Talent & Techniques: Filling the Gap: Hair Loss Treatment with the 1927 nm Thulium LaserTalent & Techniques: Filling the Gap: Hair Loss Treatment with the 1927 nm Thulium Laser
Hair is a universal symbol of youth and beauty, so it is no wonder that it has become a multibillion-dollar industry. When it comes to hair loss, many patients and providers tend to think their options are either low cost over-the-counter products or invasive and expensive surgical hair transplants. I will explore the numerous valuable and extremely effective nonsurgical treatment options that fill this gap and are a logical and easy addition to any modern medical aesthetic practice.
October 28, 2024

Hair is a universal symbol of youth and beauty, so it is no wonder that it has become a multibillion-dollar industry. When it comes to hair loss, many patients and providers tend to think their options are either low cost over-the-counter products or invasive and expensive surgical hair transplants. I will explore the numerous valuable and extremely effective nonsurgical treatment options that fill this gap and are a logical and easy addition to any modern medical aesthetic practice.
Hair Loss By the Numbers
To gain insight into the hair loss industry, it is crucial to consider its current landscape. Hair loss is a significant concern for a vast number of people, affecting both men and women across the globe. Many men will experience some form of hair loss in their lifetime, and post-menopause, a substantial percentage of women are also impacted by thinning hair. Overall, hair loss is one of the most common aesthetic issues people face, influencing not only how we look but also how we feel. In fact, some individuals feel so strongly about it that they are willing to make extreme sacrifices to restore their hair. As someone who has personally dealt with hair loss, I understand the lengths many of us are willing to go to regain what we have lost.
Yet, most patients (and providers) do not know where to start to find a solution. There exists a large gap in the market between low-cost overthe- counter solutions and high-cost invasive hair transplant surgeries. This gap signifies a lack of awareness among consumers and providers regarding the numerous effective options available for hair regrowth. These include plateletrich plasma (PRP), platelet-rich fibrin (PRF), amniotic/ placental extracellular matrix substances, mesenchymal stem cells, exosomes, growth factors, lasers and more. Aside from being extremely effective, these nonsurgical treatment options are a very logical and easy to add to your available treatment offerings.

The 1927 nm Thulium Laser
One of my favorite nonsurgical treatment options for hair loss is laser therapy – specifically, the 1927 nm thulium fractional non-ablative laser. The use of most 1927 nm lasers for hair loss treatment is currently off label, but emerging data is encouraging, so it is important to counsel your patients accordingly. Again, most patients who suffer from hair loss are willing to try new treatments, and when done correctly, this treatment is extremely safe and effective.
The 1927 nm thulium laser uses direct and indirect mechanisms to stimulate hair growth. First, it directly induces targeted thermal damage that allows for a wound healing response, robust neocollagenesis and neovascularization. Second, the laser creates microchannels in the skin, which increases topical growth factor and serum permeability to further induce hair growth and conversion from the telogen phase to the anagen phase.
My Hair Growth Treatment Approach
PREP: To start, I always have the patient wash their hair before treatment to ensure a clean scalp. I typically advise my patients to use our proprietary hair health shampoo and conditioner in general to promote a healthy scalp and to prep for the procedure. No topical anesthetic is necessary since I generally use low or medium settings on the laser.
TREAT: With the laser on low, I move the handpiece along the length of the patient’s hairline. As I do this, I am looking to see how the patient’s skin is responding. If they have a very strong response and turn very pink or red, I keep the setting on low. If the skin maintains its normal coloring and does not have as robust of a response, I turn the laser up to a medium strength setting. Personally, I never use a high setting on the 1927 nm laser for fear of causing damage to the hair follicle. I then have my medical assistant partition the patient’s hair so I can smoothly roll the laser handpiece directly over the scalp to induce direct-scalp stimulation, first in the temporal regions, then the frontal zone and crown, followed by the occipital region. After treating the full scalp, I re-evaluate the skin to ensure it is a light pink color, which indicates sufficient stimulation.
Next, I massage 3 mL of a proprietary growth factor solution onto the patient’s scalp. I typically keep the growth factor solution chilled in my medical refrigerator. After the laser treatment, patients often report that their scalp feels hot, so the chilled growth factor solution is cooling and feels nice when applied.
To draw it up, I use a 3 mL syringe and 18-gauge needle. I remove the needle and use the 3 mL syringe to apply it topically to the patient’s scalp. The micro-channels created by the laser treatment increase permeability of the growth factor solution. I then massage in the growth factor solution until the patient’s hair is dry.
The Ideal Hair Treatment Candidate
While I find that androgenetic alopecia (male and female pattern hair loss) patients often respond best to this treatment, I have also had success treating alopecia areata patients as
well. As with any skin laser treatment, my recommendation is to avoid it in any patient who has an inflamed or irritated scalp and be more cautious and use lower settings on those with higher Fitzpatrick skin types. Ideally, wait one
to two weeks before using this treatment approach on freshly tanned skin.
Post Treatment Notes of Caution
Caution patients to avoid the sun for one week post procedure. Upon completing this treatment, instruct patients to avoid washing their hair for 24 hours and to sleep on an extra pillow that night to keep the head elevated. Furthermore, advise them to avoid saunas and steam rooms, as well as dirty bodies of water such as oceans and swimming pools for at least 48 hours.
Treatment Regimen
For optimal results, I recommend doing three treatment sessions, each one month apart. This approach serves as a booster to stimulate and induce as many hairs as possible into the anagen phase of hair growth. Once the three sessions are complete, I have my patients take a six-month break to allow the hair to grow. This treatment break is based on the concept of the therapeutic index, where everything in medicine is dose dependent, and too much of a good thing can become a bad thing when done in excess. In my experience, it is possible to overstimulate the scalp and cause damage to the hair. By spacing the treatments one month apart, the skin has time to heal. Likewise, I find that after three sessions, the hair is sufficiently stimulated and needs time to grow to its potential. After the six-month break and based on results and personal preferences, patients can either opt for another round of three consecutive sessions or maintenance treatments once every six or twelve months. In other words, if they had a great response, I transition them to a maintenance phase. If their response was not sufficient, I recommend another three sessions or exploring other treatment options for growing their hair.
This procedure is especially effective for hair loss in the frontal zone and hair line, as well as for female pattern hair loss. While it is an excellent standalone therapy, I always recommend it as part of a comprehensive regimen, which in my practice also includes hair loss medications such as minoxidil, finasteride and dutasteride, as well as our own shampoo, conditioner and serum.
I encourage other practitioners to develop their own hair loss treatment regimens with the 1927 nm thulium laser and growth factor solution based on patient preferences and lifestyle. You can follow my protocol of three consecutive sessions one month apart or provide the treatment only once or twice to gauge results. Some may find satisfactory results with having this laser treatment once every three months or twice a year. As I always tell my patients, the best regimen is the one that they can follow.
Altogether, I have found this procedure to be invaluable in my practice and have been able to achieve incredible results for my patients.
About the Author

Robert Dorfman, MD
Dr. Dorfman is a hair transplant and aesthetic surgeon, with a special interest in hair restoration, aesthetic anti-aging and regenerative medicine. He has a private practice in Beverly Hills, Calif., the Done by Dorfman clinic. Dr. Dorfman is the founder and chief executive officer of the Hair 1 Thousand Corporation, a medical grade haircare and technology company that provides innovative nonsurgical hair restoration solutions to men and women nationwide.