Insights on Nutraceuticals for Hair Health

What convinced you that nutraceuticals to support hair health and hair growth are worthwhile for some patients? What specific benefits may they offer?

Michelle Henry, MD: Nutraceuticals that play a role in to supporting healthy hair and hair growth are worthwhile for some patients. We often see a lot of patients that have either restrictive diets or are under a tremendous amount of stress. I routinely order a hair loss bloodwork panel on most hair loss patients, and it’s not rare for me to see patients that may have an iron or vitamin D deficiency. Also, women tend to have mild inflammation on their biopsy, even with conditions like female pattern hair loss. I like to give hair supplements that contain anti-inflammatory components like ashwagandha, because those anti-inflammatory ingredients may help to combat hair loss.

There are a few different branded products on the market and a variety of unbranded “hair health” supplements? Do you make specific recommendations to your patients?

Dr. Henry: Yes, there are two that I often recommend. I don’t have any financial interest in either. Nor do I even sell them in my practice. They are Nutrafol and Viviscal, and although neither has level one evidence or full clinical trials (RCTs), they do have some compelling case reports. My patients tend to find good results with them.

Can hair supplements help reverse or minimize some of the damage that can happen to hair from chemicals for straightening, curling, or dyeing?

Dr. Henry: No, supplements cannot help to reverse the damage that happens to hair from chemicals, straightening, or curling or dying. Once the hair has exited the follicle, internal factors no longer play a significant role. Any bonds that are damaged in any permanent way via styling can no longer be corrected. However, if supplements are helping to improve the quality of the hair that we produce, then hopefully as we cut and trim away any damaged hair, the new hair will be of adequate caliber to make the patient happy.

We know in the case of traction alopecia that removing the mechanical stress that leads to hair loss and hair breakage is important. Beyond this, what do you recommend to patients to support hair health?

Dr. Henry: Anything that encourages a healthy millieu in the body or follicle may support hair growth in general. Traction alopecia has varying degrees of scarring. If it is not scarred completely and the follicles are just temporarily stunted, creating an environment with the appropriate nutrients that help to support hair health will also help traction alopecia.

There is internet chatter about “anti-inflammatory diets” for CCCA. Do you think there is a role for diet modification or nutraceuticals in patients diagnosed with CCCA?

Dr. Henry: CCCA is a very complex condition whose pathogenesis is partly environmental and partly genetic. We know that the body mounts a pretty aggressive immune response against portions of the follicle, which leads to chronic scarring of the scalp. I typically do not recommend restrictive diets for these patients. I don’t believe that diet plays a critical role in CCCA.

Nutraceuticals might be somewhat anti-inflammatory and in theory useful. In CCCA, we believe there may be specific targets causing the immune system to create this inflammation, however; I don’t think the diet is a contributing environmental factor.