- Hair loss is a common problem, with almost 80% of men and half of all women experiencing hair loss during their lifetime.
- Although nutritional supplements are commonly used to treat hair loss, there is limited data on their efficacy and safety.
- A recent review summarizing data from 30 previous human studies suggests that nutritional supplements could potentially treat certain types of hair loss and have 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 JAMA Dermatology synthesized data from previous research, including randomized clinical trials, on nutritional supplements that might treat hair loss.
The study found that a variety of supplements ranging from pumpkin seed oil, zinc, vitamin E, omega fatty acids, and certain commercial formulations such as 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, emphasizing the need for larger and more robust randomized clinical trials.
Hair growth cycle can be divided into three phases. The first phase, known as anagen, is characterized by hair growth and can last for several years.
About 85-90% of the hair follicles in a normal scalp are in the anagen or growth phase. The growth phase is followed by catagen, the transition phase that involves the slowing down of hair growth.
The catagen phase lasts around 14 days and is followed by the telogen or resting phase which lasts 3-4 months. Hair growth remains dormant during the resting phase and is followed by hair loss. Normally there is a loss of around 50 to 100 hair strands every day.
Hair loss above these normal values is known as 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 areataand telogen effluvium.
androgenetic alopeciaknown as pattern baldness, is the most common cause of hair loss estimated to affect fifty% of men and women upon reaching the age of 50 years. alopecia areataAnother common form of hair loss is an autoimmune disease that causes the loss of small areas of hair.
telogen effluvium It is characterized by the fact that hair follicles prematurely exit the growth phase and enter the telogen phase. This results in excessive shedding of hair in the resting phase.
Telogen effluvium often appears in response to stress, illness, or medication use.
Treatment of hair loss usually requires addressing the underlying cause, such as a nutritional deficiency or disease. There are also medications approved by the Food and Drug Administration (FDA) for androgenetic alopecia, namely oral medications finasteride and topic minoxidil.
Due to the possible negative effects of finasteride in women, only minoxidil is also used for androgenetic alopecia in women.
However, both drugs are associated with adverse effects that may result in discontinuation of their use. Specifically, finasteride can cause sexual dysfunction in men, while minoxidil is associated with dermatitis.
More recently, the FDA has also approved baricitiniba drug that modulates the immune system, for the treatment of severe alopecia areata.
Given the potential side effects associated with drug treatments, there has been interest in the use of alternative therapies, including nutritional supplements, for hair loss.
A recent study which involved patients from a hair loss clinic showed that almost 80% of people used nutritional supplements. However, there is limited data on the safety and efficacy of these supplements.
In the present study, the researchers summarized the evidence from 30 previous human studies, including 17 randomized clinical trials, that examined the effectiveness of various nutritional supplements in the treatment of hair loss.
They excluded studies involving hair loss due to nutritional deficiency, medication use, trauma, or physical stress.
The investigators 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 micronutrient deficiency such as vitamins.
While the review found high-quality evidence to suggest that zinc might improve hair growth in people with hair loss, the evidence supports a role for zinc. vitamin D Y b12 vitamin in the treatment of hair loss was of lower quality.
Despite biotin (vitamin B7) is a common ingredient in hair loss therapies, there was a lack of studies examining the effects of biotin as a stand-alone treatment.
However, the results of 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 seed oil, and antioxidants such as vitamin E and lycopene, may improve hair density in people with hair loss.
Androgenetic alopecia is associated with the excessive response of hair follicles to an androgen called dihydrotestosterone (DHT)which is derived from testosterone.
Among nutritional supplements that inhibit DHT formation, data from a randomized clinical trial suggests that pumpkin seed oil might stimulate hair growth in men.
A deficiency of other hormones, such as insulin-like growth factor-1 (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, could potentially increase insulin-like growth factor-1 levels.
Additionally, a small randomized clinical trial showed that capsaicin and isoflavones together can improve hair growth in people with alopecia.
Plant-derived compounds that can modulate the immune response, such as glycyrrhizin (licorice) and extracts from the peony plant, have also shown promise in the treatment of people with alopecia areata, which is characterized by an immune response against Hair follicles.
Similarly, studies also suggest that procyanidin B-2, an anti-inflammatory and antioxidant compound derived from certain apple species, may also stimulate hair growth.
Commercial multi-ingredient formulations including Pantogar, Nourkrin, Viviscal, nutrafoland Lambdapil have also shown positive effects on hair growth in randomized clinical trials.
Pantogar includes keratin, the main hair protein, and its basic component L-cysteinewhich could help promote hair growth.
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 a role for 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 reviewed in the current 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, most 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 manufacturers of nutritional supplements.
The authors also noted concerns about the lack of FDA regulations covering the efficacy, safety, and quality of supplements. Therefore, nutritional supplements may contain ineffective or adulterated ingredients, and the latter may have side effects.
This requires dermatologists to work with patients to weigh the risks and benefits of such nutritional supplements.
Dr Justin Romefounder of the Barber Surgeons Guild, commented to today’s medical news that:
“While nutritional deficiencies can lead to hair loss, supplementation of vitamins such as biotin for those who are not deficient has not been shown to promote hair growth. Other novel ingredients may have a beneficial result under certain circumstances; however, they can also have no results or, even worse, have potential adverse effects. It is important to note that nutritional supplements are not regulated by the FDA, which means they are not rigorously tested for safety and efficacy like drugs.”
Similarly, Dr. Thivi Maruthappuconsultant dermatologist Cadogan Clinic and lecturer in nutrition science, warned:
“Be careful when choosing supplements, look for high-quality clinical trials that support their use. High doses of certain nutrients can actually be harmful—excess selenium, for example, can cause toxicity and even worsen hair loss, and high doses of biotin can trigger acne and interfere with blood tests, so It’s important to do your research before you buy.”
Maintaining a healthy diet could also play a key role in preventing hair loss. Dr. Reid Maclellanfounder and CEO of Curtainand an adjunct professor at Harvard Medical School, told us that “[i]Increasing protein and iron intake in the 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 from 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,” advised Dr. Maclellan.
