Traditional Chinese Medicine (TCM) is an ancient eastern medicine practice.
It involves the use of herbs with medicinal properties and views the body as a “system”.
There are many reports of hair regrowth using these Chinese herbs. But, can this be supported by science?
In this article, I will describe some traditional Chinese herbs that have hair growth-promoting properties, delineate the science behind the use of these herbs, and reveal one interesting study on a formulation of Chinese herbs for hair growth.
Just keep reading!
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A Hair Loss Overview
To preface the idea of how Chinese herbs may promote hair growth, it’s important to understand how hair loss happens.
There are three types of non-scarring, reversible hair loss:
- Telogen Effluvium (TE)
- Pattern hair loss, or Androgenetic Alopecia (AGA)
- Alopecia Areata (AA)
TE occurs when many hairs transition from the anagen growing phase to the telogen shedding phase at once. It leads to diffuse hair loss.
There is no established cause for TE, but it is believed to be precipitated by stress, childbirth, and nutrient deficiencies.
Pattern hair loss or AGA can occur in both men and women. Male AGA is clearly mediated by an excess of the hormone Dihydrotestosterone (DHT), but it is less clear for women.
DHT is a powerful form of testosterone that is created when testosterone is enzymatically converted by 5α-reductase (5α-R). Some treatments for AGA target this enzyme to reduce its activity. These are called 5α-R inhibitors.
AA is a form of autoimmune hair loss that is caused by dysfunction of the immune system. Certain inflammatory signaling molecules and inflammatory immune cells are released into the scalp and inhibit hair growth (1).
Understanding this will help contextualize the beneficial properties of Chinese herbs.
- There are three types of reversible hair loss: telogen effluvium, androgenetic alopecia/pattern hair loss, and alopecia areata.
- Understanding how these may occur will will help contextualize the beneficial properties of Chinese herbs.
Chinese Herbs for Hair Growth and Thickness
Chinese herbs are certainly active substances. They contain active ingredients that interface with the body’s signaling systems at a cellular level.
If enough cells are impacted, it can influence the activity of the collective tissue. This can affect the way organs and whole body systems function.
The properties of some Chinese herbs and how they relate to hair growth are discussed below.
Chinese Skullcap for Hair Loss
Chinese skullcap is a Chinese herb that has been traditionally used within TCM to treat hair loss.
Its active ingredient, baicailin, has been investigated in animal studies to examine its effects on hair growth.
In one particular study, baicailin was shown to (2):
- stimulate the activity of dermal papilla cells (DPCs).
- increase the activity of an enzyme called alkaline phosphatase.
DPCs are cells responsible for signaling hair growth (3). They are partially responsible for activating stem cells which eventually proliferate to become hair. Without DPC activity, hair can’t grow.
Because baicailin stimulates DPC activity, this may explain the observed hair growth that results.
This property has been confirmed in other animal studies as well as human DPC culture studies (4).
Additionally, its effects on the alkaline phosphatase enzyme may be beneficial, specifically for AGA sufferers.
In AGA, DHT works in concert with free radicals and inflammation (which can be a consequence of many factors) to stimulate high levels of TGF-β expression (5). TGF-β is a growth factor that mediates the hallmark characteristic of AGA: follicle miniaturization.
It also enhances androgen activity, creating a vicious cycle (6).
Follicle miniaturization is caused by two things:
- Perifollicular fibrosis, or scar tissue formation, around the hair follicle
- Scalp blood vessel calcification which diminishes the blood supply to the hair follicle.
Eventually, fewer hairs are produced by each follicle and the hairs that remain become thin, wispy vellus hairs.
TGF-β facilitates both the perifollicular scarring and the blood vessel calcification.
Specifically in blood vessels, TGF-β decreases the activity of alkaline phosphatase. This leads to the calcification of blood vessels (7).
Considering baicailin enhances alkaline phosphatase activity, skullcap may counteract one aspect of follicle miniaturization in AGA.
Together, these mechanisms may explain why TCM healers have such success with Chinese skullcup. Although the findings in these animal studies may not necessarily be extrapolated to humans, they certainly are promising.
- Chinese skullcap is used in TCM to treat hair loss.
- Baicailin, the active constituent of skullcap, may promote hair growth by enhancing alkaline phosphatase activity and stimulating DPC activity.
- Baicailin’s effects have been duplicated in both animal and human cell culture studies.
- While these results may not necessarily be reproduced in humans, the findings are promising and may explain why skullcap is so successful in TCM treatments.
Fo-Ti root, also known as He Shou Wu, is a Chinese herb famous for its hair growth-promoting and gray hair-preventing properties (8).
It is believed to nourish the blood (9). The hair, in Chinese medicine, is believed to be an extension of the blood’s health. In other words, nourished blood means nourished hair.
In some studies, it has been shown to initiate the growing or anagen phase.
Another study was conducted to see which components of Fo-Ti were responsible for hair growth. One of the compounds, torachrysone-8-O-b-D-glucoside (T8DG), enhanced DPC activity more effectively than minoxidil (9).
The mechanism behind the effects of this compound is not known, however, it may be due to its antioxidant effects (10).
DPCs are especially sensitive to the effects of free radicals, damaging molecules that can damage cell structures and function (11). The antioxidant or free radical scavenging potential of T8DG may confer a protective effect to DPCs and support their function.
However, this hasn’t been confirmed in studies.
Although not confirmed by the literature, the documented benefits of Fo-Ti root for hair certainly warrant further investigation.
- Fo-Ti root is known for its benefits for hair in TCM.
- It is believed to nourish the blood and has been documetned to initiate the anagen phase. One compound may even increase DPC proliferation.
- DPC proliferation by T8DG in Fo-Ti may be due to its antioxidant properties but this hasn’t been confirmed in studies.
- The effects of Fo-Ti root on hair growth haven’t been well studied but certainly warrant further investigation.
White Peony Root
White peony root is a Chinese herb with potential anti-androgenic properties. This means it may be beneficial for AGA.
In TCM, it is touted for its mental and emotional support as well as immune-boosting properties.
One study suggests that white peony root may be beneficial for those suffering from autoimmune diseases (12). Because AA is an autoimmune disease, white peony root may benefit AA sufferers. This has not been studied, though.
The scientific literature on white peony root doesn’t go much further than this. Some studies suggest it may help balance testosterone levels but there are only two preliminary studies that explore this effect (13). Whether or not it works the same in the human system is unknown.
- White peony root has potential benefits for AGA due to its anti-androgen properties.
- It may be beneficial for autoimmune diseases, like AA, according to one study.
- There isn’t a lot of evidence in support of white peony root use for hair growth.
Ginseng has been used medicinally for thousands of years.
Its major constituents are ginsenosides which have been documented to promote hair growth (14). It may work by:
- Preventing free radical damage by sun exposure that can interfere with DPC activity
- Blocking TGF-β signaling
- Interacting with various signaling systems to enhance DPC activity
The effects of ginseng on hair growth have been investigated in both human and animal studies.
One rat model study indicates that ginseng promotes hair growth more effectively than finasteride, a drug used to treat AGA (14).
In one study on patients with AA, ginseng was included in the treatment regimen of corticosteroid intralesional injections (14). The researchers reported that the ginseng enhanced the thickness and density of the hair in these patients. This suggests ginseng may be an ideal conjunctive treatment for AA patients.
Cell culture studies have also reported that ginseng may prevent chemotherapy-induced hair loss.
Overall, the evidence in favor of ginseng is hopeful but more studies are needed to determine its effectiveness.
- Ginseng has documented hair growth-promoting benefits.
- It may work by preventing free radical damage to and enhancing the activity of DPCs. It may also block TGF-β signaling.
- Rat models suggest ginseng is more effective than finasteride for hair regrowth in AGA.
- Ginseng may be a good addition to AA treatment regimens, according to one study.
- Cell culture studies report that ginseng may prevent against chemotherapy-induced hair loss.
- More studies are needed to determine its effectiveness.
Dong Quai has been traditionally used by women for centuries. It is often prescribed by TCM healers for menstrual abnormalities and abdominal pain.
Although it is believed to have many beneficial properties, one of Dong Quai’s most interesting properties is that it enhances circulation (14).
Healthy circulation is important for hair growth. Without adequate blood supply to the follicle, hair cannot receive the nutrients it needs.
There are many compounds that travel via the blood to act as co-factors for hair growth. Decreased blood flow disrupts hair growth at a cellular level which can impact the whole follicle.
It should be noted, though, that Dong Quai hasn’t been studied for its effects on hair growth.
- Dong quai is traditonally used by women and is often prescribed for menstrual abnormalities.
- Dong Quai may enhance blood flow which is essential for hair growth.
- The effects of Dong Quai on hair growth specifically hasn’t been studied.
A Randomized Controlled Trial on Chinese Herbs for Hair Growth
Although individual herbs may exert beneficial effects and possess certain properties, herbal concoctions may be more effective. In one study, Chinese herbal formulations were more effective than herbs on their own (15).
There has been one very interesting clinical trial on one Chinese herb concoction (16).
In this randomized, double-blind, placebo-controlled trial on AGA patients, the active group was instructed to take 4.8 grams of this herbal formulation daily. It contained Ginseng root, Astragalus root, Dong Quai, Rehmannia, Privet fruit, and false daisy.
After six months, 47.1 percent experienced no change, 5.9 percent experienced minimal improvement, and 29.4 percent experienced moderately improved AGA.
Animal studies that attempted to investigate the mechanism of action for this formula revealed that it may influence growth factors that impact hair growth.
There are three specific growth factors known to affect hair growth:
- FGF-5 and FGF-7
VEGF is a growth factor that regulates vascularization which predicts the amount of blood flow (17). No vascularization means no blood flow. No blood flow means no nutrient delivery to the follicle.
Vascularization around the hair follicle during the anagen growing phase is essential for hair growth. VEGF controls this.
VEGF is believed to be a major regulator of hair growth.
EGF is absolutely essential for the initiation of the anagen phase and stimulating hair growth.
FGF-5 and FGF-7 are also required to stimulate entry from the telogen shedding phase into the anagen phase.
Together, these growth factors work synergistically to promote hair growth.
The moderately beneficial effects of this Chinese herb formulation may be attributed to its effects on these molecular mechanisms.
- A Chinese herb concoction that contained Ginseng root, Astragalus root, Dong Quai, Rehmannia, Privet fruit, and false daisy was shown to moderately promote hair growth in almost 30% of subjects.
- The effects of this herbal formulation may be attributed to its effects on VEGF, EGF, FGF-5, and FGF-7. These growth factors combined work together to promote transition into the anagen phase and nutrient delivery to the follicle.
- The benefits of this herbal formulation may be attributed to its effects on these molecular mechanisms.
Do Chinese Herbs Really Work?
Many Chinese herbs are used by TCM healers to treat hair loss.
While the evidence is sparse, there are a few studies that support the use of Chinese herbs for hair growth. They may be more effective in combination formulations.
Have you used Chinese herbs before? What was your experience? Leave a comment below.