Saw palmetto has for some time been a popular herbal treatment for certain androgenetic hair loss. Its frequently touted as l”natural” alternative to prescription DHT blockers. Better still, you can easily get saw palmetto over the counter in everything from oral supplements to scalp serums. As always with beauty, does the science actually back the hype around saw palmetto and hair growth? In this article, we explore the evidence behind saw palmetto for hair loss and how it compares with established treatments. We’ll also review the best ways to use saw palmetto to support hair growth.
What is Saw Palmetto?
This is a small palm plant native to the southeastern United States (particularly Florida). Saw palmetto (aka Serenoa repens) has dark berries which have long had uses in traditional and herbal medicine. Historically, common uses included as treatment for urinary tract symptoms, reproductive health concerns and benign prostatic hyperplasia (BPH). The key reasons for this are saw palmetto’s anti-androgenic and anti-inflammatory properties.
Beyond these traditional medical uses, over the past decade saw palmetto has attracted a lot of interest in the dermatology and trichology world. This is largely due to a number of skin benefits and potentially its role in managing hair loss. In fact, saw palmetto is currently under investigation as a possible treatment for androgenetic alopecia (also known as male and female pattern hair loss). This condition is the most common cause of progressive hair thinning in adults and results from hair follicle damage due to the actions of the hormone dihydrotestosterone (DHT). Research suggest that saw palmetto may exert a mild DHT-blocking effect.
Benefits of Saw Palmetto for Hair Loss & Growth
Androgenetic alopecia affects both men and women and is the most common form of hair loss in adults. It is largely driven by dihydrotestosterone (DHT) which is a hormone. DHT is produced by conversion of testosterone by the enzyme 5-alpha reductase. It then binds to androgen receptors in the scalp and triggers a process called miniaturisation. This is where hair follicles progressively shrink leading to shorter finer hairs until eventually the follicles become dormant.
Saw palmetto inhibits 5-alpha reductase. This is then lowers levels of DHT hence limiting its damaging effects on the follicles. This action is similar to how prescription DHT blockers like Finasteride and Dutasteride work. However the effect is likely to be milder and hence potentially associated with fewer systemic side effects. These claims have made saw palmetto an appealing option for individuals seeking a more natural approach to hair growth. However, it’s really important to realise that saw palmetto has not been as extensively studied as established hair loss treatments. So far early research into saw palmetto for hair loss has led to some promising findings:
- Reduced Hair Shedding: Research has shown that men with who took oral saw palmetto for 24 weeks showed reduction in progression of hair loss in androgenetic alopecia and increased quality as well as growth.
- Increased Hair Density: There is evidence that topical as well as oral saw palmetto increases hair density and growth in men and women with androgenetic alopecia after 3 months of use.
- Improved Hair Quality: Some smaller studies suggest enhanced hair texture, reduced scalp oiliness and stronger strands after using supplements and solutions with saw palmetto.
It’s really important to point out that these findings are still experimental. They are based mainly on small scale studies which vary in terms of methodology. Furthermore, the dosage and formulation varies between these studies. As such its hard to draw direct comparisons or make any generalisations. Nonetheless, the results are still encouraging and point toward saw palmetto as a potentially useful ingredient for hair growth. Larger control trials are still necessary to confirm these results. More research is also necessary to determine the optimal dosage, form and long-term efficacy as well as safety of saw palmetto for treating hair loss.
How to Use Saw Palmetto
Large scale clinical trials need to fully establish the safety and efficacy of saw palmetto as a hair loss treatment. However, for now it is widely available as an over the counter herbal supplement. You can find saw palmetto in a range of formats with the below most commonly used for hair loss:
- Oral Supplements: These are generally available as capsules or soft gels. You can either get saw palmetto as a stand alone remedy or find it in a range of specially formulated hair vitamins and supplements. This is likely to allow reliable delivery of saw palmetto to the hair follicles but there’s a risk of systemic side effects. Its also not clear what the optimal and safe dose of oral saw palmetto for hair loss is.
- Topical Serums & Lotions: You apply these directly to the scalp. Saw palmetto is often in formulations with other hair growth botanicals or peptides. The advantage of topical saw palmetto is direct delivery to the hair follicles and likely lower systemic side effects. However, there’s not much evidence on absorption or optimal dosage.
- Shampoos & Conditioners: These are increasingly available as hair loss remedies, but concentrations of active ingredients like saw palmetto are often low. As such, they’re unlikely to have significant standalone impact but may complement other treatments.
Side Effects & Risks
Whilst generally considered safe, saw palmetto does have some side effects. Reported issues include:
- Digestive upset e.g.nausea & diarrhoea
- Headache
- Hormonal effects which may result in reduced libido or affect hormone-sensitive conditions.
- Medication interactions such as with blood thinners, hormonal treatments or contraceptives.
Always consult with your medical provider before starting any supplement or herbal remedy. This is especially crucial if you are pregnant, breastfeeding, have existing health problems or taking other medications.
Comparison With Other Hair Loss Treatments
Saw palmetto offers a promising natural option male and female pattern hair loss. However, more research is necessary to establish how effective it is, who it is best for and safety. Below are some of the most established as well as a few up and coming experimental hair loss treatments which saw palmetto will complete with:
- Minoxidil: This is an oral and topical treatment that increases blood flow to the scalp and prolongs the growth phase of hair follicles. It’s one of the oldest hair loss treatments for both men and women. Minoxidil has an excellent safety profile and is the usually a first-line option. It is available over the counter as a topical treatment in strengths of up to 5% and by prescription in tablet form or higher topical strengths. However it doesn’t work for every one and results typically take several months. You also need to use it continuously to maintain gains.
- Finasteride: In its oral form, finasteride is available as prescription only medicine to treat male pattern hair loss. It inhibits 5-alpha reductase and is highly effective in slowing or halting hair loss in men. However, finasteride can cause some serious systemic side effects in a small percentage of users. It is also available off-license in topical compounded hair loss treatments.
- Dutasteride: This is a more potent 5-alpha reductase inhibitor that results in greater DHT suppression than finasteride. Although not licensed for hair loss treatment, dutasteride is sometimes used off-label usually as a topical compounded treatment for androgenetic alopecia in patients who did not respond to finasteride.
- Spironolactone: This is an anti-androgen prescription only medicine that is commonly used off-license to treat androgenetic alopecia. Spironolactone is available as an oral treatment but topical forms are most common for treating hair loss.
- Clascoterone (Breezula), PP405 and Deoxyribose Sugar: These are a few of the experimental therapies currently in the research pipeline for androgenetic alopecia. Clascoterone (Breezula) is a topical androgen receptor inhibitor designed to block DHT directly at the scalp without affecting systemic hormone levels. Early-phase clinical trials have shown encouraging results for both men and women. PP405, a novel compound targeting prostaglandin pathways, is also showing promise in preliminary studies as a hair regrowth agent, although it remains in the preclinical or early trial phase. Similarly, topical deoxyribose sugar, an experimental ingredient believed to stimulate follicular regeneration, is being explored for its potential to promote hair growth through cellular and vascular pathways. While these innovations are exciting, more robust data is needed to determine their long-term safety and efficacy.
Whilst saw palmetto is not a substitute for licensed hair loss treatments, it does show promise for hair growth. Its potential lies in its ability to gently inhibit DHT and hence may helps halt or even reverse androgen driven hair loss. However, whether it can be an effective alternative as a stand-alone solution or in a supportive role remains to be seen. Further research in the form of large scale robust clinical trials are necessary to validate the effectiveness, safety and best way to use of saw palmetto for hair loss. For now, it is readily available over the counter in the form of oral supplemmnts and topical treatments. If you’re considering trying saw palmetto to help stop shedding and promote growth, speak to your healthcare provider first especially if you have any underlying health conditions or are on any medications.
We believe in personalisation which is why we offer personalised hair loss and regrowth treatments through our online skin clinic. Our doctors create custom hair growth treatments using actives ingredients such as Minoxidil, Finasteride, Dutasteride, Spironolactone, Melatonin, Caffeine and Tretinoin where appropriate for each and every patient. Start your virtual consultation and begin your journey to great hair today.
