Do Non-Prescription Products Help in Managing Androgenic Alopecia?

BACKGROUND: 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. SUMMARY: 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, Oryza sativa 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. KEY MESSAGE: 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.