Overview

Alopecia Areata (AA) is a common skin disease where the body’s immune system attacks hair follicles. This causes loss of hair on the scalp and sometimes other areas of the body such as the face, arms or legs. The amount of hair loss is different for everyone; most people only lose hair on the scalp in circular coin-sized patches, whilst others lose a lot. AA can affect anyone, regardless of gender, race, or age, although most cases develop before the age of 30.¹ It affects about 2% of people across the world at some point in their lifetime.² 

While there is currently no cure for AA, doctors often suggest some forms of treatment to help with hair regrowth. Light Treatment, also known as “Low-Light Laser Therapy (LLLT)” or “Phototherapy” has recently been considered as a treatment for hair loss caused by alopecia, with several recent studies deeming the therapy technique as safe and effective.³ 

Understanding alopecia areata

Alopecia Areata (AA) belongs to a group of conditions called autoimmune diseases- where the body’s immune system mistakes healthy tissues as dangerous and begins attacking them. 

Several medical names are given to this type of hair loss:

• Alopecia Areata (patchy): the most common type, hair loss in one or more round patches on the scalp
• Alopecia Areata Totalis - hair loss across the entire scalp
• Alopecia Areata Universalis - hair loss across the entire body, including eyelashes and eyebrows

Researchers believe that alopecia is caused by a combination of genetic and environmental factors, and can also be triggered by stress and anxiety.⁴ Some people who lose their hair regrow it and never have another episode, while others see it fall out repeatedly. In certain cases, the hair needs help to regrow, and without any treatment, the hair loss persists or may even worsen. However, when people find a treatment that works for them, they can see full regrowth in a matter of months. 

Although at this time alopecia areata cannot be cured, several treatment options have helped people regrow their hair. The treatments offered aim to block the immune system attack and stimulate hair growth. 

Conventional treatment options include:

• Corticosteroids: Anti-inflammatory drugs are often used as treatment for autoimmune diseases. Usually injected into affected areas of the scalp or applied topically, they reduce the inflammation around hair follicles and encourage hair growth. They often take a long time to work and can have side effects such as weight gain, mood swings and blurred vision⁵
• Immunotherapy: A treatment is only recommended when hair loss happens repeatedly or in larger areas. A topical treatment is applied to the scalp to produce an allergic reaction, tricking the immune system into stopping its attack on the hair follicles. This treatment varies greatly in effectiveness, with success in hair regrowth ranging from 17% to 75%.⁶ Also, the allergic reaction brought on often causes intense itching and dry scaly skin, although long-term complications are rare⁶
• JAK Inhibitor: A medication usually taken in pill form to treat a variety of autoimmune diseases, it aims to calm overactive immune systems. This treatment has shown promising results in some clinical trials, but it’s important to note that it is a long-term treatment, and as soon as treatment stops, the hair begins to fall out again⁷
• Minoxidil: This medication is used to help people keep the hair that regrows. It is often used after other treatments have been effective and has very few side effects⁸

But not all treatments work for everyone, and many people try several before finding something that works for them. Clinical trials to broaden the treatment options for AA are constantly taking place. But it is important to understand that AA is a chronic disease, and as soon as treatment is stopped, the hair will probably fall out again. 

What is light therapy?

Light therapy is considered a safe and effective treatment option for stimulating hair growth in conditions like AA. It involves exposing affected areas to specific wavelengths of light, typically ultraviolet (UV) light or low-level laser therapy (LLLT). The treatment usually consists of two to three weekly sessions where the skin is exposed to light. Some patients are also given a treatment called psoralen in a pill or topical liquid form, which is used to make the skin more sensitive to light. 

While conventional treatments can be effective for some people, they can also bring about various side effects. Researchers are interested in exploring light therapy because it is shown to have fewer adverse effects, making it a more promising long-term treatment option. Light therapy aims to alter and regulate the body’s immune responses, but the specific way in which it does this varies between the types of light used.

Ultraviolet (UV) light therapy

UV light therapy is commonly used to treat a variety of scalp conditions, such as psoriasis and, more recently, AA. It works by slowing the speed of skin cell division within the treated area and reducing inflammation around the hair follicle, encouraging hair growth.⁹ The treatment also involves taking a tablet or applying a cream that makes the skin more sensitive to light. The areas of hair loss are exposed to UV light two or three times a week for several months. Clinical trials using UV light therapy have shown varying results, with treatment success ranging from 20% to 80%.^10,11 

Low light laser therapy (LLLT)

LLLT, also known as red light therapy, uses red or near-infrared light to stimulate hair growth. When the light penetrates the affected area, it is thought to increase blood flow to the hair follicles and promote hair regrowth. Although the treatment is most effective when performed by a medical professional at a clinic, it can also be performed at home using a smaller device which can be purchased in the form of a helmet, comb or brush. Several studies have shown LLLT to be effective for patchy AA, improving hair density in more than 50% of patients, although it has also been shown that LLLT cannot help people achieve complete hair regrowth.^11,12

Benefits of using light therapy in treating AA

There a several benefits of using Light Therapy to treat Alopecia Areata, including:

• It could be effective if other treatments have not worked for you or you have previously experienced unpleasant side effects with other treatments 
• It is a relatively non-invasive treatment, especially compared to corticosteroid injections
• No serious side effects have been reported³
• It is safe to use alongside preventative treatments such as minoxidil⁸
• At-home devices are accessible and easy to use

Potential side effects and considerations

• Some people report experiencing mild side effects such as irritation, dry skin, redness or headaches¹⁴
• At-home devices can be expensive, and the clinical procedure may not be as accessible as other treatments
• Just like other treatments, it is not guaranteed to work, and although research is promising, more is needed. To date, most of the light therapy research has been carried out on patchy AA or even androgenetic alopecia, a similar condition which is not an autoimmune disease like AA^12,13,14

Summary

Alopecia Areata (AA) is a common autoimmune disease which causes hair loss after the body’s immune system attacks hair follicles. People who experience this hair loss often go through psychological and emotional distress and frequently seek treatment. Many of the existing treatment options, such as corticosteroids and immunotherapy, come with unpleasant side effects. More recently, light therapy has been proposed as a safe and effective alternative. 

The two main types of light therapy, Ultraviolet (UV) light therapy and low-level laser therapy (LLLT), encourage hair growth through exposure to specific wavelengths of light. There has been a range of promising research showing the potential of light therapy as a treatment for AA. 

It’s very important to remember that there is no cure for alopecia. Currently, all treatments work temporarily and as soon as treatment is stopped, the hair loss returns. Regrowing hair is difficult, and results vary between individuals. Should you seek treatment, a medical professional will assess the extent of hair loss and recommend a personalised treatment plan.