Propecia for Hair Loss and Its Herbal Substitutes

Propecia is one of the two existing medications approved by the FDA in the US (Food and Drug Administration) for treating hair loss with topical minoxidil, best known under the trade name Rogaine, being the other one. Propecia uses an active ingredient called finasteride that has been used for three decades to treat benign prostatic hyperplasia. It was later found out that patients treated with finasteride (Proscar is the name of the medication used for enlarged prostates) started growing thicker hair on top of their scalp and so finasteride underwent a series of clinical studies to be used as a hair loss treatment. In late 1990s it got approved by the FDA for treating male pattern baldness in dosages of 1mg daily, now known as Propecia. Ever since millions of men around the world who use Propecia (finasteride) regularly have been reported to have managed to stop further hair thinning and hair loss.

This discovery helped to identify the real cause of baldness, being dihydrotestosterone attacks on susceptible hair follicles, and sparked off a new wave of exploration. Now, other drugs that are commonly used to treat urinary problems such as dutasteride (Avodart) or flutamide (Eulexin) as well as some other antiandrogen drugs such as spironolactone (Aldactone) are being tested for treating hair loss. Since there are a number of herbs used in folk medicine to treat urinary problems, increased attention is also being paid to the traditional medicinal plants such as saw palmetto, nettle root and pygeum africanum. These plants or their fruits have been used in the traditional folk medicine for years to treat urinary problems, including enlarged prostates and many herbalists believe they can compete with dihydrotestostosterone in binding at receptor sites in prostate and in hair follicles and so protect human body from harmful effects of this metabolite.

Saw palmetto is the best known and medicinally the best explored amongst these plants. It is a common ingredient in many herbal remedies for enlarged prostates and now also frequently used and marketed as one of the key ingredients in natural hair loss cures. However, no clinical study has been able to confirm its benefits for treating enlarged prostates so far, let alone for treating baldness. This statement also applies to the other two popular herbs now frequently used to treat baldness - pygeum africanum and nettle root (stinging nettle). These herbs are often being marketed as safe alternatives to Propecia for treating hair loss in men but their efficacy and their side-effect risk profile are unknown to support such claims.