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Effects of the extract from bergamot and boxthorn on the delay of skin aging and hair growth in mice
Abstract
To study the effects of the extract from bergamot and boxthorn on the skin and the hair growth in mice.
The skin on the back of mice was shaved topically and smeared with bergamot and boxthorn extract for 42 days. Then the activity of superoxide dismutase (SOD) and the content of malondialdehyde (MDA) and collagen in the mice were measured. The growth of hair was also observed.
Compared with control group, the extract from bergamot and boxthorn obviously increased the activity of superoxide dismutase (P < 0.05) and the content of collagen (P < 0.001), and decreased the content of malondialdehyde (P < 0.05) in the skin of mice. It also significantly promoted the growth of hair (P < 0.001).
The extract from bergamot and boxthorn plays an active role in skin and the promotion of hair growth.
... BEO also presents a variable percentage (4-7%) of nonvolatile compounds, such as pigments, waxes, coumarins, and psoralens (Mannucci et al., 2017). The main preparations used are bergamot extracts (BE), with high content of flavonoids, such as neoeriocitrin, neohesperidin, naringin (Toth et al., 2015), bergamot polyphenolic fraction (BPF) (Bruno, Pandolfo, Crucitti, Maisano, Zoccali, et al., 2017), bergamot essential oil (BEO) (Watanabe et al., 2015), and aromasticks with bergamot/sandalwood or frankincense/mandarin/lavender (Dyer, Cleary, McNeill, Ragsdale-Lowe, & Osland, 2016) bergamot/vetivert/geranium (Wiebe, 1998), bergamot/lavender/cedarwood (Graham, Browne, Cox, & Graham, 2003) and bergamot juice (BJ) (Impellizzeri et al., 2015), bergamot/boxthorn extract (Shao, 2003) or bergamot essential oil plus other citrus essential oils plus grapefruit juice (Li, Zhu, Han, & Zhang, 2016) or bergamot flavonoids and other phytoextracts (Babish et al., 2016;Saiyudthong & Marsden, 2011). ...
... Inflammation also seems to benefit from bergamot administration (Impellizzeri et al., 2015(Impellizzeri et al., , 2016. Finally, bergamot shows positive effects on psoriasis (Valkova, 2007) and on hair growth (Shao, 2003). ...
... As regards animal studies, the topical application of bergamot extract for 42 days increased the activity of superoxide dismutase (p < 0.05) and the collagen content (p < 0.001), and decreased the content of malondialdehyde (p < 0.05) in the skin of mice. It also promoted hair growth significantly (p < 0.001) (Shao, 2003). In particular: as regards the effects on hyperlipidemia, this review summarizes that: ...
We summarize the effects of bergamot (extract, juice, essential oil, and polyphenolic fraction) on cardiovascular, bone, inflammatory, skin diseases, mood alteration, anxiety, pain, and stress. This review included a total of 31 studies (20 studies on humans with 1709 subjects and 11 in animals (rats and mice)). In humans, bergamot‐derived extract (BE) exerts positive effects on hyperlipidemia with an oral dose from 150 mg to 1000 mg/day of flavonoids administered from 30 to 180 days, demonstrating an effect on body weight and in modulating total cholesterol, triglycerides, LDL, and HDL. Studies in animals confirm promising data on glucose control (500/1000 mg/day of BE with a treatment lasting 30 days) are available in rats. In animals models, bergamot essential oil (BEO, 10 mg/kg or 20 mg/kg daily for 20 weeks) increases bone volume, decreases psoriatic plaques, increases skin collagen content, and promotes hair growth. Bergamot juice (20 mg/kg) is promising in terms of pro‐inflammatory cytokine reduction. In humans, aromatherapy (from 15 to 30 min) does not appear to be useful in order to reduce stress, anxiety, and nausea, compared to placebo. Compared to baseline, BE topical application and BEO aromatherapy reduce blood diastolic and systolic pressure and could have a significant effect on improving mental conditions. We performed a systematic review of 31 studies regarding the effects of bergamot derivatives (extract, juice, essential oil, polyphenolic fraction) on lipid profile, glycemic status, skin, bone, and mental health. The results of this our support the efficacy of Bergamot as a modulator of lipid profile. Compared to placebo, bergamot aromatherapy does not appear to be useful in order to improve mental health. As regards the other aspects, the data are not sufficient to express a definitive indication.
... 식물추출물에서 기능을 나타내는 약용성분(phyto- † 주 저자 (e-mail: khjhee@kumoh.ac.kr) chemicals)은 인간의 신진대사와 생리활성을 촉진하는 물질들이며, 현재 이들에 대한 연구가 활발히 이루어지 고 있다 [1][2][3]. 알려진 약용성분들의 기능으로는 살균효 과 [4]와 미백효과 [5], 항염증 [6], 보습효과 [7], 피부의 주름개선을 포함한 노화방지 [8,9], 육모, 탈모방지 [8,10] Figure 1에 나타내었다. Hydroxypro-line의 정량곡선은 Figure 2에 나타내었다. ...
... 식물추출물에서 기능을 나타내는 약용성분(phyto- † 주 저자 (e-mail: khjhee@kumoh.ac.kr) chemicals)은 인간의 신진대사와 생리활성을 촉진하는 물질들이며, 현재 이들에 대한 연구가 활발히 이루어지 고 있다 [1][2][3]. 알려진 약용성분들의 기능으로는 살균효 과 [4]와 미백효과 [5], 항염증 [6], 보습효과 [7], 피부의 주름개선을 포함한 노화방지 [8,9], 육모, 탈모방지 [8,10] Figure 1에 나타내었다. Hydroxypro-line의 정량곡선은 Figure 2에 나타내었다. ...
Medicinal herbs have been shown to have protective functions for skin and hair. We investigated the effects of complex of soluble {\beta}-cyclodextrin and phytochemicals on the functions of skin and hair. In previous report, we evaluated the safety of supramolecules and found their anti-microbial effects and anti-fungal effect against Gram (+) and Malassezia furfur which is known to cause dandruff. Here we present that functional supramolecules-containing cream promotes the biological skin activity by inducing the collagen formation. And treatment of supramolecules-containing hair tonic increased the rate of hair growth of mouse. Taken together, supramolecular cosmetic compounds containing water insoluble phytochemicals and water soluble {\beta}-cyclodextrin exhibit the potential ability for hair growth promotion and delaying the aging of skin.
... Fresh juice from bergamot has been stud- ied to evaluate the polyphenolic composition by HPLC- DAD analysis and total polyphenols content by UV method. 43 The maltodextrin/juice powder showed nei- ther significant change in total polyphenols content nor decrease in antioxidant properties with respect to fresh juice. 44 The extract from bergamot and boxthorn plays an active role in skin and the promotion of hair growth. ...
... It also significantly promoted the growth of hair. 43 Tobacco. Tobacco leaves are traditionally known to potentiate hair growth promotion. ...
Background:
In androgenetic alopecia, a number of botanicals are available that can effectively slow or reduce hair loss and inflammation or stimulate partial hair regrowth. The aim of this study was to provide a descriptive overview of the impact and production of literature on botanicals used for androgenetic alopecia and to perform a citation analysis of the related research articles.
Methods:
We searched for "alopecia" OR "androgenetic alopecia" OR "hair loss" AND "Camelia sinensis" OR (and other 15 botanicals) in ARTICLE (Title/Abstract/Keyword) in Scopus database.
Results:
A total of 29 references, that is, research articles, were retrieved by SCOPUS search, and 93.1% had been published since 2000. The majority (48.3%) describe applications of hair grow stimulants, followed by inhibitors of 5-alpha-reductase applications (27.6%), and studies concerning inhibitors of inflammation (24.1%). The citation analysis revealed a growing interest for this topic and the papers on hair grow stimulants are most cited. Citation trend of inhibition of 5-alpha-reductase articles is growing in the last years.
Conclusions:
This study has highlighted three important aspects: (1) growing interest for this topic; (2) evidences mainly in hair grow stimulants and recently in the inhibition of 5-alpha-reductase, as demonstrated by article and citation counts across years; (3) in addition, all major studies have been focused on green tea epigallocatechin-3-gallate, Serenoa repens, Citrullus colocynthis and Cuscuta reflexa.
... Diels, used for promoting blood circulation and removing blood stasis, has been shown to promote the growth of hair follicle cells and inhibit cell death in vivo [8] . Lycium barbarum (boxthorn), used as an anti-aging product, has been shown to increase the activity of superoxide dismutase in tissues, enhance collagen expression, and increase hair growth in mice in vivo [9] . ...
... In a previous report [46], BEO was smeared to the skin of mice with hair removal once a day for 42 days, and later BEO was confirmed to enhance the activity of SOD and decrease MDA content in the skin. Wang et al. [47] Recently, research on the mechanism of Chinese medicine against anxiety via central neurotransmitters is in full swing. ...
Anxiety disorder resulting from the interaction of psychological factors-caused anxiety and mood disorder symptoms is one of the clinical mental diseases. Excessive worry, nervousness and fear often bring about several negative outcomes, and seriously impact the physical, mental, and social functioning of patients. What’s worse, with poor treatment, anxiety disorder may develop into mental illnesses such as depression and schizophrenia. The treatment of anxiety has mainly recourse to drug therapy and psychotherapy; however, Western drug therapy represented by 5-hydroxytryptamine reuptake inhibitor often causes evident adverse effects, including nausea and constipation, as well as poor long-term medication compliance of patients. Citri Sarcodactylis Fructus can sooth the liver and regulate qi, which can be applied to alleviate anxiety disorder as an ancillary drug. Modern pharmacological research revealed that bergamot volatile oil, also known as bergamot essential oil (BEO), is the main active chemical component of Citri Sarcodactylis Fructus for anti-anxiety. BEO has been confirmed to exert an anti-anxiety effect through modulating neuronendocrine-immune network, including immunoregulation, suppression of hyperactive hypothalamic-pituitary-adrenal (HPA) axis, enhancement of function of hypothalamic-pituitary-thyroid (HPT) axis, modulation of neurotransmitter, and promotion of neurotrophic effect. The study discusses the current research status regarding the application of Citri Sarcodactylis Fructus for anti-anxiety in recent years, and deeply probes into the mechanism of Citri Sarcodactylis Fructus playing an anti-anxiety role via neuronendocrine-immune network, in an effort to provide references to clinical treatment of anxiety disorder and new ideas for developing drugs targeting anxiety disorders.
... Aconiti ciliare C57BL/6 mice Aqueous Extract Activation of Wnt/β-catenin signaling pathway [62] Allium tuberosum Rottler ex Spreng extract Telogenic C57BL6/N mice Ethanol extract Increase the number of hair Follicles IGF-1 Upregulation [56] Asiasari radix C57BL/6C3Hmice Ethanol extract Regulation of cell growth and growth factor gene expression VEGF upregulation [53] Boehmeria nipononivea Mice Acetone extract Inhibition of 5α-reductase [76] bergamot and boxthorn Mice Aqueous extract NA* [77] Cercidiphyllum japonicum Mice Methanol extract NA* [78] Chamaecyparis obtusa C57BL/6mice Essential Oils Positive regulator of VEGF [54] Crinum asiaticum C57BL/6 mice Ethanol extract Proliferation of dermal papilla [79] Cuscuta reflexa Swiss albino rats ...
... Preclinical studies represent a significant part in the research on the effect of herbs and their active constituents on hair growth (Table 1). Studies carried out on rats and mice showed that topical application of Hibiscus rosa-sinensis extract [2], Buxus wallichiana extract [104], Polygonum multiflorum extract [115], Citrullus colocynthis Schrad extract [32], Zizyphus jujuba oil [166], bergamot and boxthorn extracts [135], Camellia oleifera, Angelica sinensis and P. multiflorum extract [22], grape seeds (Chardonnay variety) and 3% proanthocyanidins [148], Panax ginseng extract and ginsenoside Rb1 [93], Polyporus umbellatus extract and their constituents (acetosyringone; 3,4-dihydroxybenzaldehyde polyporusterone A and B) [60] and Nardostachys jatamansi extract and their constituents (nardal, jatamansic acid) [41] promoted hair growth. ...
Currently available conventional therapies of hair loss using synthetic drugs are still imperfect and have a number of limitations. Their effectiveness as well as the safety of their use is often questioned. It has led to an increased interest in alternative treatments with fewer side-effects such as formulations containing herbs and/or their active constituents. For this purpose several electronic databases and hand-searched references were used to summarize current knowledge regarding topically used herbal products for the treatment of hair loss acquired on the basis of preclinical and clinical studies. Moreover, mechanism of their action, follicular penetration and possible adverse effect of herbal products will be also described.
... 21세기 고령화 사회로 진입함에 따라 나이가 들어도 젊고 아름다운 피부를 원하는 여성의 수적인 증가로 노화 방지용 화장품에 대한 연구개발이 활발히 진행되고 있다[16,29]. 최근 인간이 안전하게 오랫동안 섭취하거나 외용으로 사용해왔던 천연물을 이용한 항산화, 항균력, 면역효과 등에 관한 약리학 적 효능에 관심이 집중되고 있으며 이러한 자연친화적인 트렌 드의 소비추세에 맞춰 다양한 천연소재를 이용한 기능성 화장 품의 개발이 활발히 이뤄지고 있다[14, 37]. 산화적 스트레스를 유발시키는 free radical은 화합물의 화학적 반응 및 여러 가지 산화, 환원 반응 등 내적 요인과 흡연, 음주, 스트레스, 대기오 염 등 외적요인에 의해 생성되며, 생체 내에서 free radical 반 응에 의해 생성되는 활성 산소종(reaction oxygen species, ROS)은 DNA분절과 단백질의 불활성화 및 과산화 반응을 일 으켜 세포손상이 시작되게 된다[13, 25, 33]. ...
To check the possibility of using natural extracts for cosmetic substances, we tested the bioactive effects of 11 crude extracts originating from native plants grown in the Republic of Korea on anti-oxidant and anti-wrinkle activities. When DPPH scavenging activities were measured, the crude extracts of Vitex rotundifolia, Scirpus triangulatus, S. wichurae, S. tabernaemontani, and Aeschynomene indica assays had more than 70% of DPPH scavenging activities at 100 ?g/ml concentration. The data from the hydrogen peroxide scavenging assay revealed that the crude extracts from the 10 species, except for Eleocharis mamillata var. cyclocarpa, could scavenge more than 90% at 1,000 ?g/ml concentration. The crude extract of V. rotundifolia had the highest xanthine oxidase scavenging activity at a 1,000 ?g/ml concentration. Based on the four anti-oxidant assays, the crude extracts of V. rotundifolia, S. triangulatus, S. wichurae, S. tabernaemontani, and A. indica were shown to have excellent anti-oxidant capacities overall. In addition to the anti-oxidant capacities, the crude extract from S. wichurae exhibited high collagenase inhibitory activity, therefore, it could be a promising candidate for a cosmetic ingredient with anti-oxidant and anti-wrinkle qualities. The results of this study indicate that many wild plants native to the Korea Peninsula can be used as excellent natural substances for cosmetics based on their bioactive effects.
... 식물추출물에서 기능을 나타내는 약용성분(Phytochemicals)은 인간의 신진대사와 생리활성을 촉진하는 물질들이며, 현재 이들에 대한 연구가 활발히 이루어지 고 있다 [3]. 알려진 약용성분들의 기능으로는 살균효과 [4]와 미백효과 [5], 항염증 [6], 보습효과 [7], 피부의 주 름개선을 포함한 노화방지 [8,9], 육모, 탈모방지 [ (6) and Malassezia furfur (7). The samples' abbreviation inside of each petri dish represent as follows: distiled water, D; 25 mg/disc gentamycin, G; commercial shampoo contained zinc pyrithion, SC; shampoo contained 25 % herb extract, S1; shampoo contained 25 % herb extract + 0.25 % cyclodextrin, S2; commercial shampoo contained climbazole, S3; herb extract, Ex1; herb extract contained 1.5 % cyclodextrin, Ex2; bodywash, BC; bodywash contained 2 % herb extract + 0.3 % phytoncide, B1; bodywash contained 2 % herb extract + 0.02 % cyclodextrin + 0.3 % phytoncide, B2; commercial bodywash, B3. ...
In this report, we have investigated the functional properties change of phytochemicals by the encapsulation using water soluble host, -cyclodextrin. The cream, shampoo, bodywash, and hair tonic containing phytochemical supramolecules were produced by mixing the surfactants, fragrances and the oriental herbal extracts encapsulated with -cyclodextrin. Shampoo and bodywash including the encapsulated phytochemicals exhibited anti-growth activity against Gram (+) and Malassezia furfur which is known to cause dandruff. In cytotoxicity test against HDF (human dermal fibroblast), we could not detect any toxicity when the supramolecules content was less than 1 mg/mL. Our results suggest that the supramolecule of -cyclodextrin with phytochemicals could be a safe anti-bacterial agent for cosmeceuticals.
... Intraplantar injections of BEO also exert significant antinociceptive activity (Sakurada et al., 2009;Sakurada et al., 2011;Kuwahata et al., 2013). Other documented properties of BEO include isolated reports concerning antioxidant properties (Wei and Shibamoto, 2010); skin protection and promotion of hair growth (Shao, 2003); ability to induce differentiation of some cancer cell lines, which may be relevant for cancer prevention (Kawaii et al., 1999); and to induce differentiation and gamma-globin gene expression in human erythroid cells, of potential interest for the therapy of hematological disorders, including beta-thalassemia and sickle-cell anemia (Guerrini et al., 2009), induction of skin sensitization to Grenz rays, a type of ultrasoft radiation waves used in the treatment of skin conditions such as dermatitis, warts, psoriasis, and hand eczema (Oppenheim, 1947), and even usefulness in gingival dressing (Schach, 1969). ...
Bergamot (Citrus aurantium L. subsp. bergamia) essential oil (BEO) is used in folk medicine as an antiseptic and anthelminthic and to facilitate wound healing. Evidence indicates that BEO has substantial antimicrobial activity; however its effects on immunity have never been examined. We studied the effects of BEO on reactive oxygen species (ROS) production in human polymorphonuclear leukocytes (PMN) and the role of Ca(2+) in the functional responses evoked by BEO in these cells. Results show that BEO increased intracellular ROS production in human PMN, an effect that required the contribution of extracellular (and, to a lesser extent, of intracellular) Ca(2+) . Bergamot essential oil also significantly increased ROS production induced by the chemotactic peptide N-formyl-Met-Leu-Phe and reduced the response to the protein kinase C activator phorbol myristate acetate. In conclusion, this is the first report showing the ability of BEO to increase ROS production in human PMN. This effect could both contribute to the activity of BEO in infections and in tissue healing as well as underlie an intrinsic proinflammatory potential. The relevance of these findings for the clinical uses of BEO needs careful consideration. Copyright © 2014 John Wiley & Sons, Ltd.
People commonly inquire about vitamin and mineral supplementation and diet as a means to prevent or manage dermatological diseases and, in particular, hair loss. Answering these queries is frequently challenging, given the enormous and conflicting evidence that exists on this subject. There are several reasons to suspect a role for micronutrients in non-scarring alopecia. Micronutrients are major elements in the normal hair follicle cycle, playing a role in cellular turnover. The role of nutrition and diet in treating hair loss represents a dynamic and growing area of inquiry. This chapter summarizes the role of vitamins and minerals in non-scarring alopecia. Micronutrients such as vitamins and minerals play an important, but not entirely clear role in normal hair follicle development and immune cell function. Deficiency of such micronutrients may represent a modifiable risk factor associated with development, prevention, and treatment of alopecia.
Herbal cosmetics have growing demand on the earth market and are a precious gift of nature. Herbal formulations continuously have attracted gigantic concentration on the grounds that of their good endeavor and comparatively lesser or nil side effect with synthetic medications. Herbs and spices have been used in retaining and embellishing human magnificence because time immemorial. Hair loss problem is of great significance to both men and women. The essential issues associated with hair loss are hair fading, dandruff, and falling of hair. Alopecia is the medical term for hair loss or baldness. It is an embarrassing condition for any person as he/she looks extra aged than ordinary. Many forms of medication are available to treat alopecia in special procedure of medication such as Allopathic, Homeopathic, and Ayurveda or can also be surgical like hair transplantation; however, none of them is wholly ample. This hindrance could be solved by the use of natural medicines obtained from herbs. Various herbs are being used to preclude the hair loss and remorse of hairs including Aloe vera, brahmi, nagarmotha, amla, bhringraj, and lots of different herbs. Being average medicines, there are various advantages of making use of them like patient compliance, less side results, convenient availability, inexpensive and multiple mode of applications to treat alopecia, and other hair diseases.
Lycium barbarum and Lycium chinense (Family: Solanaceae), known as goji berries and wolfberries, are cultivated in warmer parts of China. Recently in the warmer regions of the American Continent, goji plants have been cultivated. The latest studies suggest incorporating fruits and vegetables into daily meals improves health significantly. Furthermore, a healthy diet reduces the intensity of certain age-related conditions like obesity, diabetes and cardiovascular diseases. The regular consumption of fruits and vegetables protects the body from diseases caused by the pollution, contamination of microbes, radiation and chemical exposure. Goji berries have been medicinal and functional foods for centuries. In Traditional Chinese Medicine (TCM), goji berries are sweet in taste, neutral in nature with diverse biological activities. Furthermore, chemical investigations identified the presence of several secondary metabolites, polysaccharides and other volatile constituents. In the research findings, some of these compounds showed biological activities like radical-scavenging, quinone reductase (QR) and anti-aging. However, goji berries showed synergism with warfarin. The purpose of the review is to summarize the health benefits of goji berries and suggest their usage as staple diet to improve health.
This review presents an overview on plants identified to possess hair growth activity in various ethno-botanical studies and surveys of tradition medicinal plants. It also highlights the developments in hair rejuvenation strategies from 1926 till-date and reviews the potential of herbal drugs as safer and effective alternatives. There are various causes for hair loss and the phenomenon is still not fully understood. The treatments offered include both natural or synthetic products to treat the condition of hair loss (alopecia), nonetheless natural products are continuously gaining popularity mainly due to their fewer side effects and better formulation strategies for natural product extracts. Plants have been widely used for hair growth promotion since ancient times as reported in Ayurveda, Chinese and Unani systems of medicine. This review covers information about different herbs and herbal formulation that are believed to be able to reduce the rate of hair loss and at the same time stimulate new hair growth. A focus is placed on their mechanism of action and the review also covers various isolated phytoconstituents possessing hair growth promoting effect.
Objectives : This study was performed to evaluate the efficacy of ampule containing herbal extract(Ulmus davidiana, Ginkgo biloba, Perilla ocymoides, Morus alba, Glycyrrhiza uralensis (licorice), and Angelica gigas) on skin wrinkles in adult women with facial wrinkles. Methods : A total of 12 women, 30 to 46 years of age, with wrinkles in the corner of eyes, applied ampule containing herbal extract twice daily for up to 12 weeks. Silicon replicas of right crow's feet area and antecubital fossa were taken before use of test product and at 4, 8 and 12 weeks. The replicas were analyzed by optical profilometry with Skin Visiometer SV600. The wrinkle and roughness parameters, R1, R2, R3, R4 and R5 were calculated and statistically analyzed. In addition, a subjective evaluation of product efficacy was conducted by patient's assessment. Results : The mean values of all the skin roughness parameters were decreased at 4-week, and decreased significantly at 8 and 12-week except R4 at 12-week after test product use. The subjective evaluation of wrinkle by patient's assessment was also improved. However, one patient noted stiffness of face after use of test product. Conclusions : These study suggested that the application of ampule containing herbal extract twice daily for 12 weeks may effectively improve the facial wrinkles without severe side effect.
The human skin is constantly exposed to environmental irritants such as ultraviolet, smoke and chemicals. Free radicals and reactive oxygen species caused by them play critical roles in cellular damage. They not only injure the skin structure but also participate in the immensely complex inflammatory reaction. Anti-wrinkle effects of the Oriental herb extracts(OHE) were evaluated by the determination of anti-oxidation, collagenase inhibition and collagen synthesis in normal human fibroblast. OHE showed antioxidative activity as high as vitamin C, trolox and DL-penicillamine. Also OHE showed promotive effect on collagen synthesis and inhibitory effect on collagenase activity. These results demonstrated that OHE could be useful as an anti-wrinkle cosmetic ingredient.
Background:
Androgenetic alopecia (AGA) is one of the most common chronic problems seen by dermatologists worldwide. It is characterized by progressive hair loss, especially of scalp hair, and has distinctive patterns of loss in women versus men, but in both genders the central scalp is most severely affected. It often begins around puberty and is known to effect self-esteem and the individual's quality of life. In contrast to the high prevalence of AGA, approved therapeutic options are limited. In addition to the scarce pharmacologic treatments, there are numerous nonprescription products claimed to be effective in restoring hair in androgenetic alopecia.
Objectives:
The purpose of this paper is to review published medical and non-medical treatments for male and female AGA using the American College of Physicians evidence assessment methods. MEDLINE, EMBASE and Cochrane Library were searched for systematic reviews, randomized controlled trials, open studies, case reports and relevant studies of the treatment of male and female AGA. The relevant articles were classified according to grade and level of evidence.
Results:
The medical treatments with the best level of evidence classification for efficacy and safety for male AGA are oral finasteride and topical minoxidil solution. For female AGA, topical minoxidil solution appears to be the most effective and safe treatment. The medical treatments corresponding to the next level of evidence quality are some commonly used therapeutic non-FDA-approved options including oral and topical anti-hormonal treatments. Surgical treatment of follicular unit hair transplantation is an option in cases that have failed medical treatment although there is high variation in outcomes.
Limitations:
Some articles, especially those concerning traditional herbs claimed to promote hair regrowth, were published in non-English, local journals.
Conclusions:
An assessment of the evidence quality of current publications indicates that oral finasteride (for men only) and topical minoxidil (for men and women) are the best treatments of AGA.
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