What Is Saw Palmetto?
Saw palmetto is a small palm (Latin Serenoa repens) native to the southeastern United States. The oil or extracts used in supplements, shampoos, or topical treatments come from the berries. Its active components include fatty acids and plant sterols such as β‑sitosterol, which are believed to have biological activity that may interfere with the hormone pathways involved in hair loss.
How Hair Loss Works (Briefly)
One of the most common causes of hair loss—particularly androgenetic alopecia, also known as male or female pattern baldness—involves the hormone dihydrotestosterone (DHT). In genetically susceptible individuals, DHT causes hair follicles to shrink, transition more quickly to the “resting” phase, and eventually stop producing hair altogether. This process is driven by an enzyme called 5‑alpha‑reductase, which converts testosterone into DHT.
What the Evidence Shows for Saw Palmetto Oil
Recent research is increasingly supporting the idea that saw palmetto oil, or its standardized extracts, can positively affect hair loss. In a 16‑week randomized, placebo‑controlled study using a standardized saw palmetto product called VISPO, both oral and topical applications significantly reduced hair fall. Oral saw palmetto reduced hair loss by up to 29%, while the topical version saw a 22% reduction compared to baseline. In addition to reduced hair shedding, participants also experienced a modest increase in hair density and a measurable reduction in serum DHT levels with oral use.
A systematic review of multiple studies concluded that saw palmetto supplements led to improvements in overall hair quality in about 60% of participants. Hair count improved by roughly 27%, with noticeable increases in hair density and stabilization of hair loss progression in over half of users.
Smaller studies have also shown that topical saw palmetto can help slow hair loss or increase hair count, although its effects tend to be milder than pharmaceutical options like finasteride. In comparative studies, saw palmetto demonstrated positive effects—especially in mild to moderate cases—though generally not as potent as prescription medications.
Mechanisms of Action
Saw palmetto oil is believed to help reduce hair loss through several biological mechanisms. First, it inhibits the enzyme 5‑alpha‑reductase, which reduces the conversion of testosterone into DHT. This helps lower DHT levels in the scalp, which in turn protects the hair follicles.
Second, saw palmetto appears to act as an anti‑androgen, potentially interfering with DHT’s ability to bind to follicle receptors and trigger hair miniaturization. Additionally, its anti‑inflammatory properties may help reduce chronic inflammation in the scalp—a condition that can accelerate follicle damage and hair loss over time.
Limitations and What Is Still Unknown
Although results are promising, there are important limitations to consider. Most studies to date have been relatively small and short-term, which means we still lack robust data on long-term effectiveness and safety.
There is also significant variation in the types of saw palmetto used in studies. Differences in extract standardization, dosage, and formulation (oral vs topical) make it difficult to compare results across studies. Furthermore, while saw palmetto may benefit mild to moderate hair loss, it generally produces less dramatic results than pharmaceutical treatments like finasteride or minoxidil.
Saw palmetto appears to have a favorable safety profile, but mild side effects like stomach discomfort have been reported. Additionally, its use during pregnancy or with other medications has not been thoroughly studied and should be approached cautiously.
Practical Recommendations
If you’re considering saw palmetto oil as a natural option for hair loss, it’s best to consult with a healthcare provider first. This is especially important if you’re taking other medications, managing hormonal conditions, or are pregnant or breastfeeding.
Look for products that use standardized extracts, which list the concentration of active components like β‑sitosterol and fatty acids. Whether used topically or orally, it’s important to give the treatment time—most people will need to use it consistently for several weeks or months before seeing results. Setting realistic expectations and monitoring progress can help determine if it’s the right fit for your situation.
Conclusion
Saw palmetto oil is emerging as a compelling natural alternative for reducing hair loss, especially in cases of androgenetic alopecia. Clinical research suggests it can modestly reduce hair fall, increase hair density, and improve hair quality with relatively few side effects. While it may not replace pharmaceutical treatments in more severe cases, it offers a plant-based option for those looking for a gentler approach. As with any supplement or treatment, long-term studies and individualized care will be key to its effective use.
Sources:
- Oral and Topical Administration of a Standardized Saw Palmetto Oil Reduces Hair Fall and Improves the Hair Growth in Androgenetic Alopecia Subjects ‑ A 16‑Week Randomized, Placebo‑Controlled Study, PubMed.
https://pubmed.ncbi.nlm.nih.gov/38021422<?XML:NAMESPACE PREFIX = "[default] http://www.w3.org/2000/svg" NS = "http://www.w3.org/2000/svg" /> - Saw Palmetto: Usefulness and Safety, National Center for Complementary and Integrative Health (NCCIH).
https://www.nccih.nih.gov/health/saw-palmetto - Natural Hair Supplement: Friend or Foe? Saw Palmetto, a Systematic Review in Alopecia, PubMed.
https://pubmed.ncbi.nlm.nih.gov/33313047 - Can Saw Palmetto Stop Hair Loss?, Verywell Health.
https://www.verywellhealth.com/can-saw-palmetto-halt-hair-loss-89919 - Saw Palmetto for Hair Loss: Myth or Miracle?, Healthline.
https://www.healthline.com/health/saw-palmetto-hair-loss
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