Q) Dr. Jung Min Bae - In your recent manuscript on fractional laser treatment for baldness, you discuss your experience laser treatment to induce hair growth. For the average balding person reading your manuscript, what would you say is the key point they should know from your experience and report?
Baldness remains one of the major dermatologic challenges even though current treatments, such as topical minoxidil and oral finasteride are helpful for some patients. Hair transplantation can be considered for severe hair loss, however, its usefulness is limited by patient budgets and surgical burdens. The treatment options for hair loss are still limited.
Recently, fractional laser treatments have been reported to be effective in a variety of hair loss in some case series. Although the efficacy of fractional laser treatment should be validated in a large number of patients, we demonstrated that this treatment approach stimulated hair regrowth in a murine model. Our results suggest that fractional laser treatment can potentially be developed as a new treatment modality to stimulate hair regrowth.
Q) Can you tell us what patients you consider would potentially be good candidates for this treatment approach?
There were no approved treatment modalities to stimulate the telogen to anagen conversion of hair follicles. Finasteride blocks the conversion of testosterone to dihydrotestosterone, which is thought to be associated with male pattern baldness. Minoxidil seems to allow more oxygen, blood, and nutrients to the follicle by widening blood vessels and opening potassium channels. Although they are proven to be effective in hair loss, they are not associated with anagen induction directly.
In our study, fractional laser appears to be effective for inducing anagen hair follicles in a murine model. This approach could be used as an adjuvant with conventional treatments in most cases of patients with hair loss.
Q) Would a scalp biopsy be helpful before trying this approach to treating hair loss?
I don't think that the scalp biopsy is required to choose candidates for this approach.
Q) Do you always recommend minoxidil or other adjustments to your hair loss patients?
Because there are no definite treatment modality for hair loss, I prefer the combination therapy of available treatments including topical minoxidil.
Q) Would you suggest a scalp biopsy in all your alopecia patients?
In most cases, I diagnose my alopecia patients with physical examination and history with the aid of folliscope. I do not perform a scalp biopsy in all my patients, although scalp biopsy would be helpful to make a correct diagnosis in some patients.
Q) What do you think will be the next big breakthrough in hair loss and/or hair transplants?
Recently, a variety of treatment modalities including low-level laser therapy (LLLT), platelet-rich plasma (PRP), a series of mesotherapy, as well as fractional laser treatment have shown to be effective for promoting hair growth. Those adjuvant approaches could fill the gap between limited medical treatments and hair transplantation in the near future.
Q) Do you plan a follow-up report and/or study?
My research team is now exploring the detailed molecular mechanism of the fractional laser treatment in inducing hair regrowth. We believe that more in-depth knowledge would help to establish the new treatment protocol for patients with hair loss. Thank you for your interest.