Women’s Health/AOL and Marie Claire have recently written articles on oils and juices to treat hair loss. Moringa oil is lauded for its ability to nourish the scalp and protect against hair breakage. Rosemary oil is noted for its ability to increase blood flow to the scalp, while fans of onion juice say it improves scalp health. Is there any value to adding these oils and juices to a hair loss treatment plan? How should a dermatologist counsel patients who request a natural approach to treating hair loss?
For an expert take on these natural remedies, I interviewed Ronda S. Farah, MD, FAAD, associate professor of dermatology at the University of Minnesota Medical School. Dr. Farah will present a live demonstration at the ODAC Dermatology Conference on mastering a hair and scalp exam.
How often do your hair loss patients ask about natural remedies, such as these oils and juices, or mention their use in office visits?
These are great questions and I’m always happy to address them in clinic. This is a question that comes up in almost every initial hair loss consultation.
There are proven methods to treat hair loss, such as topical and oral minoxidil. Is there any value to adding moringa oil, rosemary oil, and onion juice into the treatment plan?
Rosemary has one study that is supportive, however, the quality of the data is not near that of minoxidil, topical or oral. When patients are looking for rosemary use, I direct them to shampoos that are available over the counter and have been formulated with rosemary via a cosmetic chemist. This helps to avoid other ingredients that can be mixed into products that can drive irritation, allergies, or even folliculitis.
Onion juice has been proposed to be helpful, and actually there was a product combining an onion juice extract with minoxidil on the market in the past. This is no longer available, and the reason why is unclear. There are some ideas in the literature that it can be helpful for autoimmune hair loss and sort of “confuse” the immune system so its stops attacking the hair. The data is limited to none.
I do not recommend onion juice products made at home or not formulated for the scalp. These are likely to lead to scalp irritation and allergy.
What approach do you recommend dermatologists take with patients who request natural remedies to treat their hair loss?
Listen to your patients. Obtain a comprehensive list of scalp and hair products that they’re using. Review the ingredients in each product. If there are signs of allergy on the scalp, such as redness, itching or flaking, consider referral for patch testing. If there are signs of folliculitis, remove any oils, creams, or lotions that could be causing plugging.
Do not attempt to change a patient’s regimen all at one visit. Take small steps at each visit to discuss with the patient which products are most important to them. Prioritize reviewing those products and keeping them if it’s possible.
What else should dermatology clinicians know about natural remedies for hair loss?
The over-the-counter market for hair loss has very limited regulation, if any, for some products. There are multiple marketing claims that are being made for which there is no evidence or data. Some of these products are harmful. Never ignore a patient’s list of supplements. Review the list with intention to discuss any ingredients that could prolong bleeding time, change laboratory work (i.e., biotin), impact a pregnancy, become contaminated, be involved in lawsuits, interact with other medications, or are overly costly with no evidence. Do this with great care and respect, and you will find patients will be grateful.
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