Considering 30 to 50 percent of men are affected by hair loss by age 50 — it’s no surprise that some turn to herbal remedies like saw palmetto.
A plant extract often found in hair loss supplements and shampoo for thinning hair (including DHT-blocking shampoos), saw palmetto extract may be an effective hair loss treatment. But supporting research is limited.
Below, we dig into what saw palmetto is and discuss whether saw palmetto hair loss treatment really works — or if you should try other treatment options for hair loss.
What Is Saw Palmetto for Hair?
Saw palmetto is a plant found mostly in the southeastern United States. It also answers to a scientific name, Serenoa repens.
The dietary supplement ingredient may help alleviate symptoms linked to an enlarged prostate gland, also known as benign prostatic hyperplasia (BPH). It’s also sometimes used for chronic pelvic pain, migraines and other conditions.
That’s all great. But what does this have to do with hair loss?
We’ll explain, but first, we need to dive deeper into DHT (promise it’s relevant). DHT is a pesky little male androgen that’s probably partially responsible for your hair loss. Male androgenetic alopecia is largely hormonal, and it’s the most common form of hair loss in men, affecting 30 to 50 percent by age 50.
After puberty, when DHT’s key role of growing facial hair and deepening the voice is done, it looks for something else to do. Unfortunately, the hormone doesn’t get a hobby. Instead, it decides to spend its free time shrinking hair follicles, a process also known as hair miniaturization. Smaller follicles mean thinner, patchy hair and hair loss in men.
Some things work as a shield, blocking DHT’s ability to enter the follicle. Arguably the best-known DHT blocker is the prescription medication finasteride (the active ingredient in Propecia).
You know what else is a DHT blocker? You guessed it: saw palmetto.
Now we’re full circle back to the topic at hand. In some studies, saw palmetto appears to partially block DHT.
The Different Forms of Saw Palmetto
Saw palmetto may be a buzzy ingredient these days, but it’s not new. It has a long history as a folk medicine ingredient, with records showing it was used by Native American tribes to treat urinary and reproductive health problems.
The natural ingredient comes in different forms. You may see it as an oil extract, dried berries, powder capsules or tea (though the fatty acids in saw palmetto aren’t water-soluble, so tea doesn’t really do much).
For hair loss, it’s often applied topically via shampoo or serum.
Does Saw Palmetto Block DHT?
To answer your question (okay, fine, our question), saw palmetto does block DHT — at least in part. The harder thing to answer is to what extent it blocks the hormone.
A 2012 study looked at 100 men with mild to moderate male androgenetic alopecia (AGA). It showed that 38 percent of patients treated with saw palmetto had an increase in hair growth compared to 68 percent of those treated with finasteride who noticed an improvement. But even finasteride doesn’t completely block DHT.
How Effective Is Saw Palmetto for Hair Loss?
Here’s the so-so news: While there isn’t a ton of evidence supporting the idea that saw palmetto is effective against hair loss, that doesn’t mean it’s not. Confusing, right?
Think about it like this: We don’t have much solid research supporting the belief that vitamin C helps prevent colds, but that’s not stopping anyone from downing it in powdered form all winter. And many swear by it.
Is everyone just placebo-ing themselves into oblivion? Probably not. Dietary supplements usually don’t require approval from the FDA (U.S. Food and Drug Administration) and often aren’t studied as much as their prescription counterparts.
So, just because something doesn’t have a bunch of clinical trials to its name doesn’t necessarily mean it doesn’t work.
That said, some studies do exist. A 2009 review found that saw palmetto is the most popular botanically derived 5 alpha reductase (5aR) inhibitor.
Another meta-analysis looked at both oral and topical saw palmetto. It found that 60 percent of those studied showed improvement in overall hair quality, 27 percent showed improvement in total hair count, and just over 83 percent saw increased hair density.
Saw Palmetto Dosage for Hair Loss
Many people are curious about the correct saw palmetto dosage for hair loss. Since saw palmetto is a natural supplement and haircare product ingredient rather than a medication, there’s no evidence-based dosage your healthcare provider may recommend for treating hair loss.
In the meta-analysis mentioned earlier, men were given a dose of between 100 and 320 milligrams (mg) per day.
Powder vs. Liquid Saw Palmetto Supplementation
If you’re taking saw palmetto berry powder capsules (as opposed to an oil capsule or liquid tincture), it’s important to note that this formulation usually contains much less saw palmetto than you’d find an oil-based extract.
The liquid extract is much more potent, even if the pills are the same size or contain the same number of milligrams. This means the powder may not have enough fatty acids or phytosterols to be effective, which is a bummer for hair loss and potentially dangerous for those using saw palmetto to treat BPH.
When using saw palmetto, always check the instructions on the packaging for information about the recommended dosage. It’s also best to talk to your healthcare provider before taking any supplement or using a haircare product containing saw palmetto as an active ingredient.
Your hair needs many vitamins, minerals and macronutrients to make strong follicles. Here, you can find a list of some hair vitamins that will encourage healthy hair growth.
Side Effects of Saw Palmetto for Hair
If you’ve ever seen a drug commercial, you know every medication or supplement has some side effects — and saw palmetto is no exception there (though the side effects are generally mild).
Some may experience stomach discomfort after taking saw palmetto, which can usually be alleviated by eating first.
There’s also a risk that self-medicating with saw palmetto (or any medication that reduces levels of 5-alpha reductase) may delay the discovery of prostate cancer.
This is because with continued use of six months to a year, saw palmetto reduces levels of PSA (prostate-specific antigen), an antigen that can indicate prostate cancer when found in high numbers. Findings on this topic are mixed, so it’s always a good idea to check in with your provider if you have concerns.
Saw palmetto may also interact with other medications, including:
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Blood thinner medications, such as warfarin (sold under the brand name Coumadin), clopidogrel (Plavix) and aspirin
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Oral contraceptives, such as the birth control pill
Talk to your healthcare provider before using saw palmetto if you’re prescribed any medications.
Saw palmetto hasn’t been studied on pregnant or breastfeeding women and, for that reason, should be avoided unless otherwise specified by a medical professional.
Other Ways to Promote Hair Growth
There are plenty of other hair loss treatments, some of which can be used in combination with saw palmetto. Here are a few options to consider.
Finasteride
We touched on finasteride earlier, so we’ll keep this brief. This hair loss medication was FDA-approved in 1997 to treat AGA in men at a 1-milligram daily dose. At a higher 5-milligram dose, it’s approved to treat BPH.
Minoxidil
Minoxidil (brand name: Rogaine) is an FDA-approved medication for hair loss. It’s a vasodilator — in non-medical speak, that means it widens blood vessels, bringing blood, oxygen and nutrients to the scalp.
This medication also shortens the telogen phase of the hair growth cycle, thereby extending the anagen phase (growth phase), and it increases hair length and diameter. Significant research shows it’s an effective way to boost hair growth and thickness, if you are willing to use it, here’s more of what you need to know about it.
On the other hand, minoxidil foam may be a better option for folks with sensitive skin or who’ve experienced irritation with the medication in the past. The foam doesn’t contain propylene glycol, which some researchers think may be responsible for adverse reactions.
Finasteride-Minoxidil Combo
Sonny and Cher. Hall and Oates. Mary-Kate and Ashley. Topical finasteride & minoxidil spray. Yep, our spray makes it easy to apply this absolutely iconic duo at once.
A 2019 meta-analysis found that when used in combination, finasteride and topical minoxidil are more effective but just as safe as using one or the other on its own.
Biotin
Biotin helps produce a protein known as keratin, which hair is made of. A biotin deficiency is rare (but possible if you follow a strict diet), though it could be the reason your hair is falling out.
Volumizing Hair Products
Volumizing shampoo and volumizing conditioner are like the mascara of the scalp world. While they make your hair look fuller and longer, the results aren’t permanent. Still, it’s a great fake-it-til-you-make-it solution, especially when used in tandem with other hair loss treatments.
The Verdict on Saw Palmetto for Hair
Does saw palmetto work? The age-old question (or at least the question of the hour). If you’re beginning to notice the signs of hair loss, saw palmetto can be a good addition to your hair loss prevention stack.
Here’s the verdict:
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Saw palmetto is a type of palm tree. Oil from the saw palmetto berry is extracted to help treat certain health conditions, including hair loss and prostate enlargement.
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More research is needed, but saw palmetto shows promise in helping with hair loss that has a hormonal cause, like androgenic alopecia. However, since it works on DHT, it won’t be effective in aiding hair regrowth from non-hormonal causes, like telogen effluvium (aka hair loss from stress).
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We talked a lot about how saw palmetto is an alternative to finasteride, but what about “dupes” for other hair loss drugs? Those exist too.
This article originally appeared on Hims.com and was syndicated by MediaFeed.org.
More from MediaFeed:
7 Common Causes of Hair Loss for Men (& How to Treat Them)
What probably comes to mind when you think of hair loss, or alopecia, is an older man with a receding hairline and a bald spot on the top of his head. But from male pattern baldness to hair loss caused by autoimmune conditions, vitamin deficiencies, or stress, hair loss comes in many patterns and affect men of all ages.
You might be thinking, “Why is my hair thinning?” or “Why is my hair falling out?” More importantly, you might be wondering if your hair falling out is permanent or if there’s something you can do to treat it.
Some forms of hair loss can actually be reversed, and the sooner you start, the better the outcome.
So let’s dive into all things hair loss — its symptoms, causes, treatments, and more.
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Classically, symptoms of hair loss in men include a receding hairline (particularly over the temples, creating a characteristic “M” shape) and signs of balding at the top of the head, referred to as the crown.
But, as we mentioned, this only represents one of many types of hair loss (more on these below).
Hair loss can be sudden or gradual. In can come in waves or happen in stages. It can be permanent or temporary. In some cases, hair loss might not be a complete loss of hair. Instead, the hairs get thinner, shorter and lighter.
It’s not a one-size-fits-all situation, and it comes with many potential signs and symptoms. Some of the common ones include:
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Hair loss on different parts of the head or body
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Thinning hair
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Patchy hair loss
In some cases, hair loss can also include:
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Itching
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Irritation
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Redness
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Scaling
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Oozing
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Pain
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Burning
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Tenderness
If your hair loss is related to a medical condition or vitamin deficiency, you could also experience:
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Skin changes
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Nail changes
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Other symptoms
Lastly, depending on how you feel about your hair loss, you may have symptoms such as:
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Stress
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Distress
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Low self-esteem or confidence
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Depression
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As you can guess, each type of hair loss has its own causes.
Broadly speaking, the different types of hair loss can be broken down into two categories: non-scarring alopecia and scarring alopecia (also called cicatricial alopecia).
With non-scarring alopecia, hair follicles are preserved, meaning hair loss is potentially reversible. With scarring alopecia, hair follicles are irreversibly damaged, leading to permanent hair loss.
Of the two, non-scarring alopecia is the more common. Let’s take a look at each common cause of hair loss.
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Male pattern hair loss — also called androgenetic alopecia or androgenic alopecia — is a progressive type of hair loss. It’s mostly influenced by genetics, meaning the genes you get from your parents determine if you develop this type of hair loss.
In the case of male pattern hair loss, in susceptible men, a hormone called dihydrotestosterone (or DHT), which is a derivative of testosterone, causes hair follicles to undergo a process called follicular miniaturization.
Follicular miniaturization is what it sounds like — hair follicles get smaller, and the hairs they produce get thinner and lighter. Technically speaking, hairs transform from terminal hairs (the longer, darker hairs like the ones typically found on the scalp) to vellus hairs (the tinier hairs on the rest of the body).
As the hair follicle shrinks, it also loses attachment to the arrector pili muscles under the skin that help hold it in place.
This whole process takes time. If you start addressing male pattern hair loss early on, hair loss can be delayed or even stopped completely. In some cases, it can even be reversed and you can regrow hair. But if the process is allowed to go on for too long, hair follicles can reach a point of no return.
In women, this form of hereditary hair loss is called female pattern hair loss.
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Telogen effluvium is a type of hair loss that occurs when hair falls out rapidly.
It’s caused by stress (such as by experiencing a trauma) or a sudden change to the body, such as being in an accident, getting surgery, weight loss, having a change in your hormones (like during menopause, in women), childbirth, having an illness or starting a new medication.
This type of hair loss is usually temporary.
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Alopecia areata is a type of hair loss that results in patches of complete hair loss. It’s an autoimmune hair loss disease, so it’s caused by the body’s immune system attacking your own hair follicles.
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Traction alopecia is a type of hair loss that can occur from certain hairstyles. When hair is pulled too tight repeatedly or for a prolonged period (like in tight braids or ponytails), it can result in areas of hair loss where the hair is being strained. While certain hairstyles can cause traction alopecia, wearing a hat is not considered a cause of hair loss.
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Some vitamin deficiencies, such as a biotin deficiency and iron deficiency, can lead to hair loss or unhealthy hair.
(Related: 12 Best Vitamins for Hair Growth)
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Trichotillomania, also called hair-pulling disorder, is a mental health condition in which a person habitually and compulsively pulls out their own hair. The hair can be pulled directly from the scalp, but can also include other parts of the body including the eyebrows, arms, legs, and elsewhere.
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Other medical conditions can cause hair loss, such as psoriasis, syphilis, thyroid disease or a fungal infection like ringworm (tinea capitis). Depending on the medical condition and severity, these may also be scarring alopecias.
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Hair loss can sometimes be a side effect of medication. If you suspect this is the case, talk to your healthcare provider — don’t stop taking any medication without their guidance. Other medical interventions can also cause hair loss, such as chemotherapy, which is associated with anagen effluvium.
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There are many different kinds of scarring alopecia. In these cases, hair follicles are damaged by inflammation. Types include but aren’t limited to frontal fibrosing alopecia, lichen planopilaris, discoid lupus erythematosus, folliculitis decalvans, dissecting cellulitis and central centrifugal cicatricial alopecia.
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Just like there are many types of hair loss, there are also many different risk factors.
Chief among them is your genes. Having a history of hair loss on either side of the family — your mother’s or your father’s — can increase your risk of experiencing hair loss.
Other risk factors include:
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Advanced age
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Poor diet
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Having a medical condition that can cause or contribute to hair loss
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Taking a medication that can cause hair loss as a side effect
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Stress
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Certain hairstyles that pull on the hair
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A sudden change, such as something major happening physically or emotionally
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According to the American Academy of Dermatology, losing 50 to 100 hairs a day is normal. So, if you’re waking up with just a few hairs on your pillow or you see some hairs stuck in your comb after using it, there usually isn’t cause for concern — this is normal hair shedding.
However, if you notice a sudden change in how much hair you’re losing, feel like your hairline has changed or your hair feels thinner when you run your hands through it, it can be time to talk to a healthcare provider.
In some cases, you might not be the first person to notice hair falling out. A friend might tell you that the hair at the top of your head looks thinner, or after looking at an old photo of you, a friend might say it looks like your forehead has gotten larger. These can also be signs that your body is changing, and a conversation with a healthcare professional is a good idea.
You should also contact a provider if your symptoms are sudden or if you’re experiencing other symptoms along with your hair loss, like irritation, redness, flaking, skin and nail changes and more.
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To diagnose hair loss, a medical professional will typically start by asking you about your symptoms and taking a medical history.
They may ask things like:
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How long you’ve been experiencing hair loss
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If you have hair loss in your family
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If you recently started taking any new medications or supplements.
Next, a healthcare provider might do a physical exam in which they pay close attention to your hair, skin and nails.
During this physical exam, they’ll look for signs of what could be causing your hair loss and other skin conditions you might have. There are also specific tests they might do, like the pull test. The pull test involves pulling several hairs at once to see how many come out.
In some cases — like if you have very classic male pattern hair loss — additional testing might not be necessary.
In others, your healthcare provider may run additional tests — like a scalp biopsy, blood tests or microscopic hair exams — to help figure out what might be causing your hair loss.
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The specific medical treatment for your hair loss will depend on the type of hair loss you have.
For many, medication is the right approach for treating hair loss. And there are lots of treatment options to choose from. The two most common medications used for treating male pattern hair loss in men are finasteride and minoxidil. They can be used separately or together. So let’s take a closer look at each of these.
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Finasteride is a type of prescription medication known as a 5-alpha-reductase inhibitor. Remember DHT, the hormone that can lead to follicular miniaturization and male pattern hair loss? Well, 5-alpha reductase inhibitors like finasteride prevent the conversion of testosterone to DHT.
Finasteride is available as a generic medication or as the brand name Propecia, which is FDA-approved to treat male pattern hair loss. It’s also available in a higher dose as a generic and as the brand name Proscar.
Proscar is FDA-approved to treat the symptoms of benign prostatic hyperplasia (BPH), which is an enlarged prostate.
There’s another 5-alpha-reductase inhibitor called dutasteride that’s also FDA-approved to treat the symptoms of BPH, but is sometimes used off-label to treat hair loss in men.
Propecia, or generic finasteride, is a pill intended to be taken daily. It is also sometimes found in compounded medications — alone or combined with other active ingredients — and in a topical form that can be applied directly to the scalp.
Some men may prefer this form of finasteride because it reduces the risk of experiencing unwanted finasteride side effects, such as intimacy side effects (including decreased libido and ED).
(Related: Finasteride for Hair Loss: Side Effects, Dosage & More)
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Minoxidil is the active ingredient found in the brand name Rogaine. It is a topical medication that is available over the counter, and it comes in different strengths — 2% and 5% — and in various forms — as a topical solution or foam.
Researchers aren’t entirely sure of how minoxidil works, but it’s thought that it increases blood flow to hair follicles and could prolong the anagen phase (growth phase of the hair growth cycle) of a hair.
Recently, there has also been a lot of buzz about oral minoxidil. Oral minoxidil is an FDA-approved blood pressure medication, but research shows it can effectively be used off-label to treat hair loss.
Like all medications, both finasteride and minoxidil can cause side effects. They also aren’t appropriate for everyone and could interact with other medications you’re taking. Keep your healthcare provider up to date with all of your medications and medical conditions.
(Related: How Much Does Rogaine (Minoxidil) Cost?)
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While finasteride and minoxidil are the most common medications used for hair loss and the only ones specifically FDA-approved for male pattern hair loss, other interventions can also be effective. The exact treatment depends on the type of hair loss you are experiencing — some of these treatments can be effective for male pattern hair loss, while others are better for other hair loss types.
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Ketoconazole, an antifungal medication, has some activity against 5-alpha-reductase (similar to how finasteride works).
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Spironolactone, another blood pressure medication, can be used to treat hair loss in women because of its effects on hormones.
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Low-level laser therapy (LLLT) uses a laser, typically over several treatment sessions, to stimulate hair growth.
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Platelet-rich plasma (PRP) involves injections of your own blood components to prevent hair loss and promote new growth.
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Other injections, such as corticosteroids, can be given as a potential treatment.
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Supplements like biotin (vitamin B7), vitamin E, saw palmetto and more. Research on the efficacy of supplements for hair loss is generally weak or mixed, so we still need to learn more before these can be considered hair loss “treatments.”
In general, medications and treatments to treat hair loss and promote hair growth can take time to work — typically several months. In some cases, it can also appear that things are getting worse before they get better.
And if all of this doesn’t work for you, surgery can be an option, too. Different types of hair transplantation surgery include follicular unit transplantation (FUT) and follicular unit extraction (FUE). To learn more about whether hair transplant surgery is right for you, talk to a healthcare provider.
Lastly, let’s not forget about hair tattoos, wigs and toupees. Is it your natural hair? No. But can it be just as stylish? Yes!
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Hair loss is a BIG topic. It affects many people. There are many different types. There are many different causes. There are many different treatments. It seems like it would be easiest just to avoid hair loss in the first place. So, is that possible? Can you prevent hair loss?
Unfortunately, preventing hair loss altogether just isn’t in the cards for some people. Nearly everyone’s hair will thin with age and, for a large part of the population, genetics determines what you get to keep on your head.
But that doesn’t mean there isn’t anything you can do. If you’re concerned about hair loss, try to:
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Eat a healthy, balanced diet
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Manage stress
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Use hair care products that aren’t damaging to your hair and scalp
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Avoid hairstyles that tightly pull on your hair
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Cut back on unhealthy habits, like smoking
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Treat other health conditions you might have
And if you notice your hair is falling out and want to do something about it, schedule an appointment with a healthcare provider. For some kinds of hair loss, the sooner you intervene, the better — and you could not only prevent further hair loss but potentially even regrow some new hair.
You can go to your primary care provider or a dermatologist, or you can connect with a healthcare provider online from the comfort of your own home and start addressing hair loss today.
When it’s that easy, why wait? A fuller head of hair — if you want it — might be just around the corner.
This article originally appeared on Hims.com and was syndicated by MediaFeed.org.
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