Full-Spectrum phototherapy in hair loss management: a systematic review of wavelength-dependent mechanisms, clinical efficacy, and future directions.

Abstract

Alopecia is a complex condition with profound social and psychological implications, creating an urgent need for safe and effective therapeutic interventions. This review introduces a novel "Wavelength-Penetration Depth-Targeting Mechanism" model to clarify the multi-level regulatory effects of full-spectrum phototherapy (spanning from ultraviolet to mid-infrared wavelengths) on hair follicle regeneration. Unlike traditional treatments such as drugs and surgery, phototherapy provides non-invasive, wavelength-specific modulation of key pathways. Specifically, UVB/UVA selectively induce apoptosis of T cells, thereby restoring immune privilege in alopecia areata (AA). Red light activates mitochondrial cytochrome c oxidase, promoting dermal papilla cell proliferation and inhibiting the progression of androgenetic alopecia (AGA) and fibrosis in scarring alopecia. Short-wavelength near-infrared light enhances hair follicle angiogenesis and metabolic activity by penetrating deep tissues. Long-wavelength near-infrared and mid-infrared light can induce minimally invasive wound healing responses. Despite progress in clinical applications across different spectral bands, several challenges remain unresolved, including narrow therapeutic windows, variable patient responses, and limited tissue penetration. These factors collectively represent bottlenecks for the advancement of full-spectrum phototherapy. Future research directions encompass artificial intelligence-driven parameter optimization (e.g., dual-network deep learning for real-time hair follicle monitoring), collaborative strategies (e.g., dual-wavelength synergy and the use of optical clearing agents to enhance light transmission efficiency), and the integration of multi-dimensional efficacy evaluation. This review elucidates the significance and future development potential of phototherapy as a precise and non-invasive treatment modality, while also delineating feasible pathways for transitioning from mechanistic insights to clinical translation.