Saw palmetto has for some time been a popular herbal treatment for certain types of androgenetic hair loss. It is frequently touted as a “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 traditional 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 (also known as Serenoa repens) has dark berries that have long had uses in traditional and herbal medicine. Historically, common uses included 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 uses, saw palmetto has attracted a lot of interest in dermatology and trichology over the past decade. This is largely due to a number of skin benefits and potentially its role in managing hair loss. In fact, saw palmetto is now under investigation as a possible treatment for androgenetic alopecia (male and female pattern hair loss). This condition is the most common cause of progressive hair thinning in adults. It results from hair follicle damage caused by the hormone dihydrotestosterone (DHT). Research suggests 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), a hormone produced when the enzyme 5-alpha-reductase converts testosterone. DHT 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 then lowers levels of DHT, 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 so potentially associated with fewer systemic side effects. These claims have made saw palmetto an appealing option for those 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 who took oral saw palmetto for 24 weeks had a reduction in the progression of hair loss in androgenetic alopecia, as well as increased hair quality and 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 that vary in methodology. Furthermore, the dosage and formulation vary between these studies. As such, it’s hard to draw direct comparisons or make any generalisations. Nonetheless, the results are still encouraging and point towards saw palmetto as a potentially useful ingredient for hair growth. Larger controlled trials are still necessary to confirm these results. More research is also needed on the optimal dosage, form, and long-term efficacy and safety of saw palmetto.
How to Use Saw Palmetto
Large-scale clinical trials are still necessary to 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 get saw palmetto as a stand-alone remedy or in specially formulated hair vitamins and supplements. This is likely to allow reliable delivery to the hair follicles, but there’s a risk of systemic side effects. It’s also not clear what the optimal and safe dose of oral saw palmetto for hair loss is.
- Topical serums and lotions: you apply these directly to the scalp. Saw palmetto is often combined 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 and 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 a 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 the following:
- Digestive upset, such as nausea and diarrhoea.
- Headaches.
- Hormonal effects, which may reduce libido or affect hormone-sensitive conditions.
- Medication interactions, for example with blood thinners, hormonal treatments or contraceptives.
Always consult your medical provider before starting any supplement or herbal remedy. This is especially crucial if you are pregnant, breastfeeding, have existing health problems or are taking other medications.
Comparison with Other Hair Loss Treatments
Saw palmetto offers a promising natural option for male and female pattern hair loss. However, we need more research to establish how effective it is, who it suits and how safe it is. Below are some of the most established treatments, as well as a few up-and-coming experimental ones, that saw palmetto will compete 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 usually a first-line option. It’s available over the counter up to 5% topical strength, and by prescription as tablets or stronger topicals. However, it doesn’t work for everyone, and results typically take several months. You also need to use it continuously to maintain gains.
- Finasteride: in its oral form, finasteride is a prescription-only medicine to treat male pattern hair loss. It inhibits 5-alpha-reductase and is highly effective at 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-licence 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, 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-licence 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 that blocks 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 under investigation for its potential to promote hair growth through cellular and vascular pathways. Whilst 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, which may help 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 is necessary to validate its effectiveness, safety and best use. For now, it is readily available over the counter in the form of oral supplements and topical treatments. If you’re considering saw palmetto to help stop shedding and promote growth, speak to your healthcare provider first. This is especially important if you have underlying health conditions or take other medications.
We believe in personalisation, which is why we offer bespoke topical hair loss treatments for men and women through our online clinic. Our doctors create custom hair growth treatments using active ingredients such as minoxidil, finasteride, dutasteride, spironolactone, melatonin, caffeine and tretinoin where appropriate for each and every patient. To start your personalised plan, book a virtual video consultation or use our online consultation form. The journey towards great skin and hair starts here.
This article is intended for general informational purposes only and is not a substitute for medical advice, diagnosis or treatment. Always consult a qualified medical provider for any health concerns or questions you might have.
