The "Active" Ingredient in Many Popular Hair Loss Treatment Products

Many popular hair loss treatment options today such as Provillus, Procerin, and Avacor contain the “active” ingredient saw palmetto. It can also be purchased as a standalone supplement in most nutritional stores. But the age old question of whether or not it can effectively treat baldness in men and women with alopecia is still heavily debated. By taking a look at the scientific evidence available we are able to draw some conclusions as to its potential benefit for those with thinning hair.

What is Saw Palmetto?

Saw Palmetto berries are a deep red fruit that grow wild on palm trees in warmer climates, typically found in the Southeastern United States. The liposerolic berry extract is typically used as an herbal supplement for the promotion of a healthy prostate.

Saw Palmetto Hair Loss Study:

Similarly to finasteride (the active ingredient in Propecia and Proscar), studies have shown that when taken orally, it may be an effective anti-androgen by lowering dihydrotestosterone (DHT) levels in the body by blocking 5 alpha-reductase enzymes. Additionally it is said to block receptor cites on cells which is required for cells to absorb DHT.

Tests have also been performed on its use in the treatment of benign prostatic disease, which similarly to androgenic alopecia, depends on the production of DHT.

It is also noteworthy to state that a small preliminary study in 2002 was performed as reported by The Journal of Alternative and Complementary Medicine(2002;8:143-52) that shows a select group of 19 men between the ages of 23 and 64 taking either (400mg of saw palmetto and 100mg of Beta-sitosterol) or a placebo orally. Those who took the herbal combination had 60% improved hair growth over those who took the placebo. There have been no studies to date indicating the efficacy of saw palmetto applied topically for male pattern baldness, female hair loss, or anything to date.

In our opinion, there are two potential difficulties with this study:

• Many scientists would argue that the control study group was too small to determine any real efficacy and improved hair growth could have happened by chance. A larger study therefore may be necessary to determine any level of real efficacy.
• “Improved hair growth” is not the same thing as newhair growth and hair regrowth, nor should it necessarily imply that it works to stop hair loss
• There are no regulations or suggested daily value as to how much saw palmetto would be required to successfully treat baldness. The appropriate dosage therefore is questionable.
• The above study was only performed on saw palmetto taken orally. Hair loss products that promote topical use for baldness are basing their belief in its efficacy on something other than published clinical evidence.

The Dosage:

But if there are no current standards on dosages of herbal medications in the United States, how do these popular hair loss treatments produce an appropriate dosage?

Clinical studies on Benign Prostrate Hyperplasia (BPH) have used a dosage of 320mg of the berry extract daily (either one 320mg pill or 2 X 160 mg pill). A daily dosage of 480 mg of saw palmetto berry extract was not found to be any more effective in a six-month study. If the entire berry was used, up to 1000mg or 2000mg would be required to reach the same goal.

The theory therefore is that if saw palmetto can successfully treat an enlarged prostate similarly to finasteride, it can effectively treat hair loss with a similar dosage Many popular “baldness cure” products contain approximately 1500mg of the berry which is equivalent to approximately 240-320mg of the berry extract.

Side Effects and Warnings:

One false assumption is that “all natural” treatments don’t have potential side effects. It is stated that use of saw palmetto has not proven to be safe for women with hair loss during pregnancy and lactation. Medical supervision is suggested for women of childbearing age. Similar warnings are listed about Propecia.

Conclusions:

Based on some anecdotal evidence, saw palmetto is said to treat baldness because of its tendency to act like finasteride by helping those suffering from BPH. However, authentic clinical studies have not been performed to date that support this claim. Dosage and how it should be used (orally or topically) therefore is based on conjecture rather that scientific evidence.

Alopecia areata (sometimes referred to as“spot baldness”) is a medical condition that typically results in patchy hairloss or bald spots on the scalp, beard, arms and legs. Though the exact cause of alopecia areata is unknown, it is thought to be an autoimmune disorder causing the body’s immune system to attack its own hair follicles, resulting in hair loss.

Roughly 2% of the world’s population suffers from alopecia areata and approximately 5% of these have a family history of "alopecia", the medical term for hair loss.

Diagnosing Alopecia Areata

Alopecia areata is normally diagnosed through the observation of symptoms. However, occasionally a scalp biopsy or blood tests may be performed.

Treating Alopecia Areata

There is no cure for alopecia areata and current treatments, while sometimes effective, offer limited success.  Current treatments for alopecia areata include; steroid injections, topical corticosteroids (steroid hormonesnaturally produced in the adrenal cortex of vertebrates), topical immunotherapy, Rogaine(minoxidil) and ultraviolet light therapy.

Although permanent hair loss is a possibility, the course of the disease is unpredictable and varies from patient to patient. The good news is that, even without treatment and after many years,the hair follicles do remain viable and ready to resume normal hair production if and when they receive the appropriate signal. Hair regrowth may, and often does, occur in time.

Are Alopecia Areata Patients Good Candidates for Hair Transplantation?

Patients suffering from alopecia areata are rarely considered good candidates for hair transplant surgery because donor hair grafts harvested from the “safe” zone at the rear and sides of the scalp are still vulnerable to the effects of the body’s immune system once transplanted to the recipient sites. However, if the affected area is small, has remained unchanged for an extended period of time and if there is no sign of inflammation below the scalp, hair transplantation may be an option. This would require a thorough consultation with a skilled and experienced hair restoration surgeon and the patient would need to fully understand and accept the risks of such a procedure.

Adapting to and Living with Alopecia Areata

Depending upon the severity of the condition, hair loss concealers like Toppik, Nanogen and DermMatch may help disguise bald patches. In more severe cases, a hair replacement system or full wig may be necessary.

Aswith all forms of hair loss, patients suffering from alopecia areata may experience emotional and psychological trauma. It’s important to reach out to family and friends, join an alopecia support group and/or seek the services of a mental health professional if you are experiencing intense, prolonged and overwhelming psychological effects.

What is Traction Alopecia?

Traction alopecia is a form of hair loss resulting from the repeated yet unintentional pulling, twisting or rubbing of the hair. Traction alopecia can affect both men and women, though it's more commonly seen in women. Though it can be temporary, balding from traction alopecia may become permanent if these traumatic forces are applied to the hair and scalp repeatedly and for prolonged periods, resulting in scarring.

What Causes Traction Alopecia?

Practices that may result in traction alopecia include; wearing tight braids, ponytails or cornrows and extended use of hair extensions.  Due to the popularity of these hairstyles, traction alopecia has become one of the leading causes of hair loss among African America women.

Balding from traction alopecia can also occur from repeatedly wearing tight-fitting hats, helmets or other headgear.This is likely where the popular hair loss myth about hats causing hair loss derived, but it is important to note that, under normal circumstances, wearing a properly fitted hat will not negatively impact hair growth.

Treating Traction Alopecia

The first step in treating traction alopeciais to change the habits leading to the condition. This may mean adopting a new hairstyle or altering your wardrobe. Finally, applying a vaso dilator like Rogaine(minoxidil) to the affected area can increase blood flow to the damaged follicles and effectively speed up new hair growth. Assuming the hair follicles have not been permanently damaged, new hair growth will likely occur though it may take several months.

In cases of severe and permanent tractional opecia, the only effective method of restoring hair to the bald areas is surgical hair restoration. State of the art, ultra-refined follicular unit hair transplantation allows quality surgeons to harvest DHT resistant hair from the donor region at the rear and sides of the head. These hairs are then implanted into the balding areas of the scalp, resulting in a natural and undetectable appearance. To see which physicians we recommend and for a free virtual consult, visit the Coalition of Independent Hair Restoration Physicians.

To learn more about how surgical hair restoration can be used to treat traction alopecia hair loss, view the following results from our hair loss forum and social community:

• Dr.Robert Dorin - 1909 Grafts on a Traction Alopecia Patient
• Dr.Victor Hasson / 3560 Grafts / One Session / Traction Alopecia / One Year

One of the more popular hair loss products on the market today for those with thinning hair is Provillus. Available for both men and women, making promises to “re-grow beautiful healthy hair”, this product consists of a topical and oral solution with an FDA approved hair regrowth ingredient and a number of conjectured “all-natural” dihydrotestosterone (DHT) blockers.

Other ingredients that promote a healthy scalp and head of hair are also contained in this product. The theory behind Provillus is to revive the hair follicles with growth stimulators and attack hair loss at its source by blocking DHT.

In order to fully evaluate the efficacy of this product, we must further explore each ingredient to determine whether or not this hair loss treatment delivers what it promises. Below you will find a list of ingredients and information that will help you determine whether or not Provillus is right for you.

Topical Ingredients:

Minoxidil (found in Rogaine, Xandrox and other solutions) is an FDA approved hair growth treatment and many balding men and women use it with great success. This particular ingredient is what allows Provillus to advertise their product as FDA approved.

Azelaic acid has been found to clean the skin and potentially inhibit DHT, the hormone responsible for androgenic alopecia.

Combining these two “forces” therefore in theory, may be a more powerful treatment than minoxidil alone. However, no clinical studies have been performed on azelaic acid as a standalone product therefore, whether or not it can stop hair loss is purely conjecture.

Oral Ingredients:

The Provillus oral solution contains a number of supposed DHT blockers including saw palmetto for hair loss, Vitamin B6 and Zinc, pumpkin or cucurbita maxima, and nettle root. Because evidence exists that these ingredients may be an effective treatment for benign prostatic hypertrophy (BPH), theories have been produced that they might also effectively treat baldness. Though we can appreciate the aspiration for balding men and women to use herbal products as an “all-natural” replacement for Propecia (finasteride), the problem we have is that most of them only contain anecdotal if any evidence at all that they can successfully treat baldness.

Provillus oral solution also contains a number of components that are said to promote healthy hair growth and cleanse the scalp. These include eleuthero, uva-ursi, muria puama, horsetail, para-aminobenzoid acid (PABA), and magnesium. Understand however, that promoting a healthy scalp and hair is not the same as stimulating newhair growth and hair regrowth, nor does it signify an effective hair loss treatment.

Possible Side Effects

The only side effect that we could find listed on the Provillus website is an upset stomach. It is reported that taking it with food often stops this. Be sure to follow the links to the ingredients listed above as many of them also have potentially reported side effects. Consulting with a physician before taking any herbal hair loss medication is advised.

Dosage

Currently there are no standards on dosages of herbal medications in the United States. In addition, no formal clinical studies have been performed on them for treating baldness. Therefore, the suggested daily value listed on the ingredient package is based on something other than government regulation and scientific study.

Costs

A one month supply of Provillus topical and oral supplement for men or for women costs about $50 per month. Discounted prices are available when bought in bulk.

For the cost of Provillus, one can purchase generic finasteride and generic minoxidil which are FDA approved hair loss treatments for safety and efficacy.

Conclusions and Our Opinion

Given that Provillus topical treatment contains FDA approved hair regrowth ingredient minoxidil; we can at least agree that it may have some marginal benefit for men and women suffering from androgenic alopecia. However, due to the lack of compelling evidence in these other conjectured hair loss solutions, it may be more beneficial and cost effective to spend your money on Propecia (finasteride)for men only and Rogaine (minoxidil) that has helped balding men and women worldwide.