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Saw Palmetto & Hair Loss, Does it Work?

Saw Palmetto & Hair Loss, A Novel Use Of An Intriguing Botanically Derived Ingredient. Androgenetic alopecia (AGA), commonly called pattern hair loss shares a striking degree of hormonal factors with other diseases including benign prostatic hyperplasia (BPH). Over several decades, multiple European research studies have examined the use of saw palmetto in the setting of BPH. Until recently however, saw palmetto was not considered as a tool against hair loss. There are several reasons for this disparity.

To begin, a definitive biochemical connection between BPH and AGA was not fully worked out until quite recently. Also, inasmuch as saw palmetto is available in a number of forms and concentrations, it has been difficult to test its activity in a standardized dose. For another thing, saw palmetto, in its most concentrated form, LSESr (liposterolic extract of Serenoa repens) is notoriously difficult to combine with hydrophilic (water loving) materials, such as those desirable in hair treatment formulations. This limitation has tended to render the available dosage forms of LSESr less than ideal. Finally, saw palmetto, when exposed to the air, tends to oxidize readily, leading to rapid inactivation.

Despite these caveats, saw palmetto extract represents a genuinely exciting substance for incorporation into hair loss treatment compositions. Saw palmetto extract is like a biochemical stew, comprising multiple fatty acids and sterols, some, including betasitosterol, have been shown to block the enzyme 5 alpha-reductase (5AR) a key precursor of BPH and AGA.

Because 5AR is a critical feature of BPH and AGA, it has represented a highly attractive drug target for both disorders. Pharmacologic 5AR blockade has proven to be efficacious against AGA as well as BPH. Unfortunately, 5AR inhibiting drugs like finasteride and dutasteride have been linked to quite serious negative side effects, including feminizing birth defects. Fortuitously, this has not proven to be the case with saw palmetto.

So if saw palmetto represents a useful nutraceutical tool against hair loss, why is it not in wider use? Another interesting question is 'why aren't all saw palmetto-containing hair loss treatments equally effective?'. Clearly, they are not --- and here's part of the reason why. To begin, the macromolecules which make up the fatty acids and sterols in saw palmetto do not lend themselves to easy transport across the gastric mucosa (stomach lining) or the stratum corneum (outer layer of the skin). This tends to limit the utility of saw palmetto in the hair follicle, because one can either ingest saw palmetto or apply it to the scalp --- there's really no other way to get it into the hair follicle.

So, in order to deliver the key molecules to the target tissue, carefully chosen chaperone-substances must be used; and, indeed, these have proven to be extremely valuable in getting saw palmetto to work against hair loss. Certain botanically-based hair loss treatments, such as those successfully tested in placebo-controlled research, have been formulated with this key understanding in mind.

As has been learned through more than ten years of hair loss related research, saw palmetto, while not an ideal hair loss treatment 'in and of itself', constitutes a genuinely effective tool in careful combination with other substances. The art and science is knowing how much of each material to use, how to combine finicky substances like saw palmetto extract with other reagents, how to keep the admixture in solution, how to maintain potency, and other challenges.

The good news is that for the most part, these challenges have been solved --- at least in our lab. Published medical research supports this assertion. As time passes, newer and better hair loss treatments will undoubtedly be put together in our lab and other dedicated facilities. For the foreseeable future however, it is likely that saw palmetto will continue to play an interesting role.

geno marcovici

Ph.D., Human Physiology, 2000. Chief Scientific Officer, Advanced Restoration Technologies, DBA, HairGenesis®. Representative published research papers include: Prager N., Bickett K., French N., and Marcovici G., A Randomized, Double-Blind, Placebo-Controlled Trial to Determine the Effectiveness of Botanically Derived Inhibitors of 5 alpha-Reductase in the Treatment of Androgenetic Alopecia. J. Alt. & Comp. Med. 8: 143-152. 2002. Chittur, S., Parr, B., Marcovici, G., Inhibition of Inflammatory Gene Expression in Keratinocytes Using a Composition Containing Carnitine, Thioctic Acid and Saw Palmetto Extract (LSESr) [2009, under review]

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