Many pharmaceutical companies are trying to come up with the ‘next big thing’ for treating genetic hair loss, however, there are already two clinically-proven options which are both clinically-proven and well-established.
Based on this, a popular area of exploration appears to be ways in which these existing hair loss treatments could be improved; such as increasing their efficiency or decreasing any potential side effect profiles.
One such example is the number of current clinical trials into using finasteride 1mg – one of the two MHRA-licensed and FDA-approved men’s hair loss treatments – as a topical solution, instead of its currently authorised oral tablet form. Another, which may soon join this list, is carbon dioxide (CO2) laser therapy.
Fractional CO2 laser therapy
According to clinical trial registration documents published on 25th February 2019, the Clinical and Translational Science Institute at America’s University of Minnesota plans to investigate whether fractional CO2 laser therapy used before applying minoxidil could improve the efficacy of topical hair loss treatment for Male Pattern Baldness.
First it is important to understand what exactly CO2 lasers do; they are commonly used for cosmetic procedures such as skin resurfacing and wrinkle, wart and scar removal as the light beams essentially remove thin layers of the skin.
An NHS Scotland patient information leaflet explains the process, as follows: “CO2 laser beam vaporises water molecules in the skin. This heats up the skin so that the top-most layer is peeled off. As a result, production of new skin is stimulated and the skin defects caused by the laser are healed over, creating a smoother skin surface.
“Fractional” CO2 laser means that only a part of the treated area is hit by the laser beam, while areas of skin between are left untouched. For this reason, fractional CO2 laser treatment is less sore and will heal quicker than “traditional” CO2 laser treatment.“
Traditional CO2 laser therapy generally causes two weeks of downtime after the procedure.
Effects of CO2 laser with and without different doses of minoxidil
The Phase 2 clinical trial is due to commence in August 2019 and will comprise 48 male participants. All test subjects will be between 21 and 65 years of age, with a professional diagnosis of Male Pattern Hair Loss.
Their pattern of shedding has been determined as important for this study; men must have moderately thinning hair on top, along their vertex from crown to hairline, corresponding with a Norwood III vertex or a V rating on the Norwood-Hamilton Scale.
There will be four arms to the trial; one will be a control group using 600nm CO2 laser-assisted, fractional ablative laser in deep mode with 5% fractional coverage delivered by an FDA-cleared laser device, and saline solution in place of high strength minoxidil.
Another is the Safety Group; the clinicaltrials.gov data provided by the study authors states that members of this experimental group “will participate in one visit, receiving laser assisted delivery of minoxidil and PK data. The safety group treatments will follow dose escalation…”.
This ‘escalation’ will follow the pattern of all group members being treated with a fractional CO2 laser – fractional ablative, deep mode, 5% fractional coverage – then each being administered different topical hair loss solutions. Participant 1 will receive 5mg minoxidil (0.25ml of 20mg/ml sterile solution), participant 2 will receive 10mg minoxidil (0.5ml of 20mg/ml of sterile solution) and participant 3 will receive 20mg minoxidil (1ml of 20mg/ml sterile solution)
The last two groups – Experimental Treatment A group and Experimental Treatment B group – will also receive the same laser therapy, but the A group will then follow this with 2% minoxidil (2ml of 20mg/ml sterile solution) for A and for B, they will follow the same protocol as group A but will have the additional step of applying minoxidil 5% (2ml or 50mg/ml Rogaine foam – known as Regaine in the UK – to their scalp, once-per-day for the duration of the 8-16 week study, at home.
Those taking part must agree not to use other hair loss treatments, non-steroidal anti-inflammatory medications, aspirin, St. John’s Wort or high dose Vitamin E supplements during the trial.
Changes in hair growth as measured by the researchers, the patients’ self-assessed levels of satisfaction with their hair growth, and changes in any scalp symptoms will all be recorded. Findings are currently expected to be finalised by 1st July 2021.
CO2 laser treatment aftercare
Whereas minoxidil use has a minimal side effect profile and is simply applied to a dry scalp and left to sink in, the preparation for and aftercare following laser therapy is more involved.
Because the beams damage the top layer of the skin, patients may find it can be a fairly painful procedure. As such, the scalp may need to be numbed locally in advance.
Afterwards, the treated skin will be tender, and may look raw before a crust or scab forms. This is likely to last a few days and during this time it’s especially important not to pick at or rub the scalp. Doing so may increase the risk of infection. When carbon dioxide laser treatment is used for some purposes, a preventative course of antibiotics may be prescribed beforehand.
A key issue of having CO2 laser therapy on the scalp is how exposed this area is to sunlight and, therefore, UV rays – even when it is cloudy. Sun exposure should be minimised as much as possible following this type of therapy as it could trigger a number of issues including sun damage and the skin changing colour.
The NHS advises using sun cream with a suitable SPF for up to four weeks before, and the same after CO2 laser procedures. However, the trial participants will undoubtedly be advised as to the specific steps and precautions they need to take based on this novel usage.
Whilst there may be more steps involved, it will certainly be interesting to see if fractional CO2 laser therapy can improve the efficacy of minoxidil for promoting hair growth in men with hereditary hair loss.
In the meantime, there are a number of other hair growth supporting products, including home-use low level laser therapy (LLLT), administered via conveniently ergonomic FDA-cleared devices such as the LaserComb or LaserBands. These products help to stimulate the follicles and can be used alongside either or both of the established pharmaceutical options, as part of a tailored treatment course to help those concerned about preventing baldness.
The Belgravia Centre is an organisation specialising in hair growth and hair loss prevention with two clinics and in-house pharmacies in Central London, UK. If you are worried about hair loss you can arrange a free consultation with a hair loss expert or complete our Online Consultation Form from anywhere in the world. View our Hair Loss Success Stories, which includes the world’s largest gallery of hair growth comparison photos and demonstrates the levels of success that so many of Belgravia’s patients achieve. You can also phone 020 7730 6666 any time to arrange a free consultation.