Ask the Dermatologist: Do Supplements Work for Hair Loss?

by Molly Verhoff, PAC

Hair loss is a frequent concern that brings people to the dermatology office, and recently has been even more common, since the COVID-19 virus can cause prolonged hair shedding that lasts months after the active infection in many sufferers.

How can you treat thinning hair successfully?

Supplements are an easy place to start for treatment, but the supplement aisle is a confusing place. The sheer number of products and labels promising miracles that sound too good to be true can be overwhelming, and supplements can be expensive and even potentially toxic when taken in excess. So how can you know what to take?

Your Dermatologist Can Help With Hair Loss

In our office we carry only products we confidently stand behind. Northeast Dermatology’s supplement of choice is Viviscal Professional Strength and we are excited to discuss new results supporting this product. A 2022 study evaluating safety and efficacy of supplements in hair loss offers more guidance on and support for certain supplements.

The bottom line: “High-quality evidence was found for the potential benefit of of Viviscal, Nourkrin, Nutrafol, Lamdapil, Pantogar, capsaicin and isoflavone, omegas 3 and 6 with antioxidants, apple nutraceutical, total glucosides of paeony and compound glycyrrhizin tablets, zinc, tocotrienol,and pumpkin seed oil. Kimchi and cheonggukjang, vitamin D3, and Forti5 had low-quality evidence for disease course improvement. Adverse effects were rare and mild for all the therapies evaluated.”

Not all types of hair loss are the same, and some types will respond more readily to dietary supplements than others. It is important to be evaluated at the dermatology office to determine what treatment is best for you.

Can You Trust Supplements to Work and Be Safe?

For supplements, we recommend sticking with well-known brands, ideally those that have had third parties verify the accuracy of labeling and product purity. Because these products are not regulated by the FDA, they do not have to undergo trials to prove they are effective. Because these products are not regulated by the FDA, they do not have to undergo trials to prove they are effective; and, though they are supposed to, there is no enforcement body to ensure they contain the ingredients listed on the labels.

Important Clinical Findings from the Study:

• When compared to healthy scalps, we do find a lack of micronutrients and proteins (Vitamins D and B*, Zinc, L-Cystine) in the scalp of many affected by various types of alopecia. Hair growth can be improved or restored with supplementation in cases like this. Marine protein based supplements (like Viviscal with the AminoMarTM marine complex, a proprietary blend of extracellular matrix components from sharks and mollusks) have been shown to aid in hair growth by providing a mix of essential nutrients to nourish the follicle.

• A chemical signaling process known as oxidative stress is thought to be a reason for poor hair growth in alopecia areata, androgenetic alopecia, and telogen effluvium. Antioxidant-containing supplements are able to neutralize the free radicals involved in this process and restore normal hair growth.

• Inflammation at the hair follicle, as in autoimmune hair loss conditions like alopecia areata, can inhibit proper hair growth. Anti-inflammatory supplements like total glycosides of paeony (TGPC) and compound glycyrrhizin tablets (CGT) help to reduce that inflammation and return growth to normal patterns.

• Growth hormone modulators (for example capsaicin, isoflavones, and miliacin which are known to modulate activity of insulin-like growth factor 1) are thought to be effective supplements in many types of alopecia as they play a role in regulating hair follicle activity.

Viviscal PRO Ingredients:

ALLERGY WARNING: Viviscal is not suitable for those with fish, seafood, or shellfish allergies.

*A Special Note on Biotin (one of the primary ingredients in Viviscal):

• Biotin may make your hair stronger, but doesn’t make it grow faster

• Biotin is a water soluble vitamin, so excess intake can be easily cleared from the body. There is no known risk of toxicity.

• Long term supplementation in healthy patients is not recommended as it can affect the validity of some types of lab testing, notably thyroid studies and troponin levels (a test used to look at health of heart muscle, notably in the ER if a heart attack is suspected). For any planned lab testing, it is best to stop all biotin-containing supplements one week prior to the blood draw.

Biotin: What it does and when it’s really necessary:

Biotin (B7) is a coenzyme that facilitates metabolic reactions regulating cell communication and DNA expression.

• The Food and Nutrition Board of the Institute of Medicine recommends 30 μg/day of biotin, and a normal Western diet consists of 35 to 70 μg/day. Dietary sources of biotin include organ meats, eggs, fish, sweet potatoes, and almonds.

• Signs of biotin deficiency: Hair loss, dry skin rashes,dandruff, inflammation around the eye, and multiple neurological symptoms (ex: depression, lethargy, poor muscle tone, seizure)

• Biotin supplementation is rarely required, but there are several circumstances where it has been recommended.

  • Lifestyle factors: smoking, pregnancy, and lactation as these circumstances increase the metabolism of Biotin thereby increasing the need for supplementation

  • Inherited disorders: congenital autosomal recessive biotin biotinidase and holocarboxylase synthetase deficiencies

  • Decreased GI absorption: long term antibiotic use and certain other medications, alcoholism, long-term consumption of raw egg whites

A Final Note About Supplements

Ultimately, it is best to notify your provider of any supplements you are taking. Use them when you need them for specific symptoms, but long term treatment may not be advisable as there can be risk of medication interactions and effects on certain lab results, some brands have a lack of quality control, and certain ingredients have a risk of toxicity in high doses.

Always ask your doctor about taking supplements for any condition. We can help!

Further Reading and References:

Lara Drake, BA; Sophia Reyes-Hadsall, BS; Jeremy Martinez, BS; Christina Heinrich, MS; Kathie Huang, MD; Arash Mostaghimi, MD, MPH, MPA. Evaluation of the Safety and Effectiveness of Nutritional Supplements for Treating Hair Loss: A Systematic Review. JAMA Dermatol. 2023;159(1):79-86. doi:10.1001/jamadermatol.2022.4867. Published online November 30, 2022.

(A systematic review in which 30 articles were included: 17 randomized clinical trials (the highest quality testing available), 11 non-randomized clinical studies, and 2 case series studies.)

Https://www.aad.org/dw/dw-insights-and-inquiries/archive/2021/biotin-supplementation-hair-nails