Humans are usually born with approximately 5 mil-
lion hair follicles, and no new f ollicles are added after
birth . The hair follicle cycle, which begins in utero,
comprises 3 stages: the anagen, telogen, and catagen
phases. Anagen represents the growth phase associ-
ated with extensive mitotic activity, and 90% to 95% of
all hair exists in the anagen phase at any given point
in time. Hair then involutes during the catagen phase
through apoptosis of the follicular keratinocytes and
is converted to club hair. Telogen is the resting phase
Received: Dec 16, 2018 Revised: Jun 4, 2019 Accepted: Jun 19, 2019 Published online Aug 5, 2019
Correspondence to: Ju Tae Seo https://orcid.org/0000-0001-6989-4549
Department of Urology, Cheil General Hospital & Women’s Healthcare Center, Dankook University College of Medicine 17 Seoae-ro 1-gil, Jung-
gu, Seoul 04619, Korea.
Tel: +82-2-2000-7585, Fax: +82-2-2000-7787, E-mail: firstname.lastname@example.org
*These authors contributed equally to this work as co-first authors.
Copyright © 2019 Korean Society for Sexual Medicine and Andrology
Do Kimchi and
Probiotics as a
Functional Food Improve Androgenetic Alopecia?
A Clinical Pilot Study
Dong-Wook Park1,*, Hyo Serk Lee2,*, Myeong-Seung Shim3, Kyu Jin Yum3, Ju Tae Seo2
1Laboratory of Reproductive Medicine, 2Department of Urology, Cheil General Hospital & Women’s Healthcare Center, Dankook University
College of Medicine, Seoul, 3Coenbio R&D Center, Seongnam, Korea
Purpose: Probiotic supplementation demonstrates beneficial effects on serum lipid profiles. We hypothesized that probiotics
could benefit patients presenting with alopecia, secondary to improved blood flow to the scalp.
Materials and Methods: Our study included men with stage II to V patterns of hair loss based on the Hamilton–Norwood
classification and women with stage I to III patterns of hair loss based on the Ludwig classification. All patients were ad-
ministered 80 mL of Mogut® (a kimchi and
probiotic product) twice a day. Hair growth and numbers were
measured using the Triple Scope System® (KC Technology, Korea) at baseline and after 1 and 4 months of administration of a
Results: At baseline, the mean hair count was 85.98±20.54 hairs/cm2 and the mean thickness was 0.062±0.011 mm in all
patients (n=46). Hair count and thickness had significantly increased at 1 month (90.28±16.13 hairs/cm2 and 0.068±0.008
mm, respectively) and at 4 months (91.54±16.29 hairs/cm2 and 0.066±0.009 mm, respectively). In this study, we found that
a kimchi and
probiotic product could promote hair growth and reverse hair loss without associated adverse
effects such as diarrhea.
Conclusions: We suggest that the observed improvements in hair count and thickness resulted from initiation of the anagen
phase in hair follicles in response to probiotics.
Keywords: Alopecia; Functional food; Leuconostoc; Probiotics; Scalp; Soybeans
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0)
which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
pISSN: 2287-4208 / eISSN: 2287-4690
World J Mens Health Published online Aug 5, 2019
Health promotion, disease prevention, and lifestyle
associated with inactivity of the hair follicle. The club
hair is shed and new anagen hair growth begins, re-
suming the cycle [2-4].
Usually, approximately 50 to 100 hairs are shed
per day. Hair loss >100 hairs/d is defined as alopecia.
There are different types of alopecia that can cause
hair loss on the scalp or on other areas of the body .
Hair loss can be attributed to multiple factors, includ-
ing dandruff, hormonal deficiencies, dietary or nutri-
ent deficiencies, certain diseases, chemotherapy, and/
or psychological issues, such as stress and depression
. In most men, androgenetic alopecia develops with
a distinctive “patterned” hair line recession. In women,
the presentation may be less clear; typically women
will develop a diff use thinning over the top of the scalp,
yielding a “Christmas tree” pattern with more thin-
ning towards the front, although the frontal hairline is
maintained . Occasionally, men may develop a female
presentation of hair loss and women, primarily those
experiencing excess androgen activity, may develop a
more men-like hair loss pattern . Five-α reductase
inhibitors are used to treat androgenetic alopecia, and
are effective for preventing hair loss progression and
induction of hair regrowth in androgenetic alopecia in
men. However, they are not recommended for women,
and side eff ects, such as erectile dysfunction and de-
creased libido have been reported [9,10]. Additionally,
alopecia may result from sun exposure, consumption of
junk food, use of styling tools, and/or extreme weight
loss . Alopecia is associated with significant psycho-
social consequences and can af f ect patients’ lives and
social behavior, often triggering psychological problems
. No robust evidence supports the consistent eff icacy
of topical treatments, including topical corticosteroids,
tacrolimus, cryotherapy, minoxidil, anthralin, or ultra-
violet light A combined with oral psoralens in treating
alopecia , and those options are usually not suitable
for patients presenting with extensive alopecia because
of their minimal efficacy [14,15]. Minoxidil is a topi-
cal vasodilator that prolongs the anagen phase and
increases the size of smaller hair follicles . Its exact
mechanism of action has not yet been determined,
although a few research studies have presented data
suggesting that an improved nutritional supply to the
scalp secondary to vasodilation may play a key role in
its demonstrated ef f icacy [16,17]. Despite positive effects
on alopecia, several adverse eff ects of commercial hair
restorers have been reported, limiting their use for
treatment of patients with alopecia [18,19].
Recently, several experimental and clinical studies
have reported that probiotic supplementation demon-
strated beneficial effects on serum lipid profiles, indi-
cating improvements in peripheral blood flow [20,21].
Based on these research data, we hypothesized that
dietary supplementation of probiotics could benefit
patients presenting with alopecia secondary to im-
proved blood flow to the scalp. We investigated the ef-
fect of administration of a kimchi and cheonggukjang
probiotic product on patients with hair loss. Kimchi
and cheong guk jang (a Korean traditional fermented
soybean product) are traditional Korean foods, but en-
suring optimal intake of probiotics f rom kimchi and
cheong guk jang is dif f icult, for two main reasons. First,
the amount of probiotics varies depending on the rip-
ening period of kimchi, as different ripening periods
lead to dif ferences in pH that could aff ect personal ap-
petite. Koreans consume cheongguk jang as a boiled hot
soup, so it contains no live probiotics. Thus, administra-
tion of live probiotics f rom kimchi and cheongguk jang
as a drinkable yogurt would be a more efficient way
to obtain the beneficial ef fects of kimchi and cheong-
guk jang. The primary ingredients in this product are
the probiotic-rich kimchi and cheongguk jan g. All pa-
tients were administered a kimchi and cheong guk jang
probiotic product over the course of 4 months, and hair
thickness and count were measured at 1 and 4 months.
MATERIALS AND METHODS
1. Study population
Patients were enrolled in the study between January
2017 and Jun e 2017. Men aged 46.52±10.14 ( standard
deviation, SD) years showing stage II to V patterns of
hair loss based on the Hamilton–Norwood classifica-
tion and women aged 44.17±10.20 years showing stage I
to III patterns of hair loss based on the Ludwig classi-
fication were included in this study . The exclusion
criteria were: use of any topical medication (such as
minoxidil or other solutions for hair growth), intake of
oral medication (f inasteride, dutasteride, or anti-andro-
gens), laser therapy or chemotherapy within 12 months
prior to enrollment in the study, smoking, a history of
hair transplantation, pregnant or lactating women, and
any chronic active scalp condition other than alopecia.
According to a rule of thumb, the sample size was de-
termined to be 23 for each sex .
Dong-Wook Park, et al: Androgenetic Alopecia and Kimchi Probiotics
2. Ethics statement
The present study protocol was reviewed and ap-
proved by the Institutional Review Board of Cheil
General Hospital (Reg. No. CGH-IRB-2016-57). Inf ormed
consent was provided by all subjects when they were
3. Study design and intervention
All patients were administered 80 mL of a kimchi
and cheong guk jang probiotic product (Mogut®; Coen-
bio, Seongnam, Korea) twice a day (before breakfast
and bedtime). The ingredients of the kimchi and cheon-
ggukjang probiotic product were: culture medium with
fermented bacilli of kimchi and cheongguk jang (Leu-
conostoc holza pf elii, Leuconostoc mesenteroides, and
Lactobacillus sakei; 99.7%), pe rsimmon v inegar (0.1%),
Hasuo extract ( Pleuropterus multiflorus; 0.1%), and
extract of Korean black soybean (Rhynchosia volubilis
Lour; 0.1% ).
4. Efficacy evaluation
Hair growth and numbers were measured using the
Triple Scope System® (KC Technology, Seoul, Korea)
after 0 (baseline), 1, and 4 months of administration
of the kimchi and cheonggukjang probiotic product.
All patients were instructed to wash their hair before
visiting the hospital and strictly advised against use
of hair treatment using cosmetics such as styling gels.
The analysis was performed on the top of the patient’s
head, and the scalp was tattooed to identify the areas
for the next measurement. The hair density (number
of hairs/cm2) was measured at 5 different sites using
a scope at ×60 magnification, and hair thickness (mm)
was measured in 5 individual hair strands using a
scope at ×100 magnification.
5. Statistical analysis
The Student t-test was used to assess the statistical
significance of diff erences. All statistical analyses were
performed using SPSS ver. 12.0 (SPSS Inc., Chicago, IL,
USA). A p<0.05 was considered to indicate statistical
significance. Data are presented as mean±SD.
Forty-six patients were enrolled in this study. All pa-
tients completed the study. The patients’ characteristics
are shown in Table 1. The hair parameters measured
after 1 and 4 months of administration of a kimchi and
cheong guk jang probiotic product were compared with
the baseline (0-month) values. At baseline, in all pa-
tients (n=46), the hair count was 85.98±20.54 hairs/cm2
and thickness was 0.062±0.011 mm. As shown in Table
2, hair count and thickness had significantly increased
at 1 month (90.28±16.13 hairs/cm2 and 0.068 ±0.008
mm, respectively) and at 4 months (91.54±16.29 hairs/
cm2 and 0.066±0.009 mm, respecti vely) compared to
the baseline value (p<0.001). We observed that after
1 month of administration of the kimchi and cheong-
guk jang probiotic product, 63.0% of the total patients
(n=29) showed improvements in the measured hair
parameters (thickness and count), and 21.8% (n=10) and
4.3% (n=2) of all patients showed improvements in only
hair thickness and count, respectively. In 10.9% (n=5)
of the total patients, no improvement was observed in
either hair parameter that was assessed (Fig. 1). Afte r
4 months, 54.3% (n=25) of all patients showed improve-
ment in both assessed parameters, while 21.8% (n=10)
and 17.4% (n=8) of the total patients showed improved
hair thickness and count, respectively, and 6.5% (n=3)
of the total patients showed no improvement in either
assessed parameter (Fig. 2).
We analyzed data based on sex (23 male and 23 fe-
male) to determine whether the ef ficacy of the kim-
chi and cheong guk jang probiotic product dif fered by
sex. In male patients, hair count increased steadily
from baseline to 4 months (86.91±22.21 hairs/cm2 at
the initial visit, 88.17±17.50 hairs/cm2 at 1 month, and
Table 1. Characteristics of the study patients with alopecia
Characteristic Male patients
Age (y) 46.52±10.14 44.17±10.20
Past history of alopecia treatment None None
Menopause (%) N/A 52.1
Values are presented as mean±standard deviation or percent only.
N/A: not available.
Table 2. Results of hair parameters in all patients
Counts (/cm2) 85.98±20.54 90.28±16.13 91.54±16.29 <0.001
Thickness (mm) 0.062±0.011 0.068±0.008 0.066±0.009 <0.001
Values are presented as mean±standard deviation.
90.78±17.65 h airs /cm 2 at 4 months; p<0.001). Thick-
ness had also increased at 1 month (0.064±0.007 mm)
and 4 months (0.063±0.006 mm ) compared to baseline
(0.058±0.009 mm, p=0.002 ) ( Table 3). In female patients,
hair count had increased at 1 month (92.39±14.72 hairs/
cm2) and 4 months (92.30±15.17 hairs/cm2) compared to
the initial visit (85.04±19.18 hairs/cm2) (p<0.001). Af-
ter 1 and 4 months, hair thickness in female patients
was observed to have increased (0.072±0.006 mm and
0.072±0.010 mm, respectively) compared to baseline
(0.066±0.011 mm, p=0.001) (Table 4). We observed that
52.2% (n=12) of male and 73.9% (n=17) of female pa-
tients showed improvement in both parameters (hair
thickness and count) af ter 1 month of administration
of the kimchi and cheonggukjang probiotic product. In
39.1% (n=9) of male patients, we observed an improve-
ment in only hair thickness, without any change in
hair count during the same period. In 8.7% (n=2) of
men, the hair parameters were unaffected f ollowing
administration of the kimchi and cheonggukjang pro-
biotic product over 1 month. After 1 month of probiotic
administration, 4.3% (n=1) and 8.7% (n=2) of female pa-
tients showed improved hair thickness and hair count,
respectively. We observed that in 13.1% (n=3) of female
Improvement in total
Fig. 1. Results of all patients at 1 month.
Improvement in total patients
Fig. 2. Results of all patients at 4 months.
Table 3. Results of hair parameters in male patients
Counts (/cm2) 86.91±22.21 88.17±17.50 90.78±17.65 <0.001
Thickness (mm) 0.058±0.009 0.064±0.007 0.063±0.006 0.002
Table 4. Results of hair parameters in female patients
Counts (/cm2) 85.04±19.18 92.39±14.72 92.30±15.17 <0.001
Thickness (mm) 0.066±0.011 0.072±0.006 0.072±0.010 0.001
Improvement in male
12 (52.2%)9 (39.1%)
Improvement in female
Fig. 3. Results by sex at 1 month.
Dong-Wook Park, et al: Androgenetic Alopecia and Kimchi Probiotics
patients, both hair parameters were unaffected after 1
month of kimchi and cheong guk jang probiotic product
administration (Fig. 3). An improvement in both hair
parameters was noted after 4 months of probiotic prod-
uct administration in 39.1% (n=9) of male and 69.6%
(n=16) of female patients. Hair thickness had improved
in 30.5% (n=7) of male and 13.0% (n=3) of female pa-
tients af ter 4 months of administration of the kimchi
and cheongguk jang probiotic product. We observed
that 26.1% (n=6) of male and 8.7% (n=2) of female pa-
tients showed an improved hair count during the same
period. No improvement in either hair parameter was
observed in 4.3% (n=1) of male and 8.7% (n=2) of female
patients af ter 4 months of probiotic administration (Fig.
4). Fig. 5 presents a vertex view of female and male pa-
tients with alopecia showing that administration of the
kimchi and cheonggukjang probiotic could increase
hair density and number af ter 4 months when com-
pared with baseline (0 month).
As their health benefits have become known, probi-
otics are being widely used globally. Probiotics primar-
ily include bacteria f rom the genera Stre ptococcus,
Enterococcus, Pediococcus, W eissell a, and Lactobacillus,
although the most commonly used probiotics belong to
Lactobacillus and Bi f id obacterium spp. . Probiotics
are live organisms that are primarily used to improve
the signs and symptoms of gastrointestinal disorders
such as diarrhea, irritable bowel syndrome, constipa-
tion, and lactose intolerance, as well as to inhibit the
excessive proliferation of pathogenic intestinal bacte-
ria. However, recent studies have suggested that probi-
otics could have beneficial ef fects that extend beyond
gastrointestinal health, as they have demonstrated
eff icacy in improving certain metabolic disorders such
as hypertension , hypercholesterolemia , and
atherosclerosis . The suggested mechanisms of pro-
biotic action in metabolic disorders include inhibition
of pathogen adhesion to the gut mucosa, stabilization
Improvement in male
Improvement in female
Fig. 4. Results by sex in 4 months.
Fig. 5. Response to administration of a
kimchi and cheonggukjang probiotic
product at baseline (0 month) and 4
months were measured by the Triple
Scope System® (×20 magnification).
of microbial f lora, and/or improvement of mucosal
integrity and barrier function, which can improve
energy metabolism and insulin sensitivity . Meta-
bolic diseases such as hypercholesterolemia negatively
aff ect microvascular function, which can be reversed
with use of cholestyramine lipid-lowering therapy .
Based on these data, intake of appropriate quantities
of probiotics could lead to a beneficial effect on periph-
eral vascular blood f low and hair growth.
The kimchi and cheong guk jang probiotic product
analyzed in this study included various kinds of pro-
biotics and prebiotics obtained f rom kimchi, cheon g-
guk jang, and natural herbs. Choi et al  reported
that ultra-high molecular weight poly-γ-glutamic acid
(UHMW γ-PGA) isolated f rom Bacillus subtilis (used to
ferment cheongguk jang) could improve hair growth in
vivo. The authors showed that UHMW γ-PGA inhibited
activity of 5-α reductase, an enzyme produced in the
prostate, adrenal glands, and scalp, which metabolizes
the male hormone testosterone into dihydrotestoster-
one , resulting in an improvement of alopecia in
men. Thus, in that study, we concluded that the diff er-
ence in the pattern of improvement observed between
men and women was secondary to the difference in its
ef fect on the 5-α reductase present in the scalp.
In our present study, all enrolled patients were ad-
ministered a kimchi and cheong guk jang probiotic
product over a maximum period of 4 months. Overall,
93% of all patients demonstrated beneficial effects in
terms of the hair parameters that were assessed (thick-
ness and hair count); furthermore, the proportion of
those who experienced no effects decreased over time
(10.9% vs. 6.5%) (Fig. 1, 2). These effects were evident
within a month of intake of the kimchi and cheong-
guk jang probiotic product. The effectiveness of the
kimchi and cheonggukjan g probiotic product varied
between men and women. Men were more likely to
experience an effect on only hair thickness (30.4%) or
only hair count (26.1%) than an effect on both param-
eters (39.1%). In contrast, most women showed a posi-
tive effect on both hair parameters that were assessed
(65.2%), and only 13.0% and 8.7% of women showed
improvements in only hair thickness or only hair
count, respectively. We observed that administration of
the kimchi and cheongguk jang probiotic product was
ineff ective in 4.3% of men and 8.7% of women (Fig. 4).
Cheong guk jang is a known source of thrombolytic en-
zymes. Jeong et al  studied the characterization of
a f ibrinolytic enzyme from Bacillus subtilis CH3-5 that
was isolated from cheongguk jang. This thrombolytic
enzyme could increase the peripheral blood flow, in-
cluding to the scalp, and increase the amount of nutri-
tion provided to hair follicles.
In this study, the efficacy of the kimchi and cheong-
guk jang probiotic product was diff erent between male
and female patients, as improvements in both criteria
(thickness and count) at 1 month (73.9% vs. 52.2%) a nd
4 months (65.2% and 39.1%) were more common than
in male patients in the same period. However, male
patients were more likely to experience improvements
in only hair thickness at 1 month (39.1% vs. 4.3%) an d
4 months (30.4% vs. 13.0%) than female patients in the
same period. The prevalence of androgenetic alopecia
in Korean shows a sex bias, as 10.8% of Korean men
and 3.8% of Korean women in their 40s are diagnosed
with androgenetic alopecia . According to our data,
we suggest that kimchi and cheongguk jang probiot-
ics exert limited effects on androgenetic alopecia, and
further study is therefore needed to verif y the dif fer-
ent effects of kimchi and cheong guk jang probiotics on
men and women.
The use of drugs associated with hair regrowth such
as f inasteride and minoxidil is limited and temporary,
due to adverse eff ects associated with their use, such as
irregular heartbeat and weight gain . In this study,
we f ound that a kimchi and cheonggukjang probiotic
product could promote hair growth and reverse hair
loss without associated adverse effects such as diar-
rhea. Thus, we conclude that the use of natural probi-
otic products is a safer treatment strategy for patients
presenting with alopecia.
This study has some limitations. First, we did not
measure changes in the blood flow of the scalp and or
blood lipid profiles of all patients enrolled this study.
Second, we did not use a placebo group as a negative
control. However, we did compare the ef fects of probi-
otics before and after administration. Third, the obser-
vation period was relatively short, and the number of
patients was relatively small; therefore, we were not
able to establish whether the probiotic eff ects on alo-
pecia would be reversed or maintained during a longer
To summarize, we suggest that the observed im-
Dong-Wook Park, et al: Androgenetic Alopecia and Kimchi Probiotics
provements in hair count and thickness resulted from
initiation of the anagen phase in hair follicles second-
ary to the improved blood flow and modulation of
androgenetic effects by probiotics. However, ours is a
clinical study. Therefore, further studies investigating
the mechanism of action of probiotics and their role in
hair growth are warranted.
This study was financially supported by the Coenbio
Conflicts of Interest
Myeong-Seung Shim and Kyu Jin Yum are advisers and Ju
Tae Seo is non-executive director of the Coenbio R&D Center,
Seongnam, Korea, but they had no influence on this work in re-
lation with the company or its products. The other authors have
no potential conflicts of interest to disclose.
Conceptualization: JTS, HSL. Data curation: HSL. Formal
analysis: HSL. Funding acquisition: JTS. Investigation: JTS,
HSL. Methodology: JTS. Project administration: JTS, HSL. Re-
sources: JTS. Supervision: KJ Y, MSS. Validation: JTS, HSL. Vi-
sualization: HSL. Writing–original draft: DWP, HSL. Writing–
review & editing: DWP, HSL.
Data Sharing Statement
The data required to reproduce these findings cannot be
shared at this time as the data also forms part of an ongoing
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