With so many topical hair treatments on the market, it’s hard to know what works and when to use them. As a trichologist (hair and scalp specialist), I can tell you that not all treatments are created equal, and they’re only effective for certain conditions.  

Finding the right treatment starts with the correct diagnosis. For example, if someone is suffering excessive hair loss as a result of iron deficiency or a thyroid imbalance, then you need to correct the underlying imbalance in order to stop the hair loss; rubbing things into your scalp will only be a waste of time and money. On the other hand, if someone is experiencing temporary excessive hair loss as a result of an operation or rapid weight loss, they may notice improvement after three months of topical therapy – but that’s only because of natural resumption of the hair growth cycle, which results in regrowth after around three months without any therapy! So in these cases, topical treatments don’t make any difference.

However, there are some hair loss problems that can be helped (not necessarily cured) by the application of topical therapies. To determine if a topical treatment is appropriate, you need to ask yourself three main questions: Is the problem associated with inflammation of the hair follicles? Can the problem be helped by antioxidants? And, is the microbiome (or balance of microorganisms) on the scalp out of balance? If the answer to any of these questions is ‘yes’, then the appropriate topical treatments can be of benefit. Furthermore, the application of some oils to the hair can undoubtedly improve the quality and look of the hair.

Treating the Hair Follicles

With male and female pattern (genetic) hair loss, some topical applications can help reduce the production of dihydrotestosterone (DHT) at the level of the hair follicles, which helps to reduce hair loss. Saw palmetto, green tea, stinging nettle and pumpkin seed oil are beneficial for this.

Reducing Inflammation

Using a trichoscope, I can easily see when there’s inflammation around the hair follicles. This is a common finding and is caused by white blood cells attacking the stem cells of the hair follicles. Topical therapies including aloe vera, chamomile, oats, turmeric, neem oil, calamine, quercetin, oregano, thyme, rosemary, fennel and bergamot can all help to reduce inflammation. These ingredients are often included in shampoos.

Turmeric, and its most active compound curcumin, is well known for its anti-inflammatory and antioxidant properties, and can be taken as a supplement or applied topically.

Antioxidants

With genetic hair loss, testosterone induces oxidants that, in turn, increase transforming growth factor (TGF) ß1, which reduces hair growth. Taking or applying antioxidants can help counteract this. Vitamins A, C, D and E all act as antioxidants, and N-acetylcysteine (NAC), a supplement that trichologists often suggest to patients, has both anti-inflammatory and antioxidant properties. Interestingly, NAC seems to reduce the tendency of children to pull out their hair, a problem termed trichotillomania.

Oil Treatments

Tea tree oil is well known for its antimicrobial activity and can reduce the yeast and bacteria associated with dandruff, itchiness and oily scalp conditions. Anti-dandruff shampoos also improve the scalp’s microbiome, and by doing so benefit the hair and scalp.

Rosemary oil, which increases the production of prostaglandin E2 (PGE2, a hormone-like substance), is known to benefit hair growth in cases of genetic hair loss. Jojoba oil has wonderful healing properties, and I recommend that patients who have had radiotherapy to the scalp apply it as soon as possible after therapy to hasten hair regrowth. Coconut oil is another beneficial oil, able to penetrate the hair, increase its strength, reduce protein loss, and increase moisture retention (especially in dry climates).

Caffeine

And what about the topical application of caffeine for hair loss? Caffeine is able to counteract the effects of stress on the hair and therefore helps reduce stress-related hair loss. Caffeine also increases cell metabolism and is an anti-inflammatory and antioxidant. So perhaps a ‘hair café’ where clients can have caffeine or green tea, with a touch of rosemary oil massaged into their scalp, is not as silly as it sounds.

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