DAVID FOLK THOMAS: If you're trying to put an end to your hair loss, you've probably encountered an endless array of products which claim to stop or even reverse the process. A few are FDA-approved medications, but there are also many natural or herbal treatments which have not been subjected to the same rigorous tests. Now, do any of these actually work, and is there any harm in trying? In this program we'll take a close look at some of the popular herbal remedies for hair loss.
Joining me are two experts in the field. On my left is Dr. Peter Halperin. He's an Assistant Professor in the Department of Dermatology at Weill Medical College of Cornell University and New York Hospital. To Peter's left is Dr. Shari Lieberman. She's a nutrition scientist, exercise physiologist, and she's also on the faculty of the University of Bridgeport, and she's the author of a few books on the subject.
DAVID FOLK THOMAS: Let me start with you, Peter. Is there any difference between herbal treatments for hair loss and other medical treatments available, and if so, can you talk about those?
PETER HALPERIN, MD: One key difference is the way they're studied, David. Medically approved treatments undergo a certain type of testing, and in the best scenario they undergo something called placebo, blinded, controlled testing. That means that you take 1,000 people and give them a medication, and you take another 1,000 people, kind of like the same group as the first, and give them a placebo, or sugar pill, and see if the medication influences their life in what you're trying to study. So if you're trying to grow hair, then you give one group an active hair pill and you give another group a sugar pill and you see if the group taking the pill meant to grow hair actually grow hair, then you've done something. That's really what the FDA-approved types of treatments look at. They are medicines that have been studied. We know about their side effects, we know about their efficacy, how effective they are. We know that if you use the medicine in L.A., it'll do the same thing in New York, and it's down to a science. We know what it does, we know the side effects, we know how it works.
We don't know a lot about these herbal supplements, and that's the thing. They're not studied as rigorously, or studied at all. They need no approval to appear on the shelf, so a manufacturer can really say whatever they want about it. It can just sit there and say it's going to grow hair and detoxify your liver and do whatever else it wants to say, but it's not a medication and it doesn't come under the thumb of the FDA, like a medicine does.
DAVID FOLK THOMAS: So if it's not under the thumb of the FDA, is there any agency out there that if there was some product that you said, "This will grow your hair in three weeks," or something outrageous, would somebody rein that in?
PETER HALPERIN, MD: You know, the FDA still is in control of that. However, they can only get involved if the product has been shown to be harmful to a patient, so that if you mix up something and throw it out there on the shelf and it does no benefit to anybody, the FDA won't go after you unless that product hurts somebody in some way.
SHARI LIEBERMAN, PhD: That's actually untrue. The FDA very heavily regulates the dietary supplement industry. In fact, the Dietary Supplement Health and Education Act was passed. If you put on any product a claim that it will grow hair, you will be fined. I do agree that herbal products, from what I can gather, certainly have not gone through the rigorous scientific scrutiny that most of the drugs have, although there are maybe a handful of studies on some of these herbs, and we'll talk about that. However, you do have some herbs that have maybe 1,000 to 2,000 to 4,000 history year of use, so I think that that shouldn't be completely discounted, especially if we're talking about Chinese herbs, because selectively, people have used things over the course of thousands of years because they work.
Something like saw palmetto, there is no published study on saw palmetto in hair loss, but the mechanism by how it works sounds reasonable and may be worth a try because it works as a similar mechanism to finasteride. It is a 5-alpha reductase inhibitor. It will stop the conversion of testosterone to dihydrotestosterone. The research published on saw palmetto has only been for BPH, for benign prostatic hyperplasia, with great results comparing it to finasteride and other drugs, as well. Should it work, could it work for hair loss? Perhaps. There's some anecdotal evidence. There are lots of practitioners who have used it. If you look on the Web, places like Rodale Press, which is kind of conservative, has some data on it, as well. It could be worth a try. There are no published studies on it.
DAVID FOLK THOMAS: Do you buy it in an herbal vitamin shop?
SHARI LIEBERMAN, PhD: You would by it in an herbal vitamin shop. You want to look for a product that's standardized. There are some very, very good herbal companies like Nature's Way and Enzymatic Therapy and Solgar. There are some very reputable companies that do sell saw palmetto, and once again, if blocking 5-alpha reductase is how finasteride is working or how Propecia is working, theoretically it seems reasonable that something like saw palmetto, Pygeum africanum or even beta-sitosterol may work similarly. We don't know it for a fact, but it sounds reasonable and might be worth a trial.
DAVID FOLK THOMAS: What about cayenne pepper scalp massage?
SHARI LIEBERMAN, PhD: That's an ancient remedy. As a matter of fact, some of the hair tonics -- and one of them is Fabio 101, which I never knew about until I looked on the Internet --
DAVID FOLK THOMAS: Fabio, like the supermodel?
SHARI LIEBERMAN, PhD: I don't know if it stands for "fabulous" or what it stood for.
PETER HALPERIN, MD: He's got good hair.
SHARI LIEBERMAN, PhD: Yeah, he's got good hair, so maybe he's done something right. You actually mix cayenne with water. You make a paste. You massage your scalp with it. Don't touch your eyes or genitals. Or no one will ever talk to me again.
DAVID FOLK THOMAS: Note to self.
SHARI LIEBERMAN, PhD: Note to self. What it does is, it actually increases blood flow to the scalp. You leave it in 20 to 30 minutes and then you'd wash it out. I have seen excellent results with alopecia, I've seen excellent results with male pattern baldness, and I've seen excellent results also in women that have lost their hair, and maybe they're going through menopause or for any number of reasons. If you look on James Duke's Web site, and he's at the U.S. Department of Agriculture, he actually lists cayenne as one of the herbs that has historically been used for hair loss, and it is also in a Chinese herbal combination known as Fabio 101 that, once again, I didn't know about before tonight, and they have about three clinical studies. Definitely not the level of scientific investigation of any of the available FDA-approved drugs, but some promising results. Perhaps worth a try.
DAVID FOLK THOMAS: Let's say somebody's not getting any results from Rogaine or any of the other medically tested medications. Would you say, "Let's try anything at this point?"
PETER HALPERIN, MD: No. These things have never been rigorously tested and they've never been shown to help anyone.
DAVID FOLK THOMAS: Another concern is the purity of the product if you're dealing with herbal supplements. How do you know if a product actually contains the herb?
SHARI LIEBERMAN, PhD: That's a great question, and that's place where the FDA is supposed to be intervening more. Companies are supposed to be responsible for that, and the consumer won't know, and that is a very big problem in the industry. So what I would recommend that they do is that they look for larger, more reputable brands. They can always call. They can call and ask for research. I mentioned some brands. I have visited many labs, so I know as a doctor what are reputable labs. Nature's Way brings in a lot of proprietary formulas and specific herbal extracts from German pharmaceutical companies. So does Enzymatic Therapies. So does Solgar. Endina is one of the raw material suppliers. I can go on and on and on, but there are ways. You might have to jump through some hoops to really find out.
Also, as I said before, these things have not been scrutinized scientifically like Propecia or any of the other drugs, but there is some clinical data on some of these things, like the Fabio 101, where there are three human clinical trials, and the essential oil one, that suggest that it may work. Not tons of data on it.
DAVID FOLK THOMAS: All right. That's all the time we have. Peter and Shari thank you for joining us today.