Quite a few women have asked me recently what they can do to halt and reverse the hair loss that can accompany PCOS. Not that any of the symptoms of PCOS are particularly pleasant, but the loss of head hair seems to be one of the most upsetting for many women.
WHAT CAUSES HAIR LOSS IN PCOS?
There are several hormones which comprise what we collectively call androgens: testosterone, androsteinedione, and the very potent form dihydrotestosterone (DHT) all of which are made in men’s bodies in large amounts, and also in women’s bodies but normally in quite small amounts.
In those who are genetically susceptible, when testosterone comes in contact with enzymes residing in the hair cell, it can be converted into DHT, the more potent androgen, which then binds with receptors deep within the hair follicle.
Over time, an excess build-up of this very potent form of testosterone in the follicle causes it to start shrinking, which then alters the natural resting and growth phases of the hair, resulting in some of the follicles dying off and some becoming incapable of growing or maintaining a healthy level of hair growth.
So basically, DHT is the ‘root’ of all evil when it comes to hair loss for the majority of women with PCOS. (Sorry I truly couldn’t help myself).
WHAT CAN YOU DO TO REDUCE DHT LEVELS?
As hair growth is a slow process, you will need to allow for at least 3 and maybe 6 months for any significant difference, however there are plenty of things you can do:
SAW PALMETTO: This medicinal herb (serenoa repens) has been shown to have antiandrogenic effects (Testosterone lowering). It acts in a similar way to the male pattern hair loss drug Propecia by blocking the enzyme 5-alpha reductase, which when it interacts with testosterone in the body turns it into the far more potent form, DHT. It also blocks the receptor sites on your cell membranes that allow the absorption of DHT.
SPEARMINT: You can also add things like spearmint tea into your diet, it has been shown to lower testosterone levels when taken regularly.
AVOCADO: Blocks the conversion of testosterone to DHT.
LIQUORICE & WHITE PAEONY: These herbs which are also in a chinese formula together called TJ-68 have also been shown in clinical studies to lower testosterone.
STINGING NETTLE, GOTU KOLA & SIBERIAN GINSENG all act to block the formation of DHT as I think does Pygeum an african prune.
GREEN TEA EXTRACT contains a very potent antioxidant polyphenol called epigallocatechin gallate (EGCG) which inhibits 5-alpha reductase, blocking the formation of DHT. In a study on rodents, a third of those who had green tea extract added to their drinking water had significant hair regrowth.
NUTRITIONAL SUPPORT: Magnesium, Zinc and B6 are all very good for your hair, skin and nails and also DHT blockers. In additionally a good quality multivitamin is a good idea for everybody. The amino acids l-lysine and l-arginine also help to combat hair loss.
KETOCONAZOLE: There is an antifungal/antidandruff shampoo called Nizoral which contains ketoconazole, which can reduce DHT levels when used as a shampoo or in tablets, can actually reduce the amount of androgens produced. You can get a 1% shampoo over the counter at a pharmacy or a 2% one on prescription.
You could also try a regenerative hair oil treatment including oils such as:
- Emu Oil as a Base (as it is a DHT blocker) and any of the following:
- Sunflower (supplies more Vitamin E than any other oil) (Its strengthening and protective agents help to further nourish and condition dry or damaged hair)
- Olive (beneficial for dry or damaged hair),
- Basil (Useful for split ends. Stimulates scalp circulation, resulting in increased hair growth)
- Bay (stimulates scalp and helps hair health, great old fashioned hair tonic for thinning hair)
- Cayenne (increases circulation and stimulates growth)
- Cedarwood (promotes hair growth)
- Cedar & Chammomile (great tonic for fair hair)
- Citrus Oils (all cleanse oil and increase shine)
- Cypress (Shine and condition. Also an uplifting scent)
- Eucalyptus (Stimulating and cleansing)
- Grapefruit (stimulates scalp)
- Juniper (great for toning an oily scalp)
- Lavender (stimulates hair growth, has a lovely fragrance and is a good cleanser)
- Lemon (treat underactive glands, promotes hair growth)
- Lemongrass (Great for adding shine)
- Patchouli (Deep cleansing)
- Peppermint (promotes circulation, is stimulating and cleansing and removes shampoo buildup)
- Rose (Shine, scent, youthfulness)
- Rosemary (stimulates hair growth, increases volume, good for getting rid of dandruff)
- Sage (stimulates hair growth)
- Tea Tree (Eradicating Lice, Dandruff & Fungus. Stimulates Scalp)
- Thyme (stimulates hair growth by deep cleansing hardened sebum)
- Ylang-Ylang (Good for split ends, stimulates scalp increasing hair growth, soothes skin, balances sebum production)
Add 3 drops of each oil (choose the ones you think will help you the most but best not to use more than 7 at a time) to a base of emu oil and/or sunflower oil and/or olive oil, making sure you keep the essential oils at less than 10% – I would probably go for 2.5% – 5%. There are roughly 20 drops to one millilitre, and there are 5ml in a teaspoon. If you use 36 drops or roughly 2 ml, you would need between and 25 and 100 ml depending upon how strong you wanted to make it. I definitely recommend starting with the lower concentration until you see how sensitive your scalp is.
You can also add essential oils to your existing shampoo or conditioner. I add 10 drops of tea tree oil to my shampoo and rinse my hair with vinegar instead of using conditioner. (I use brown, but apple cider vinegar, live with the ‘mother’ such as Braggs is best). This alters the pH of your hair and scalp and prevents yeasts and fungal infections from taking up residence. It also makes your hair REALLY silky smooth. I have long, thick, curly hair (currently down to my tailbone) and find that rinsing with vinegar makes it much easier to brush and detangle and reduces the amount of hair you shed each time you wash. I have found it to be better than conditioner, even the expensive salon brands.
Prager N, Bickett K et al. A randomized, double-blind, placebo-controlled trial to determine the effectiveness of botanically derived inhibitors of 5-alpha-reductase in the treatment of androgenic alopecia. J Altern Complement Med. 2002 Apr;8(2):143-52.
Rushton DH. Nutritional factors and hair loss. Clin Exp Dermatol. 2002 Jul;27(5):396-404.
Liao S, Hiipakka RA. Selective inhibition of steroid 5 alpha reductase isozymes by tea epicatechin-3-gallate and epiallocatechin-3-gallate. Biochem Biophys Res Commun 1995 Sep 25;214(3):833-8.
Esfandiari A, Kelley P. The effects of tea polyphenolic compounds on hair loss among rodents. J Natl Med Assoc 2005 Jun;97(6):816-8.
Life Extension eds., Disease Prevention and Treatment, 4th ed. (Hollywood, Florida: Life Extension Media, 2003), Balding, online: