Are herbal remedies the answer to hair loss?

Hair loss is prevalent and can affect both males and females of different age groups. Despite the availability of many conventional treatment options, these might cause side effects, leading to a growing interest in natural and herbal remedies (HRs).

This review aimed to investigate the efficacy and safety of various HRs for hair loss and examine the current scientific evidence behind them. A literature search identified relevant studies published up to March 2024. The results suggested potential benefits in promoting hair growth and treating various forms of hair loss (HL). Several remedies were found to be effective in different conditions, including:

• androgenetic alopecia (AGA),
• telogen effluvium,
• alopecia areata (AA).

Various mechanisms of action (MOA) seem to be involved,
including

• 5α-reductase inhibition,
• increased microcapillary blood flow,
• antioxidant effects,
• modulation of the hair growth signaling pathways.

The authors concluded that natural and herbal remedies show promise in treating hair loss, However, many of these studies have limitations such as lack of long-term follow-up, small sample sizes, and short treatment durations. Due to this variation in the quality of evidence, further well-designed randomized trials with larger sample sizes are required to confirm the efficacy of these HRs.

The herbal remedies included in this review are:

• rosemary,
• saw palmetto,
• onion juice,
• Korean red ginseng,
• pumpkin seed oil,
• azelaic acid,
• olive oil,
• coconut oil,
• henna,
• honey,
• rice bran extract,
• Ashwagandha,
• Amla.

The authors claim that they “show promise”. Is it ‘splitting hair’ to ask: all of them? Closer inspection finds significant ‘hair in the soup’ and reveals that this statement is ‘pulled by the hair’ and based largely on wishful thinking. The truth is that evidence from rigorous clinical trials is almost totally absent.

I am tempted to say that this review is ‘hair-raising’ – alas there is not much hair left on my head to raise – even for a review as poor and misleading as this one.