## 4 Discussion
Different low-level laser and light sources for the management of alopecia, such as LLLT, [31; 32; 33; 34; 35; 36], various wavelengths of LED light [11; 37], and several other techniques combined, such as LED-LLLT [38], have been analyzed by many investigators, with the aim to establish the related treatment parameters and the outcomes. In a 26-week trial, [PERSON] et al. [38] randomly assigned 110 AGA patients with MPHL IIa V to receive therapy with the HairMax LaserComb(r). At 26 wks, HD had an average increase of 19.8% in the study group patients. [PERSON] et al. [31] performed a 24 wk trialincluding 40 AGA patients treated with a helmet-type 3R LLL-T device doted both LEDs emitting wavelengths of 630 nm and 660 nm that LD with wavelengths of 650 nm. At 24 wks, the mean percentage of increase in HD was 14.7%. Finally, [PERSON] et al. [25] conducted a 24 wk, trial that included male AGA patients treated with RAMACAP(r), a combat helmet-shaped device containing single-mode LD, emitting at a wavelength of 660 \(\pm\) 10 nm [25]. At 24 wks, the mean percentage of increase in HD was 9.1%. There was a substantial distinction between light and laser sources, though. The shape, light source, number of LEDs and LDs, wavelength, and overall power output of LLLT devices made each protocol different. Additionally, the hand-free devices, such as hats [31] and helmets [30; 39; 40], which were also demonstrated to be clinically effective, frequently employed a large number of user-friendly diodes, ranging from 40 to 304. The mean change in HD from baseline to week 24 in [PERSON]'s study [25] was 10.21 \(\pm\) 3.25 hairs/cm\({}^{2}\) in the laser group against 3.95 \(\pm\) 1.32 hairs/cm\({}^{2}\) in the sham group. In the laser group, the mean change in hair diameter from baseline to weeks 24 was 6.11 \(\pm\) 2.15 \(\upmu\)m, compared with 3.76 \(\pm\) 1.24 \(\upmu\)m in the sham group. These date appear to be in line with the data published by [PERSON] et al. [9] (12 \(\pm\) 2 hairs/cm\({}^{2}\) at 16 wks). Considering standard treatments including oral Finasteride(r) and topical Minoxidil(r) with LLLT, taking 1 mg of Finasteride(r) in MPHL for 12 months significantly increased total HC by 7.3% at 24 wks [41]. Applying 2% and 5% topical Minoxidil(r) showed a significant HC increase for 8.84% (\(p\) = 0.013) and 12.3% (\(p\) < 0.001) at 48 wks, respectively [42]. The LLLT effectiveness revealed a significant HC increase for 20.9 (12.79%, \(p\) = 0.0249) vs. 25.7/cm\({}^{2}\) (16.96%, \(p\) = 0.0028) in the 9- and 12-beam laser comb treated side at 26 wks after treatment, respectively [43]. Hence, the effectiveness of LLLT appeared to be comparable to the conventional HL treatment. Furthermore, the combination treatment of 5% Minoxidil(r) and LLLT seemed to provide a better response of HD than Minoxidil(r) or LLLT alone [43]. In every case, the efficacy and safety of LLLT in the treatment of MPHL and FPHL have been demonstrated [43]. In the present research paper, 10 patients whose hair growth stalled after taking Finasteride(r), and 10 patients who did not achieve good results from Finasteride(r) were treated with LLLT with MND and GFs. Encouraging results, in terms of hair growth booster, have been reported confirmed from an HD increase of 19 \(\pm\) 2 hairs/cm\({}^{2}\) at T1 after 16 wks (16 wks vs. 0 wks) in the TA compared with baseline (70 \(\pm\) 2 hairs/cm\({}^{2}\) at T1 versus 51 \(\pm\) 2 hairs/cm\({}^{2}\) at baseline). Therefore, it was proven that the combination of MND with LLLT and GFs can provide a good HRG effect on subjects who did not achieve a good effect from Finasteride(r) or who were on a stagnant period due to some limitations of Finasteride's DHT production inhibitory effect alone. As known, Finasteride(r) relieves the capillaries constricted by DHT and supplies a small amount of blood to the hair follicles, but when there is not enough nutrition, passing through a period of stagnation seems to be mandatory, which is the limit of Finasteride(r) treatment.