- Hair loss is a common problem, with nearly 80% of men and half of all women experiencing hair loss in their lifetime.
- Although nutritional supplements are commonly used to treat hair loss, there is little data on their effectiveness and safety.
- A recent review summarizing data from 30 previous human studies suggests that nutritional supplements could potentially treat certain types of hair loss while having generally tolerable side effects.
- The authors noted that these studies included a limited number of participants and showed variability in design, suggesting the need for larger randomized clinical trials.
A recent systematic review published in the journal
The study found that a range of supplements ranging from pumpkin seed oil, zinc, vitamin E, omega fatty acids and some commercial formulations like Viviscal and Nutrafol, among others, have shown promise in treating specific types of hair loss.
The studies included in the review were generally small and used subjective inclusion criteria, highlighting the need for larger and more robust randomized clinical trials.
About 85-90% of hair follicles on a normal scalp are in the anagen or growth phase. The growth phase is followed by catagen, the transition phase involving the slowing of hair growth.
The catagen phase lasts about 14 days and is followed by the telogen phase or resting phase which lasts 3 to 4 months. Hair growth remains dormant during the resting phase and is followed by hair loss. A loss of around 50 to 100 strands of hair normally occurs each day.
Hair loss that exceeds these normal values is called hair loss or alopecia.
Hair loss can occur for many reasons, including genetics, aging, autoimmune diseases, hormonal changes, and stress. Some of the common types of hair loss include androgenetic alopecia, alopecia areata, and telogen effluvium.
Androgenetic alopecia, known as male pattern baldness, is the most common cause of hair loss believed to affect
Telogen effluvium is characterized by hair follicles prematurely exiting the growth phase and entering the telogen phase. This results in excessive hair loss during the resting phase.
Telogen effluvium often appears in response to stress, illness, or medication use.
Treating hair loss usually requires addressing the underlying cause, such as a nutritional deficiency or disease. There are also Food and Drug Administration (FDA) approved medications for androgenetic alopecia, namely oral finasteride and topical minoxidil.
Due to the potential negative effects of finasteride in women, only minoxidil is also used for androgenetic alopecia in women.
However, both drugs are associated with side effects that can lead to discontinuation of their use. Specifically, finasteride can cause sexual dysfunction in men, while minoxidil is associated with dermatitis.
More recently, the FDA also approved baricitinib, a drug that modulates the immune system, for the treatment of severe alopecia areata.
Given the potential side effects associated with pharmacological treatments, there has been interest in using alternative therapies, including nutritional supplements, for hair loss.
A recent study involving patients at a hair loss clinic showed that nearly 80% of individuals used nutritional supplements. However, there is limited data on the safety and effectiveness of these supplements.
In the current study, the researchers summarized evidence from 30 previous human studies, including 17 randomized clinical trials, examining the effectiveness of various nutritional supplements in treating hair loss.
They excluded studies looking at hair loss due to nutritional deficiency, medication use, trauma, or physical stress.
The researchers also ranked the studies according to the quality of the evidence, with randomized clinical trials representing the highest level of evidence in the review.
Studies suggest that various types of hair loss, including alopecia areata, androgenetic alopecia, and telogen effluvium, are associated with oxidative stress and a deficiency of micronutrients such as vitamins.
While the review found high-quality evidence to suggest that zinc may improve hair growth in people suffering from hair loss, the evidence supporting a role for vitamin D and vitamin B12 in treating hair loss. hair loss were substandard.
However, results from randomized clinical trials suggest that tocotrienols, antioxidant compounds belonging to the vitamin E family, and a combination of fish oil (omega-3 and omega-6), blackcurrant and antioxidants such as vitamin E and lycopene, may improve hair density in people suffering from hair loss.
Androgenetic alopecia is associated with the excessive response of hair follicles to an androgen called dihydrotestosterone (DHT), a derivative of testosterone.
Among nutritional supplements that inhibit DHT formation, data from a randomized clinical trial suggests that pumpkin seed oil may stimulate hair growth in men.
A deficiency in other hormones, such as insulin-like growth factor (IGF-1), is also associated with hair loss. Studies suggest that capsaicin, the active ingredient in chili peppers, and isoflavones, a subclass of antioxidant compounds, may potentially increase levels of insulin-like growth factor-1.
Additionally, a small randomized clinical trial has shown that capsaicin and isoflavones can improve hair growth in people with alopecia.
Herbal compounds that can modulate the immune response, such as glycyrrhizin (licorice) and peony extracts, have also shown promise in treating people with alopecia areata, which is characterized by an immune response against the hair follicles.
Similarly, studies also suggest that procyanidin B-2, an anti-inflammatory and antioxidant compound, derived from certain species of apples, may also stimulate hair growth.
Commercial multi-ingredient formulations including Pantogar, Nourkrin, Viviscal, Nutrafol and Lambdapil have also shown positive effects on hair growth in randomized clinical trials.
Pantogar includes keratin, the main hair protein, and its building block
Viviscal and Nourkirn contain proteins derived from marine animals that may facilitate hair growth. Nutrafol contains DHT synthesis blockers, antioxidants and anti-inflammatory compounds, while Lambdapil contains L-cysteine, plant-derived silicon and DHT synthesis blockers.
There is a lack of sufficient or high quality evidence to support the role of other commercial multi-ingredient formulations such as Omni-Three and FORTI-5 in stimulating hair growth.
In addition to having beneficial effects on hair growth, the interventions examined in this study generally had mild side effects. These results suggest that nutritional supplements could potentially help treat certain types of hair loss.
However, the authors noted that the studies included in the review had several limitations. For example, the majority of studies had a small sample size or used subjective reports of hair loss at baseline.
The authors also cautioned that some of the studies included in the review were funded by the manufacturers of the nutritional supplements.
The authors further noted concerns about the lack of FDA regulations covering supplement efficacy, safety, and quality. Thus, nutritional supplements could potentially contain ineffective or adulterated ingredients, the latter causing side effects.
This forces dermatologists to work with patients to weigh the risks and benefits of these nutritional supplements.
Dr. Justin Rome, founder of the Barber Surgeons Guild, commented for Medical News Today this:
“While nutritional deficiencies can lead to hair loss, supplementation of vitamins such as biotin in those who are not deficient in them has not been shown to promote hair growth. Other new ingredients may have a beneficial result under certain circumstances; however, they can also have no results or, worse, potential adverse effects. It is important to note that nutritional supplements are not regulated by the FDA, which means that they are not subjected to rigorous testing for safety and efficacy as drugs.
Similarly, Dr. Thivi Maruthappu, Consultant Dermatologist at Cadogan Clinic and Senior Lecturer in Nutritional Sciences, cautioned:
“Be careful when choosing supplements, look for high quality clinical trials supporting their use. High doses of some nutrients can actually be harmful, for example excess selenium, can lead to toxicity and even worsen hair loss , and a high dose of biotin can trigger acne and interfere with blood tests, so it’s important to do your research before buying.
Maintaining a healthy diet could also play a vital role in preventing hair loss. Dr. Reid Maclellan, Founder and CEO of Cortina, and Adjunct Professor at Harvard Medical School, told us that “[i]Increasing your protein and iron intake in your diet can help prevent hair loss in both men and women.
“Iron deficiency or anemia is the most obvious factor that can lead to hair loss, as it can affect the follicles producing proteins to grow hair,” he added.
“Some foods you can incorporate into your diet that can help add to your hair loss prevention plan include bone broth, eggs, seaweed/kelp, seeds (flax, sunflower, chia) , fish oils and berries. Avoid alcohol, sugar, and processed foods that block DHT,” Dr. Maclellan advised.
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