Vitamin and mineral supplementation to counter thinning hair is a burgeoning area of clinical interest. Patients often ask about such interventions, and physicians can direct them in an evidence-based fashion.

Hair-loss treatments like finasteride or minoxidil yield satisfactory hair regrowth in only between 50% and 60% of patients, thus adjuvant measures like supplements are also applied to improve response.

Milani M, Colombo F. (2023). Efficacy and tolerability of an oral supplement containing amino acids, iron, selenium, and marine hydrolyzed collagen in subjects with hair loss (androgenetic alopecia, AGA or FAGA or telogen effluvium). A prospective, randomized, 3-month, controlled, assessor-blinded study. Skin Res Technol., 29(6), doi: 10.1111/srt.13381.

 

 

These supplements are effective

 

 

Results of a systematic review published in JAMA Dermatology found highest-quality evidence supporting the potential benefit of capsaicin, isoflavone, Viviscal, Nourkrin, Nutrafol, Lamdapil, and Pantogar.

Drake L, Reyes-Hadsall S, Martinez J, et al. Evaluation of the Safety and Effectiveness of Nutritional Supplements for Treating Hair Loss: A Systematic Review. JAMA Dermatol., 159(1):79-86. doi: 10.1001/jamadermatol.2022.4867.

On the other hand, the use of kimchi and cheonggukjang, vitamin D3, and Forti5 to treat hair loss was supported by low-quality evidence.

 

In patients with androgenic alopecia or telogen effluvium and low iron levels, supplementation with iron and vitamin C may improve symptoms.

Almohanna HM, Ahmed AA, Tsatalis JP, Tosti A. (2019). The Role of Vitamins and Minerals in Hair Loss: A Review. Dermatol Ther (Heidelb), 9(1):51-70. doi: 10.1007/s13555-018-0278-6.

Experts have debated the link between hair loss and low serum ferritin levels for a long time, including whether low serum ferritin levels should be used as a biomarker for nutritional deficiency triggering hair loss.

 

 

Potential mechanisms

 

“There are several reasons to suspect a role for micronutrients in non-scarring alopecia,” wrote authors publishing in Dermatology and Therapy. “The most noteworthy of these is that micronutrients are major elements in the normal hair follicle cycle, playing a role in the cellular turnover of the matrix cells in the follicle bulb that are rapidly dividing.”

Almohanna HM, Ahmed AA, Tsatalis JP, Tosti A. (2019). The Role of Vitamins and Minerals in Hair Loss: A Review. Dermatol Ther (Heidelb), 9(1):51-70. doi: 10.1007/s13555-018-0278-6.

 

The three most common types of non-scarring alopecia are androgenetic alopecia, telogen effluvium, and alopecia areata.

Hydrolyzed collagen (HC) oral supplementation ameliorates nail and skin health and might help with hair growth.

Milani M, Colombo F. (2023). Efficacy and tolerability of an oral supplement containing amino acids, iron, selenium, and marine hydrolyzed collagen in subjects with hair loss (androgenetic alopecia, AGA or FAGA or telogen effluvium). A prospective, randomized, 3-month, controlled, assessor-blinded study. Skin Res Technol., 29(6), doi: 10.1111/srt.13381.

 

Methionine is an essential amino acid that constitutes keratin, which is a chief protein found in hair. Studies show that it upregulates β-catenin, with the wnt/β-catenin signaling pathway mediating hair follicle induction.

Taurine is a product of methionine and cysteine metabolism and moderates in vitro hair survival and thwarts the deleterious effects of transforming growth factor, which inhibits hair growth at the level of the hair follicle.

The impact of iron on the hair cycle requires further elucidation. One hypothesis is iron may upregulate genes located in the bulge region of the hair follicle.

Almohanna HM, Ahmed AA, Tsatalis JP, Tosti A. (2019). The Role of Vitamins and Minerals in Hair Loss: A Review. Dermatol Ther (Heidelb), 9(1):51-70. doi: 10.1007/s13555-018-0278-6.

 

 

Other treatment options

 

Topical minoxidil and oral finasteride are indicated to treat androgenic alopecia and have been combined with supplements to treat hair loss in studies.

Milani M, Colombo F. (2023). Efficacy and tolerability of an oral supplement containing amino acids, iron, selenium, and marine hydrolyzed collagen in subjects with hair loss (androgenetic alopecia, AGA or FAGA or telogen effluvium). A prospective, randomized, 3-month, controlled, assessor-blinded study. Skin Res Technol., 29(6), doi: 10.1111/srt.13381.

 

 

Activated platelets in PRP release growth factors and cytokines from their alpha granules. These stimulate hair growth via cell proliferation, differentiation, and angiogenesis and include transforming growth factor β (TGF-β), platelet-derived endothelial growth factor (PDGF), insulin-like growth factor-1 (IGF-1), fibroblast growth factor-2 (FGF-2), vascular endothelial growth factor (VEGF), epidermal growth factor (EGF), and glial cell line-derived neurotrophic factor (GDNF).