Efficacy comparison between oral saw palmetto and oral finasteride in treating androgenetic alopecia in male patients

Androgenetic alopecia is the most common cause of hair loss and can adversely affect the self-image and self-confidence of the suffering individuals. The relatively few number of approved medications which may not be effective in all subjects or tolerable by all those who take them has resulted seeking for new treatment modalities. Saw palmetto (serenoa repens), a herbal medication primarily used for the treatment of benign prostate hyperplasia (BPH) due to it's 5-a-reductase inhibitory effects, is one of the over-the-counter supplements that has been widely used by individuals all around the world to treat hair-loss. This study is a triple-blinded RCT aimed at determining the true effectiveness and potential side-effects of this herbal medicine by it's comparison with it's synthetic counterpart finasteride. 40 male subjects with androgenetic alopecia, between 18-41 years of age and with no history of internal diseases or consumption of medications effective on scalp hair growth for 1 year enter the study. Subjects are then randomly allocated to either the oral saw palmetto 320 mg/d or the oral finasteride 1 mg/d group. Treatment is continued for 6 months. Before and after the treatment the number of hair follicle units are counted in a photograph of 1 cm2 area of the sagital scalp. The participants, the physician who prescribes the medications and the physician who counts the hair follicles and grades the degree of alopecia, are all blinded to the subject's medication. The scoring physician is also blinded to the stage of therapy (i.e. before or after). Occurrence of side-effects that are life threatening or intolerable by the subjects, as well as self-willed discontinuation of the medications or concurrent use of other treatments which can potantially affect hair growth are considered as major exclusion criteria.

Vice chancellor for research of Tehran University of Medical Sciences