Physiotherapy methods

We would like to stress that before you turn to physiotherapy to treat your hair loss, you first have to ensure that your hair loss is genetic and is not a symptom of some other condition.  Hair loss is often a symptom of some other more serious condition or skin disease and if this is the case, the source of the problem will have to be treated rather than the result.

Now let us discuss what physiotherapy is and its potential use.

What is physiotherapy?

Physiotherapy is a field of medicine that specializes in treating various  body conditions through physical means.  It is mainly used to help ease pain and to help people regain lost mobility due to injury, aging, environmental factors or disease.

Physiotherapy is also used for many other conditions including hair loss.  The physiotherapeutic methods that are used to treat hair loss include:

  • Electric stimulators
  • Massage techniques
  • Ultrasound
  • Acupuncture
  • Magnets.

Physiotherapeutic methods of hair loss treatment have a range of advantages over traditional methods which include:

  • No need to use drugs
  • No side effects
  • There is no need to apply various oily or smelly products on one’s head
  • The treatment is usually very pleasant.  After each session, you feel relaxed and rested with a tingling sensation in your scalp due to improved blood flow which may give you assurance that the treatment is working.

Now let us go into more detail about different methods used in physiotherapy.

Massage of the scalp

scalp-massageObviously, scalp massage is a great way of stimulating blood circulation and increasing the blood flow to the hair follicles.  It should be performed with care since excessive friction and rough handling can damage your hair and increase oiliness and dandruff.   Proper massage relaxes the muscles of the scalp which constrict the blood vessels  depriving the hair follicles of needed nutrients.

This massage can either be performed by a professional or you can do it yourself.  Having the massage done for you is preferred since you can completely relax and just enjoy the feeling of tension being relieved.

If you choose to massage your head yourself, start by washing your hands.  Begin rubbing the tips of your fingers over your scalp. Move your hands in small circles making sure that your finger tips are gently moving the skin of your scalp and not just rubbing your fingers over the skin.  Resist the temptation of scratching your head.  You should be using just the pads of your fingers and not your nails.

After you are finished massaging, gently pull on your hair and see how many hairs become loose.   It is fine if just a few are loose.  However, if lots of hair  falls out, this probably means that you were rubbing too vigorously.

An electric massaging device specifically designed for head massage can also be used.  After using it, you should still perform the “gentle pulling” test.

Vacuum massage

vacuum-massageAnother method that people have discovered as useful is vacuum massage.  By no means is this a modern use of the invention.  There is a commercial leaflet dating back to 1910 which advertises the use of a vacuum-cap device that  will draw the blood to the head promoting hair growth and preventing dandruff.  These devices appeared about  the same time as the invention and promotion of the “breast pump bust enlargers”.  Needless to say, these devices did not help with either  hair growth or the breast enlargement.  By the sheer number of vacuum devices promoting  penile enlargement that are on the market, we can assume people today are still falling for this scam.  We live in a consumer-based world, and companies that sell and promote these products are more than happy to provide us with innumerable testimonials that these products actually work.

Acupuncture

Acupuncture-scalpDespite the rising amount of places which offer this service, there is little to no evidence that acupuncture can treat hair loss. In essence, acupuncture is a stimulation of certain points on the body using needles. This method has long been used in traditional Chinese medicine to treat a large number of conditions. Professionals in the field of acupuncture claim that this method corrects the imbalances in the flow of qi, though real scientists have yet to prove its existence.

Ever since the late 20th century, acupuncture has been the focus of many scientific studies, which tried to evaluate its effectiveness. However, all the studies that were conducted turned out to produce variable and inconsistent results for any condition that was being treated. A systematic review of high-quality randomized controlled trails was performed by Complementary Medicine, Peninsula Medical School, Universities of Exeter & Plymouth, Exeter, UK in 2011. It has found that the pain reducing effect of acupuncture was as good for the real acupuncture as the one for the “sham” acupuncture.

This falls nicely in line with the fact that placebo effect is the greatest if the person is not just given a sugar pill, but given an injection with neutral substance.

Therefore, whether you go to a professional that specializes in the field of acupuncture or a charlatan, you’re going to get the same results from this procedure, which are actually pretty good for relieving pain.

As for hair growth, unfortunately, placebo effect cannot make your hair grow back or make it stop from falling out. Thus, acupuncture is ineffective in treating hair loss.

Magnets

magnetic-stimulationCan magnets affect your body? How large a magnet should be to be effective? Will 1 kg neodymium magnet heal the hell out of you? Of course we’re only joking… Unless you have metal implants, bullets, or a pacemaker inside your body, magnets aren’t going to affect you. And surely they will do nothing in helping you grow back your hair. The idea that they might have some magic properties stems from the fact that people are completely ignorant of how magnets work, making them very mysterious and fascinating. On the other hand, they can’t hurt you, so if you wish, go ahead and use as many magnets as you like. Just don’t place your head in between two strong neodymium magnets… that might not end well.

Electric stimulators

hair-electric-stimulatorsThe  method of using electricity for treating hair loss is called D’arsonvalization.  This method uses a high-frequency impulse current (from 110 to 400 kilohertz), low amperage (no more than 200 milli-amperes), and high voltage (10,000-20,000 volts).
This type of treatment results in an improved activity of the nervous system while, at the same time, boosting metabolic processes, tissue trophism, and blood circulation.  Phagocytosis is also increased, which can be used to increase the rate at which wounds heal.  This method is used for a number of purposes which includes initial stages of varicose veins of the legs, obliterative vascular diseases and hemorrhoids.  D’arsonvalization is also used for treating ulcers and wounds that fail to heal, as well as for cosmetic purposes and first-degree frostbite.

In 1990, The Division of Dermatology, University of British Columbia School of Medicine, Vancouver, Canada, evaluated the effectiveness of using a pulsed electrical field (electrotrichogenesis) on the scalp of patients for 36 weeks.  This study concluded  the mean hair count of the treatment group was considerably higher than that of the control group, with 29 out of 30 subjects in the treatment group experiencing hair regrowth or no further hair loss.

The reason for the phenomenon is not yet clear.  It is believed that the electrophysiological effect of this procedure is similar to the effect seen in the treatment of bone fractures and damage to soft tissues using the same technique.  Possibly, the electrical pulse may increase the cell mitosis by increasing the concentration of calcium within the cells. 1

Further study has been conducted to gather data on the long-term efficacy of electrotrichogenesis and to explore clinical effects in control subjects who were then administered with active treatment.  The groups formed where as follows:

  • Treatment group that had received active treatment between weeks 0 to 36 of the initial study continued the treatment up till week 70; thus this group received active treatment without any breaks for 70 weeks;
  • Crossover group that had received sham treatment between weeks 0 to 36 of the initial study was switched to active treatment for 30 additional weeks.

The results of the extended study confirm that the Treatment Group showed considerable improvement in hair regrowth during the first 36 weeks and had continued (and even enhanced if compared with the results of the first 36 weeks) improvement in hair regrowth beyond week 36 and through week 70.   As for the Crossover Group, between weeks 0-36, while having been on sham treatment, showed no improvement in hair growth, but it did show significant hair regrowth once switched to active treatment.  The results of the study also proved that extended treatment using a pulsed electrical field is safe and causes no side effects. 2

Another study was conducted in New Zealand to understand whether specific pulsed electrostatic fields or ETG could prevent or reduce the loss of hair in women who were undergoing CMF chemotherapy for breast cancer.  The following results were achieved: 12 out of 13 patients treated with CMF chemo and ETG experienced only negligible hair loss thoughout the whole course of treatment and afterwards. There was no delayed alopecia either. 3  However, further control studies should be developed to validate the theory that the pulsed electrostatic fields technique could help prevent chemotherapy-induced hair loss.

Conclusion

The above-mentioned studies directly investigated the effect of pulsed electrical field in connection with hair loss therapy.  As a result of these studies, it is the only physiotherapeutic method that has actually been proven to work.  However, there are too few such studies that explore the effectiveness of this method.   Therefore it is rather difficult to draw a definite conclusion as to whether this method is unquestionably effective or will be appropriate to use in treating every person who suffers from hair loss.

Ultrasound therapy

ultrasound-for-hair-lossUltrasound therapy has long been used to treat many conditions that have caused chronic pain,  This includes arthritis, fibromyalgia, as well as joint and muscle injuries.  Ultrasound therapy  uses high frequency sound waves to produce heat deep in the targeted tissues.   This procedure stimulates blood flow, increases the absorption of nutrients, reduces inflammation and stimulates cell membranes.

There are two types of ultrasound therapy:

  • Pulsed wave ultrasound – This type of ultrasound does not produce heat and is only used to provide relief for the pain.
  • Continuous wave ultrasound – This type of ultrasound generates heat and is usually used for chronic conditions.

Whether the effects of ultrasound are useful for promoting hair growth is up for debate since there have been no scientific studies on the matter.   However, ultrasound waves are potentially effective when used as a supplementary treatment method in combination with therapy that uses topical preparations.  Such use of ultrasound waves is called sonophoresis and is said to increase the permeability of the skin which allows  various therapeutic compounds to be better absorbed.

In 2004, a study was conducted to explore whether low-frequency sonophoresis (25 kHz) can improve the absorption of active compounds, stimulate some disaggregation of the skin’s horny layer and promote convective movements within the epidermis.  The study included 30 patients with alopecia areata, 48 patients with solar lentigo and 48 with melisma.  The results achieved for the patients with alopecia areata are of particular interest.  Alopecia areata patients were treated by the application of a cyclosporine or methylprednisolone solution followed by low-frequency sonophoresis (36 applications of LFS, the treatment lasted for 3 months).  The results obtained are as follows:

  • 33% of AA patients had partial regrowth and 34% had total regrowth when cyclosporine was used;
  • 57% of AA patients had partial regrowth and 39% had total regrowth when methylprednisolone was used.

The researchers state that low-frequency sonophoresis is a non-aggressive technique and can enhance the penetration of topical agents into the levels of the dermis, epidermis and appendages. 4

Regretfully, it is the only study that shows the effectiveness of sonophoresis when used for the treatment of alopecia areata andtherefore it remains unclear whether it is still a subject for further research in connection with other types of hair loss.

In addition, there is a patented device which uses ultrasound on the scalp to cause sub-lethal damage to small subcutaneous sites.  Allegedly this causes regrowth of the hair follicles and makes them produce thicker hair.  Whether this is true is yet unclear.  Unlike other physiotherapeutic methods, ultrasound therapy might actually be unsafe for the patient.

References:

  1. The biological effects of a pulsed electrostatic field with specific reference to hair. Electrotrichogenesis. (Maddin WS, Bell PW, James JH; Int J Dermatol. 1990 Jul-Aug;29(6):446-50); http://regeneracioncapilar.com.ar/ETG_Downloads/ETG-Journal-1990.pdf
  2. Electrotrichogenesis: further evidence of efficacy and safety on extended use (Maddin WS, Amara I, Sollecito WA; International journal of dermatology 31:12 1992 Dec pg 878-80); http://www.haircell.co.kr/date/IJDDec1992.pdf
  3. Pulsed Electrostatic Fields (ETG) to reduce hair loss in women undergoing chemotherapy for breast carcinoma: a pilot study (Benjamin B, Ziginskas D, Harman J, Meakin T; Psychooncology. 2002 May-Jun;11(3):244-8.); http://regeneracioncapilar.com/ETG_Downloads/ETG-Psycho-oncology.pdf
  4. Intradermal drug delivery by low-frequency sonophoresis (25 kHz) (Santoianni P, Nino M, Calabro G.; Dermatol Online J. 2004 Oct 15;10(2):24.); http://www.ncbi.nlm.nih.gov/pubmed/?term=sonophoresis%20alopecia