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Received: 5 January 2019    Revised: 13 February 2019    Accepted: 14 February 2019

DOI: 10.1111/jocd.12930

REVIEW ARTICLE

An overview of herbal alternatives in androgenetic alopecia

Maria Yusuf Dhariwala M. Pharm  | Padmini Ravikumar M. Pharm

Dr. Bhanuben, Nanavati College of

Pharmacy, Mumbai, India
Correspondence
Maria Yusuf Dhariwala, Dr. Bhanuben
Nanavati College of Pharmacy, Mumbai,
India.
Emails: dhariwalamari@gmail.com;
maridhariwala@gmail.com
Summary
The second most common alopecia—Androgenetic alopecia (AGA)—occurs due to
hormonal imbalance. Dihydrotestosterone (DHT) an androgenic hormone is a sex
steroid, produced in the gonads. The target sites of DHT are similar to that of testos‐
terone, and it attaches easily remaining bound for 53 minutes as compared to 35 min‐
utes of testosterone. Excess of DHT causes miniaturization of hair reducing the
anagen phase and increasing the telogen phase leading to hair loss. Normally up to
ten percent of testosterone in the body irreversibly gets converted into DHT by the
action of enzyme 5‐alpha‐reductase. Inadequate blood flow to the scalp can also be
another reason for hair loss encountered due to lower oxygen and nutrients reaching
it. AGA affects both sexes; however in males, it leads to major hair loss. Conventional
drugs such as minoxidil and finasteride are widely used for the treatment. However,
several drawbacks such as allergic contact dermatitis, burning, ejaculation disorder,
and decreased libido are reported. Available literature suggests the role of herbal
drugs to have the action against 5‐alpha‐reductase enzyme inhibiting it and reducing
the hair loss. This can be further potentiated since they exhibit lesser side effects.
Recent advancements observed in the medicinal, cosmetic, and engineering fields
can prove to be an asset. This article focuses on herbs which can be used in AGA. A
review of Saw palmetto (Serenoa repens), Green tea (Camellia sinensis), Pumpkin seed
(Curcurbita pepo), Rosemary (Rosmarinus officinalis), Grape seed (Vitis vinifera), and
Licorice (Glycyrrhiza glabra) is attempted.

KEYWORDS
androgenetic alopecia, conventional drugs, dihydrotestosterone, herbal alternatives,
mechanism of action, side effects

1 |  I NTRO D U C TI O N
Androgenetic alopecia (AGA) is a highly common and chronic prob‐
lem which is characterized by advancing miniaturization of the hair
follicles.1,2 The term AGA was coined by Norman Orentreich in
1960.3 AGA expressly is seen of scalp hair having distinct patterns
of hair loss in both genders most commonly the central scalp and
1
habitually initiates around puberty. AGA can be capable of affecting
4
all races. The highest prevalence is observed in Caucasians. AGA is
also known as male pattern hair loss (MPHL) and female pattern hair
1
loss (FPHL). The highest prevalence is observed in ages between 30
and 65 years.5 The earliest indications of AGA can be observed after
puberty.6 Prevalence statistical data are presented in Table 1.
Androgenetic alopecia is generally an androgen hormone‐de‐
pendent process in which testosterone is converted into an active
androgen dihydrotestosterone (DHT) by enzyme 5‐alpha‐reductase
(Figure 1). DHT binds to androgen receptors present in the hair fol‐
licles triggering a process diminishing the anagen phase and over a
period of time the terminal hair converts into a thinner and shorter
vellus hair. The probability of AGA increases with aging.6 The aim
of this review article was to provide a brief introduction about
the herbal remedies which have potential to replace conventional

J Cosmet Dermatol. 2019;1–10. © 2019 Wiley Periodicals, Inc. |  1

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2       DHARIWALA and RAVIKUMAR

TA B L E 1   Study of prevalence of population affected by relatively due to the vehicles such as ethyl alcohol and propylene
androgenetic alopecia (AGA)2,4 glycol used in its dosage form used at high concentration.11 Similarly,

Affected with AGA for Finasteride oral treatment have been found to show adverse ef‐
fects.9,12 All the side effects and adverse reactions are presented in
Population Men Women Study
Table 3.
Caucasians 80% 40‐50% Kelly Y et al (2016)2 Current research on drugs mentioned in Table 4 focuses on
Asian 58% overall Kaliyadan F et al reduction of the active concentrations by using their combina‐
(2013) 4 tions and transforming them into novel dosage forms for topical
Chinese 21.3% 6.0% Kaliyadan F et al use. Minoxidil, a FDA approved drug, has been tested for a wide
(2013) 4
range of concentrations. A conventional solution of 5% was found
African 14.6% 3.5% Kelly Y et al (2016)2 to be more effective than a 2% conventional solution. Currently,
Kean 14.1% 5.6% Kaliyadan F et al reported literature proves the efficacy of a 2% solution in a novel
(2013) 4
carrier system.13,14 Similarly finasteride, another FDA approved
drug, has been reported effective in 0.25% and 0.5% topical solu‐
therapies. AGA needs long‐term treatment, and there are side ef‐ tion compared to an oral 1 mg/d dose.14,15 Other treatments such
fects and toxicities associated with the conventional FDA approved as low‐laser therapy, microneedling in scalp, hair mesotherapy,
drugs. Herbal sources can provide beneficial treatment along with, and hair transplantation are alternative treatments. Janus kinase
minimum side effects when compared to the conventional marketed and use of platelet‐rich plasma are in research; however, there is
drugs. The pathogenesis of normal hair cycle (A) and the hormone‐ limited information available and use in AGA.14 MorrF, a combina‐
affected cycle (B) is presented in Figure 2. tion of minoxidil 5% solution and Finasteride 0.1% lipid solution,
is used for alopecia.12
Following Table 5 represents few clinical trial studies that are
2 |  M E TH O DS ongoing, completed, and terminated.
Following are the herbal sources that can be potentially used fin
A methodical literature review was executed. Study exploration the treatment of AGA.
was conducted using online databases—PubMed and Science Direct
using keywords Androgenetic, Alopecia, Hair Loss, Saw Palmetto, 1. Saw palmetto (S repens)
Serenoa repens, Curcurbita pepo, Rosemary, Green Tea, Minoxidil, 2. Green tea (C sinensis)
Finasteride, Pumpkin Seed, Camellia sinensis, Glycyrrhiza glabra, 3. Pumpkin seed (C pepo)
Onion, Garlic, Grape seed, etc Literature focuses on the alternatives 4. Rosemary (Rosmarinus officinalis)
to synthetic drugs, case studies, clinical trials, case reports, and com‐ 5. Grape seed (Vitis vinifera)
parison type studies. 6. Licorice (G glabra)

3 |  R E S U LT S A N D D I S CU S S I O N
Androgenetic alopecia requires long‐term treatment therapy. Many
medications are available for hair loss out of which only two are ap‐
proved by FDA for AGA. Minoxidil available in two concentrations a
2% which is approved for FPHL and 5% is approved for MPHL topi‐
cal treatment and Finasteride at 1 mg oral medication (Figure 3).8,9
Some of the brands that are prescribed are presented in Table 2.
Conventional therapy presents many side effects and disad‐
vantages due to long‐term treatment. Side effects of Minoxidil are
3.1 | Saw palmetto
Saw palmetto is known as S repens (commonly available), Serenoa ser-
rulata, or Sabal serrulata. It is extracted from palm tree berries be‐
longing to the Arecaceae family inherent to the West Indies, Atlantic
coast of North America (from South Carolina to Florida). The extract
or oil obtained from the berries of saw palmetto is found to be rich
in fatty acids (85%‐90%), other constituents include sterols rich in
carotenoids, lipases, tannin, sugars and beta sitosterol, anthranilic
acid, capric acid, caproic acid, caprylic acid, ‐carotene, ferulic acid,

OH OH

H
H
5-alpha-reductase
H H
H H
O
O H
F I G U R E 1   Pathway for conversion of
TESTOSTERONE DHT Dihydrotestosterone testosterone to dihydrotestosterone
DHARIWALA and RAVIKUMAR |
      3

(A) Normal hair physiology .4,5,6,7

(B) Pathogenesis of hair loss .4,5,6,7

F I G U R E 2   Normal and affected hair

physiology. A, Normal hair physiology.4-7
B, Pathogenesis of hair loss4-7

O
NH

H
N

H
N N N H H

H O H O N
H
H H
F I G U R E 3   Structure of minoxidil and
finasteride MINOXIDIL FINASTERIDE

mannitol, ‐sitosterol, ‐sitosterol‐d‐glucoside, linoleic acid, myris‐
tic acid, lauric acid, oleic acid, palmitic acid, 1‐monolaurin, and
17-19
1‐monomyristin.
It is observed that beta sitosterol and fatty acids (lauric acid,
myristic acid, and oleic acid) are responsible for the inhibition of
5‐alpha‐reductase out of which lauric acid, myristic acid, and oleic
acid may be the main fatty acids responsible as saw palmetto is rich
in them (85%‐90% fatty acids are present).10
The mechanism of action of saw palmetto is similar to finasteride,
that is, inhibition of 5‐alpha‐reductase which converts testosterone
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4       DHARIWALA and RAVIKUMAR

TA B L E 2   Brands used for the

Drug Brand/Company
Minoxidil 1. Rogaine, Johnson &
Johnson
2. Adhair, Unichem
Laboratories Ltd.
3. Kirkland signature
Minoxidil
4. Lipogaine for men and
women
Finasteride 1. Propecia, Merck & Co.
2. Aindeem, Actavis Pharma
3. Finax, Dr Reddy's
Laboratories, Inc
4. Finpecia, Cipla
Pharmaceutical company
Mechanism of action Study
treatment of androgenetic alopecia
Even though the mechanism Usmania et al
of action is unknown, it may (2017) 8
increase the blood supply in
hair follicles allowing boost
of blood, oxygen, and
essential nutrients to the
follicles which help extend
the anagen phase
Finasteride is a synthetic Lauren L Levy
azo‐steroid which selec‐ et al (2013)9
tively and competitively A. Rossi et al
inhibits type II 5‐alpha‐re‐ (2012)10
ductase which converts
testosterone to
dihydrotestosterone

TA B L E 3   Limitations of long‐term
Side effects and adverse reactions
treatment of androgenetic alopecia
Minoxidil Finasteride Study

Scalp dryness Impotence Lauren L levy et al (2013)9

Karine Padois et al (2011)11
Ateeq Ahmad et al (2014)12
Skin irritation Decreased libido Lauren L Levy et al (2013)9
Karine Padois et al (2011)11
Ateeq Ahmad et al (2014)12
Rashes Erectile dysfunction and testicular pain Lauren L Levy et al (2013)9
Karine Padois et al (2011)11
Ateeq Ahmad et al (2014)12
Burning Ejaculation disders Lauren L Levy et al (2013)9
Karine Padois et al (2011)11
Ateeq Ahmad et al (2014)12
Redness Breast enlargement or tenderness Lauren L Levy et al (2013)9
Karine Padois et al (2011)11
Ateeq Ahmad et al (2014)12
Erythema Headache Lauren L Levy et al (2013)9
Karine Padois et al (2011)11
Ateeq Ahmad et al (2014)12
Dryness Menstrual irregularity Lauren L Levy et al (2013)9
Karine Padois et al (2011)11
Ateeq Ahmad et al (2014)12
Allergic contact Dizziness Lauren L Levy et al (2013)9
dermatitis Karine Padois et al (2011)11
Ateeq Ahmad et al (2014)12
Increased body hair growth Karine Padois et al (2011)11
Ateeq Ahmad et al (2014)12
Hypersensitivity reactions Karine Padois et al (2011)11
Ateeq Ahmad et al (2014)12

to DHT responsible for AGA.10,20,21 Dose 320 mg/d10,20 was found
to be effective.
Other uses of saw palmetto include the following: Baldness,
benign prostatic hyperplasia (BPH), in strengthening and build‐
ing tissues, increasing metabolism (stimulates appetite), diuretic
which improves urinary flow, expectorant (relieve chronic
bronchitis), asthma, chest congestion, thyroid disorders, di‐
gestion and absorption of nutrients, and polycystic ovary
syndrome.10,17,20
It can be observed that the side effects associated with finas‐
teride can be avoided with the use of herbal remedy like S repens
(Figure 4). 22
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It is reported that green tea leaves extracts have polyphenolic

3.2 | Green tea
Green tea is known as C sinensis obtained from leaves belonging to
family Theaceae. It is cultivated widely in India, Sri Lanka, China,
Indonesia, and Japan.19,23 Green tea is widely consumed by people
all around the globe especially in most parts of Asia, North America,
United States, and Europe. 24 Green tea consists of constituents like
powerful antioxidants which include polyphenols and flavonoids
containing catechins and its derivatives epicatechin (EC), epigallo‐
catechin gallate (EGCG), epigallocatechins, and epicatechin gallate. It
is reported that EGCG is one of the major and biologically effective
catechins of green tea, it also contains proteins, pigments—chloro‐
phyll, carotenoids, volatile components—aldehydes, alcohols, esters,
lactones, hydrocarbons, and traces of lipids‐ linoleic and linolenic
acids, vitamins (B, C, E). 20-22
components exhibit anti‐inflammatory and stress inhibitory effect
which may influence hair growth among mice.19 EGCG that is a major
component of green tea stimulates human hair growth via its prolif‐
erative and antiapoptotic effects on dermal papilla cells also affects
Type I 5‐alpha‐reductase activity which converts testosterone to
DHT. 25-27
Other significant uses of green tea include antioxidant activity,
improved insulin sensitivity, cardiovascular diseases, antiviral po‐
tentials, therapeutic potentials against Parkinson's and Alzheimer's
disease, anti‐allergic potentials, anti‐carcinogenic activity, rheu‐
matoid arthritis and osteoarthritis, usefulness in skin damage,
dental caries, periodontal disease, tooth loss, combat obesity, pre‐
vents hair loss, antibacterial activity, and effective in renal failures
(Figure 5). 24-26

TA B L E 4   Marketed products to treat alopecia

Disder Drug Strength Brand name Dosage fm

Nonscarring alopecia's
Androgenic alopecia 1. Minoxidil 1. 2% or 5% 1. Rogaine 1. Topical
2. Finasteride 2. 1 mg 2. Propecia 2. Oral
3. Minoxidil & Finasteride 3. Minoxidil 3. Intas pharmaceuticals LTD 3. Topical
[5%]+Finasteride
[0.1%]
Alopecia areata 1. Minoxidil 1. 2% or 5% 1. Rogaine 1. Topical
2. Anthralin 2. 0.5%‐1.0% 2. Dritho‐Scalp 2. Cream
3. Diphenylcyclopropenone 3. 1% 3. Micanol 3. Topical cream
(DPCP)
Telogen effluvium No treatment is necessary after the initial cause is removed; common triggers for telogen effluvium are medications,
illness, childbirth, and crash diets
Trichotillomania Selective serotonin reuptake 1. 25 mg 1. Zoloft 1. Oral
inhibit (SSRI) 2. 25 mg, 80 mg, 2. Luvox 2. Oral
100 mg 3. Sarafem 3. Oral
3. Not to exceed
80 mg/d
Traction alopecia Minoxidil 2% or 5% Rogaine Topical
Tinea capitis Antifungal medications 2% Sandoz Shampoo
Ketoconazole
Sht and loose anagen Minoxidil 2% or 5% Rogaine Topical
syndrome
Tempal alopecia Minoxidil 2% or 5% Rogaine Topical
triangularis
Scarring alopecia's
Lichen planopilaris 1. Hydroxychloroquine 1. 200 mg 1. Plaquenil 1. Oral
Combination of topical, sulphate 2. 10 mg/mL 2. Aristocort 2. Injection
intralesional andal 2. Triamcinolone 3. 25‐40 mg/d 3. Deltasone 3. Oral
therapies 3. Prednisone
Frontal fibrosing Minoxidil 2% or 5% Rogaine Topical
alopecia
Chronic cutaneous Hydroxychloquine sulphate 6.5‐20 mg Plaquenil Topical
lupus erythematosus
Central centrifugal 1. Hydroxychloroquine 1. 6.5‐20 mg 1. Plaquenil 1. Topical
cicatricial alopecia sulphate 2. 300 mg 2. Declomycin 2. Oral
2. Tetracycline
Folliculitis decalvans Tetracycline 300 mg Declomycin Oral
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6       DHARIWALA and RAVIKUMAR

TA B L E 5   Clinical studies for androgenetic alopecia (AGA)16

CT No. Title Drug Phase

Completed
NCT03004469 A multicentre, randomized, double‐blind, parallel‐group, Drug: P‐3074 Phase 3
controlled study, to assess the efficacy and safety of
P‐3074 cutaneous spray, solution, in the treatment of
male pattern baldness
NCT02503852 Subcutaneous transplantation of autologous cell enriched PureGraft and celution system Phase 2
adipose tissue ffollicular niche stimulation in early stage
alopecia androgenetica (STYLE): a randomized, blinded,
controlled trial
NCT01286649 Randomized, single‐centre, double‐blind, placebo‐con‐ Human autologous hair follicle cells Phase 1 Phase 2
trolled, Phase I/IIa study to evaluate the safety and
efficacy of human autologous hair follicle dermal sheath
cup cells (DSCC) in women and men with AGA
NCT02503137 A Phase 2, multicenter, randomized, double‐blind study of Topical SM04554 solution Phase 2
SM04554 applied topically to the scalp of male subjects
with AGA analyzed by biopsy of the scalp prito and post
dosing
Ongoing
NCT03742518 Multicenter, randomized, double‐blind, placebo‐con‐ Topical SM04554 solution Phase 3
trolled study of the efficacy and safety of 0.15% &
0.25% concentrations of topical SM04554 solution in
male subjects with androgenetic
NCT03676400 Clinical study for the assessment of the hair growth Conditioned media of umbilical cd Not applicable
efficacy and safety of a cosmetic investigational blood‐derived stem cells
product, after repeated applications for 24 wk, under
normal conditions of use, in the Asian adult subjects
with androgenic alopecia
NCT03388840 The effect of adipose derived stem cells combined with Adipose‐derived stem cells Phase 4
platelet rich plasma vs platelet rich plasma alone on suspension
follicular unit extraction hair transplantation in male
androgenic alopecia: clinical trial
NCT03723369 The effect of microneedling with low energy laser in Acupuncture Not applicable
androgenic alopecia patients
Terminated
NCT02676310 Dose escalation study of the safety, tolerability, and Bimatoprost Phase 1
pharmacokinetics of bimatoprost topical solution in the
treatment of AGA in men
NCT01292746 An evaluation of the effect of the Erchonia Ml scanner Erchonia MLS Not applicable
(MLS) on the treatment of androgenic alopecia in
females

OH
OH

LAURIC ACID MYRISTIC ACID

OLEIC ACID

HO

H F I G U R E 4   Structure of lauric acid,

O H myristic acid, and oleic acid
DHARIWALA and RAVIKUMAR
OH
OH
O OH
OH
O
OH
HO O H
OH
OH
Epigallocatechin Gallate (EGCG)
F I G U R E 5   Structure of epigallocatechin (EGCG)
3.3 | Pumpkin seed
Pumpkin seed or C pepo, locally known as “Kadoo” in Indian na‐
tive languages while in English “Squash,” belongs to family
Cucurbitaceae. 28 Pumpkin seed origin is from Central and South
America but it also cultivated in Tropical Asia. 25,26 Curcurbita pepo
is the most common species whereas Cucurbita maxima are the
second most common pumpkin species. The chemical constitu‐
ents also vary species to species but it was found that the yield of
fatty acids, sterols or phytoestrogens and tocopherols remained
the major three components of pumpkin seeds. Conversely, com‐
ponents present in minor‐ protein, mineral, terpenic alcohol, and
fiber gave a synergistic effect to the major components and could
not be neglected. Curcurbita pepo is rich in polyunsaturated fatty
acids about 80%‐ palmitic acid, myristic acid, stearic acid, oleic
acid, and linoleic acid, vitamin E like α‐tocopherols, γ‐tocophe‐
rols and carotenoid, phytoestrogens, and phytosterols and trace
29,30
components.
In a study by Schiebel‐Schlosser and Friederich, it was observed
that BPH patients when treated with capsules containing 500 mg of
pumpkin seed extract there were no side effects. 29 In another study
by Young Hye Cho et al, volunteers for a period of 12 months 320 mg
of pumpkin seed oil dose were tested which showed improvement
than compared with placebo. It is observed that the combination of
31
pumpkin seed and saw palmetto can be beneficial.
Pumpkin seed oil and extract has been reported to inhibit 5‐
alpha‐reductase activity with a dose of 400 mg/d for 24 weeks. This
action is suggested due to phytosterols, also the presence of lipids
10,32
can be a factor that adds synergistic effect for treatment of AGA.
Other uses of pumpkin seed:‐ arthritis, antitumor effect, ther‐
apy for irritable bladder, hypertension, hypercholesterolemia, anti‐
oxidant and anti‐inflammatory, benign prostate hyperplasia, bladder
stone disease, alleviated diabetes, abdominal cramps, antiestrogenic,
anti‐oxidative, antiviral, antibacterial, insecticidal or fungistatic,
|
      7
H
H
PHYTOSTEROLS
H
HO
F I G U R E 6   Structure of phytosterols
treatment of heterophyiasis, immune‐regulatory potential, anti‐per‐
oxidative properties, and diabetic complications (Figure 6). 29
3.4 | Rosemary
Rosemary biological name R officinalis family Labiatae is grown
widely around the world along the sub‐Himalayan areas, having cul‐
tivations since ancient days in England, Germany, France, Denmark,
America, Venezuela, Philippines, and the northern and southern
coasts of the Mediterranean sea.33 Its fresh leaves and flowering
buds contain rosmarinic acid, caffeic acid, chlorogenic acid, carnosic
acid, rosmanol, carnosol, and different diterpenes and many other
natural antioxidants, ursolic acid, glycolic acid, and rosmaricine. The
rosemary oil contains esters (2%‐6%) largely as borneol, cineoles,
and several terpenes, chiefly a‐pinene, camphene, 1%‐2% volatile oil
containing 0.8%‐6% of esters and 8%‐20% of alcohols.19,33
Caffeic acid, 1, 8‐cineole, and rosmarinic acid are potential ther‐
apeutic agents obtained in rosemary oil by steam distillation.19,33 It
was observed that when compared to Minoxidil, Rosemary results
did not show a significant difference from the results obtained of
Minoxidil.34 Rosemary acts by improving blood circulation and im‐
proving vascularity helping the regeneration of follicles similar effect
that is provided by Minoxidil.33,34
Other uses of Rosemary are antidepressant activity, antitumor
genic effect, choleretic and hepatoprotective effects, antimycotic
activity, treatment for alopecia areata, treatment of dermatological
disorders, anti‐inflammatory action, spasmolytic activity on smooth
muscles helping relaxation, and antioxidant activity (Figure 7).33,34
3.5 | Grape seed
Grape seed or V vinifera berries of which belong to family Vitaceae35
are grown widely in Russia, Europe, Iran, Afghanistan, and in India
having presence of anthocyanins, flavan‐3‐ols (ie, catechins), vita‐
min E (α‐tocopherol), petiole, linoleic acid, flavonoids (resveratrol,
quercetin and catechin, and polyphenols (flavonoids, phenolic acids,
phenolic alcohols, stilbenes, and lignans), procyanidins (B4 and B6),
and trimer gallate, unsaturated fatty acids, and phytosterols in which
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8       DHARIWALA and RAVIKUMAR

OH

OH

Caffeic Acid
O

O OH
HO

O O
H
H
H
H
CH3

CH3 HO
HO
CH3 OH
F I G U R E 7   Structure of caffeic acid,
OH 1,8-CINEOLE ROSMARINIC ACID
1,8‐cineole and rosmarinic acid

OH Other remarkable uses observed in grape seed or V vinifera are

OH
as follows:‐ activity in various cancer therapy lung cancer, colon
cancer, bladder cancer, breast cancer, prostate cancer, pancreatic

HO O
cancer, head and neck squamous, cervical cancer, colorectal cancer,
skin cancer, oral cancer, intestinal tumorigenesis, antioxidant, anti‐
inflammatory effect, antimicrobial activity, scavenging activity, anti‐
OH mutagenic activity, antitumor‐promoting effects, antifungal activity,
OH antiulcer activity, capillary protective action, anti‐hypertensive ef‐
OH fect, and hair‐growing activity (Figure 8).35-37

OH

3.6 | Licorice
HO O
Licorice is obtained from root or stem of G glabra belonging to fam‐
ily Leguminosae and is well known traditionally and widely availa‐
OH ble flavoring herb. 38,39 Glycyrrhiza glabra is known as Yashtimadhu,
OH n Sweet wood (English). 39 It is used widely in all countries of the
OH world with wide cultivation in India (Jammu and Kashmir, Punjab,
OH and Sub‐Himalayan).40 Its constituents include glycyrrhizin which
is a 60 times sweeter than sugar cane, glycyrrhizic, and glycyr‐
HO O rhetinic acids, rich in flavonoids such as liquiritin, isoliquiritin,
neoisoliquiritin, liquiritigenin, isoliquiritigenin, rhamnoliquiritin,
glabrine, glabranine, formononetin, licuraside, lichalcones (A and
OH
B), hispaglabridin (A and B), licoricidin, glabrene, pinocembrin,
OH prunetin, saponeretin, 11‐deoxoglycyrrhetic, 24‐hydroxyliquiritic,
OLIGOMERIC PROCYANIDINS: n=0-5 liquiridolic acids, glabrolide, deoxoglabrolide, deoxoglabrolide,
POLYMERIC PROCYANIDINS: n>5
isoglabrolidde, licoflavonol, glycerol, licoricone, glabridin, glabrol,
F I G U R E 8   Structure of procyanidins 7‐acetoxy‐2‐methylisoflavone, 7‐methoxy‐2‐methylisoflavone,
7‐hydroxy‐2‐methylisoflavone, glyzarin, glyzaglabrin, licoisofla‐
catechins, epicatechins, trans‐resveratrol, and procyanidin B1 are vones, glycyrin, sugars, and aspargin. 39,40 The main constituents
19,35,36
the most active and potential ones. are glycyrrhizin, potassium, and calcium salt of glycyrrhizinic
It was found that proanthocyanidins found in grape seed oil and acid.41
extract showed an activity in the proliferation of hair follicle cells iso‐ The extract was identified to have the presence of glycosides,
lated from mice by about 230% relative to controls (100%) also pos‐ terpenoid, phenolics, and flavonoids which were widely available
sessed remarkable hair‐cycle‐converting activity from the telogen having antagonizing testosterone effect. It is seen that phytosterols
phase to the anagen phase in C3H mice in vivo test systems.19,35,37 may be the inhibitor of some steroid dehydrogenases (which could be
DHARIWALA and RAVIKUMAR |
      9

HO chronic fatigue stress, antinociceptive activity, antiulcer activity,

hepatoprotective activity, memory enhancing activity, anticon‐
O vulsant activity, antistress activity, antioxidant activity, testicular
toxicity, cytotoxic activity, antihyperglycemic activity, antimalarial
H activity (licochalcone a), antiviral activity (glycyrrhizin, licochal‐
cones, glycyrrhetinic acid), anticancer activity, antioxidant activity
(licochalcone, glabridin, isoliquiritigenin, licocoumarin), memory en‐
hancer (glabridin), muscle relaxant (rhamnoglucoside), and spasmo‐
O H lytic (liquiritin; Figure 9).39,41,43,44
GLYCYRRHIZIN
H

O
4 | CO N C LU S I O N
O
O
Androgenetic alopecia is a type of most prevalent alopecia and of
HO
major concern. It occurs majorly due to excess of testosterone get‐
ting converted into DHT via enzyme 5‐alpha‐reductase in the body
HO O
and also can be due to inadequate blood flow in the scalp. Minoxidil
OH OH
O
and finasteride are FDA approved drugs where minoxidil increases
the blood flow and vascularity in the scalp when topically applied
O
and finasteride inhibits the enzyme 5‐alpha‐reductase preventing
OH
the conversion of testosterone to DHT when given orally. Side ef‐
HO OH
fects accompanied with these FDA approved drugs include scalp
F I G U R E 9   Structure of glycyrrhizin dryness, impotence, skin irritation, decreased libido, rashes, erec‐
tile dysfunction, testicular pain, burning, ejaculation disorders, red‐
ness, breast enlargement Or tenderness, erythema, and headache.
5‐alpha‐reductase) that converts testosterone to DHT and thus be the To overcome these side effects, herbal therapy can be a potential
beneficial in treatment of AGA.40 In another study, it was compared treatment. Saw palmetto (S repens), Green tea (C sinensis), Pumpkin
to the standard Minoxidil 2%; it showed better activity in hair growth seed (C pepo), and Licorice (G glabra) are reported to inhibit 5‐alpha‐
when used as a hydro‐alcoholic extract 2% concentration. Therefore, reductase enzyme whereas Rosemary (R officinalis) shows action
it can be said that G glabra has a powerful hair growth activity.40,42 by improving blood circulation to scalp and Grape seed (V vinifera)
Other important uses of G glabra are immunomodulatory activ‐ showed proliferation of hair follicle cells and activity in hair physi‐
ity (glycyrrhetinic acid), antitussive activity (glycyrrhizin), anti‐in‐ ological cycle. Herbal drugs can be more advancing than conven‐
flammatory activity (glycyrrhetic acid, liquiritoside, licochalcone a), tional when used topically on the scalp. More research towards

TA B L E 6   Marketed formulations containing Herbal drugs

Herb Dosage form Brand Dose

Saw palmetto 1. Extract‐capsules 1. Dailywellness 1. 200 mg/d

2. Extract‐soft gel capsule 2. The Vitamin Shoppe 2. 320 mg/d
3. Extract‐capsules 3. Now 3. 160 mg twice daily
4. Shampoo and conditioner 4. Artnaturals 4. 16 oz
Green tea 1. Extract‐capsules 1. Holy natural 1. 1000 mg twice daily
2. Extract‐capsule 2. Sinew nutrition 2. 700 mg/d
3. Nutritional drink 3. Nutrova simplifying good health 3. 10 mg
4. Nutritional drink 4. Himalaya wellness 4. 2000 mg per sachet
Pumpkin seed 1. Extract‐capsule 1. Inlife group 1. 500 mg/d
2. Oil‐Soft gel capsule 2. Now foods 2. 2000 mg twice daily
Rosemary 1. Capsules 1. HealthVit. 1. 700 mg twice daily
2. Oil 2. Good vibes 2. Essential oil for hair
3. Capsules 3. Eclectic institute massage
3. 300‐900 mg/d
Grape seed 1. Nutritional drink 1. Nutrova simplifying good health 1. 10 mg
2. Extract‐capsule 2. Inlife group 2. 400 mg
Licorice 1. Chewable tablets 1. Planetary herbal 1. 380 mg/d
2. Root extract alcohol free 2. Natures answer 2. 2‐6 mL (500‐2000 mg/d)
 |
10       DHARIWALA and RAVIKUMAR

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