level lasers and LEDs are used in hair restoration, they are not identical in effectiveness. Laser devices typically produce coherent, focused light, which can penetrate deeper into the scalp and may result in stronger stimulation of hair follicles. In contrast, LEDs emit non-coherent, diffused light, which may have shallower penetration and variable biological effects.

While both technologies can promote hair growth to some extent, clinical outcomes tend to be more consistent with laser-based devices, especially those with wavelengths optimized for follicular stimulation. Therefore, it is important to consider the type of light source when evaluating low-level light therapy ( LLLT ) for hair loss.

Publications On LLLT

More than 1,000 publications have reported that laser or low energy lasers can effectively increase cell survival, proliferation and function. Clinical controlled trials have shown that lasers can stimulate and preserve hair follicles affected by androgenetic alopecia and other alopecia.

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