Gupta Aditya K, Wang Honglin, Wang Tong, Talukder Mesbah
Division of Dermatology, Department of Medicine, University of Toronto, Toronto, ON, Canada.
Mediprobe Research Inc, London, ON, Canada.
Skin Appendage Disord. 2025 Jun;11(3):270-281. doi: 10.1159/000542880. Epub 2024 Dec 6.
Androgenetic alopecia (AGA) is the most common cause of hair loss. Currently, approved medications for AGA are topical minoxidil and oral finasteride, both of which are prescription medications which may cause side effects. Non-prescription products such as herbal extracts and over-the-counter medications have limited evidence regarding safety and efficacy; however, they may be an alternative for patients unable or unwilling to use prescription medication.
This article reviews investigator-blinded, controlled clinical trials assessing the efficacy of non-prescription monotherapies in treating AGA. A total of 13 studies were included using procyanidin, cetirizine, caffeine, bran, pumpkin seed oil, rosemary oil, saw palmetto, and watercress. The available data demonstrate considerable improvements in one or more parameters: total hair density, terminal hair density and hair diameter. Procyanidin and cetirizine were investigated in more investigator-blinded, randomized controlled trials than other agents. Minimal adverse events were observed; however, more robust clinical trial and long-term safety and efficacy data are warranted.
Additional investigations through the conduct of high quality randomized, controlled trials with larger numbers of patients will help determine the effectiveness and safety of this class of compounds, either as monotherapy or as an addition to current pharmacological interventions.
雄激素性脱发（AGA）是脱发最常见的原因。目前，获批用于AGA的药物是外用米诺地尔和口服非那雄胺，这两种都是可能会引起副作用的处方药。诸如草药提取物和非处方药等非处方产品在安全性和有效性方面的证据有限；然而，对于那些无法或不愿使用处方药的患者来说，它们可能是一种选择。
本文回顾了评估非处方单一疗法治疗AGA疗效的研究者设盲的对照临床试验。总共纳入了13项使用原花青素、西替利嗪、咖啡因、麸皮、南瓜籽油、迷迭香油、锯棕榈和西洋菜的研究。现有数据表明，在一个或多个参数上有显著改善：总毛发密度、终毛密度和毛发直径。与其他药物相比，原花青素和西替利嗪在更多研究者设盲的随机对照试验中得到了研究。观察到的不良事件极少；然而，需要更有力的临床试验以及长期安全性和有效性数据。
通过开展更多患者参与的高质量随机对照试验进行进一步研究，将有助于确定这类化合物作为单一疗法或作为当前药物干预补充疗法的有效性和安全性。
