Abstract
Hair loss is a widespread concern in dermatology clinics, affecting both men’s and women’s quality of life. Hair loss can have many different causes, which are critical to identify in order to provide appropriate treatment. Hair loss can happen due to many variables, such as genetic factors or predisposition, vitamin and mineral deficiencies, skin problems, hair growth disorders, poor diet, hormonal problems, certain internal diseases, drug use, stress and depression, cosmetic factors, childbirth, and the chemotherapy process. Treatment for hair loss varies depending on the type of alopecia, deficiency, or excess of structures such as vitamins and minerals, and also on hair and skin structure.
The Mediterranean diet is characterized by low amounts of saturated fat, animal protein, and high amounts of unsaturated fat, fiber, polyphenols, and antioxidants. The main nutrients found in the Mediterranean Diet are rich in antioxidant, anti-inflammatory components. It also has an important place in hair loss treatment, since recently treatment strategies have included polyphenols and unsaturated oils more and more frequently. The goal of this work was to review published articles examining alopecia and its types, the many micronutrients that affect alopecia, and the role of the Mediterranean diet in alopecia. The literature shows that little is known about hair loss, nutritional factors, and diet, and that the data collected are conflicting. Given these differences, research into the function of diet and nutrition in the treatment of baldness is a dynamic and growing topic.
References
[2] Almohanna HM, Ahmed AA, Tsatalis JP, Tosti A. The role of vitamins and minerals in hair loss: a review. Dermatol Ther (Heidelb) 2019;9:51-70. https://doi.org/10.1007/s13555-018-0278-6
[3] Lin RL, Garibyan L, Kimball AB, Drake LA. Systemic causes of hair loss. Ann Med 2016;48:393-402. https://doi.org/10.1080 /07853890.2016.1180426
[4] Pham CT, Romero K, Almohanna HM, Griggs J, Ahmed A, Tosti A. The role of diet as an adjuvant treatment in scarring and nonscarring alopecia. Ski Appendage Disord 2020;6:88-96. https://doi.org/10.1159/000504786
[5] Cardoso CO, Tolentino S, Gratieri T, Cunha-Filho M, Lopez RFV, Gelfuso GM. Topical treatment for scarring and non-scarring alopecia: An overview of the current evidence. Clin Cosmet Investig Dermatol 2021;14:485-99. https://doi.org/10.2147/CCID.S284435
[6] Rambwawasvika H, Dzomba P, Gwatidzo L. Alopecia types, current and future treatment. J Dermat Cosmetol 2021;5:93-99. https://doi.org/10.15406/jdc.2021.05.00190
[7] Cotsarelis G, Millar SE. Towards a molecular understanding of hair loss and its treatment. Trends Mol Med 2001;7:293-301. https://doi.org/10.1016/S1471-4914(01)02027-5
[8] Martinez-Jacobo L, Villarreal-Villarreal CD, Ortiz-López R, Ocampo-Candiani J, Rojas-Martínez A. Genetic and molecular aspects of androgenetic alopecia. Indian J Dermatol Venereol Leprol 2018;84:263-8. https://doi.org/10.4103/ijdvl. IJDVL_262_17
[9] Fanti PA, Baraldi C, Misciali C, Piraccini BM. Cicatricial alopecia. G Ital Dermatologia Venereol 2018;153:230-42. https://doi.org/10.23736/S0392-0488.18.05889-3
[10] Karakuzu A. Primary cicatricial alopecia. Turkderm 2014;48:56-9. https://doi.org/10.4274/turkderm.48.s13
[11] Civaş E, Aykan A, Aksoy B, Eski M. Surgical correction of primary cicatricial alopecia: Experience with nine patients. TURKDERM 2018;52:85-90. https://doi.org/10.4274/turkderm.20270
[12] Filbrandt R, Rufaut N, Jones L, Sinclair R. Primary cicatricial alopecia: Diagnosis and treatment. Cmaj 2013;185:1579-85. https://doi.org/10.1503/cmaj.111570
[13] Villablanca S, Fischer C, García-García SC, Mascaró-Galy JM, Ferrando J. Primary Scarring Alopecia: Clinical-Pathological Review of 72 Cases and Review of the Literature. Skin Appendage Disord 2017;3:132-43. https://doi.org/10.1159/000467395
[14] Finner AM, Otberg N, Shapiro J. Secondary cicatricial and other permanent alopecias. Dermatol Ther 2008;21:279-94. https://doi.org/10.1111/J.1529-8019.2008.00210.X
[15] Olsen EA, Bergfeld WF, Cotsarelis G, Price VH, Shapiro J, Sinclair R, Solomon A, Sperling L, Stenn K, Whiting DA, Bernardo O, Bettencourt M, Bolduc C, Callendar V, Elston D, Hickman J, Ioffreda M, King L, Linzon C, McMichael A, Miller J, Mulinari F, Trancik R. Summary of North American Hair Research Society (NAHRS)-sponsored Workshop on Cicatricial Alopecia, Duke University Medical Center, February 10 and 11, 2001. J Am Acad Dermatol 2003;48:103-10. https://doi.org/10.1067/MJD.2003.68
[16] Kanti V, Röwert-Huber J, Vogt A, Blume-Peytavi U. Cicatricial alopecia. JDDG 2018;16:435-61. https://doi.org/10.1111/DDG.13498
[17] Mounsey AL, Reed SW. Diagnosing and treating hair loss. Am Fam Physician. 2009;80:356-62.
[18] Lourith N, Kanlayavattanakul M. Hair loss and herbs for treatment. J Cosmet Dermatol 2013;12:210-22. https://doi.org/10.1111/JOCD.12051
[19] Gentile P, Garcovich S. Advances in regenerative stem cell therapy in androgenic alopecia and hair loss: wnt pathway, growth-factor, and mesenchymal stem cell signaling impact analysis on cell growth and hair follicle development. Cells 2019;8:466. https://doi.org/10.3390/cells8050466
[20] Alessandrini A, Bruni F, Piraccini BM, Starace M. Common causes of hair loss- clinical manifestations, trichoscopy and therapy. J Eur Acad Dermatol Venereol 2021;35:629-40. https://doi.org/10.1111/jdv.17079
[21] Batrinos ML. The endocrinology of baldness. Hormones 2014;13:197-212. https://doi.org/10.1007/BF03401334
[22] Thom E. Stress and the hair growth cycle: Cortisol-induced hair growth disruption. J Drugs Dermatology 2016;15:1001-4.
[23] Chien Yin GO, Siong-See JL, Wang ECE. Telogen Effluvium – a review of the science and current obstacles. J Dermatol Sci 2021;101:156-63. https://doi.org/10.1016/J. JDERMSCI.2021.01.007
[24] Asghar F, Shamim N, Farooque U, Sheikh H, Aqeel R. Telogen Effluvium: A Review of the Literature. Cureus 2020;12:e8320. https://doi.org/10.7759/cureus.8320
[25] Alonso LC, Rosenfield RL. Molecular genetic and endocrine mechanisms of hair growth. Horm Res 2003;60:1-13. https://doi.org/10.1159/000070821
[26] Anzai A, Hsi E, Wang C, Lee EY, Aoki V, Christiano AM. Pathomechanisms of immune-mediated alopecia. Int Immunol 2019;31:439-47. https://doi.org/10.1093/intimm/dxz039
[27] Bertolini M, McElwee K, Gilhar A, Bulfone-Paus S, Paus R. Hair follicle immune privilege and its collapse in alopecia areata. Exp Dermatol 2020;29:703-25. https://doi.org/10.1111/EXD.14155
[28] Rahmani W, Sinha S, Biernaskie J. Immune modulation of hair follicle regeneration. npj Regen Med 2020;5. https://doi.org/10.1038/s41536-020-0095-2
[29] Patel M, Harrison S, Sinclair R. Drugs and Hair Loss. Dermatol Clin 2013;31:67-73. https://doi.org/10.1016/j.det.2012.08.002
[30] Bi MY, Curry JL, Christiano AM, Hordinsky MK, Norris DA, Price VH, Duvic M. The spectrum of hair loss in patients with mycosis fungoides and Sézary syndrome. J Am Acad Dermatol 2011;64:53-63. https://doi.org/10.1016/j.jaad.2009.12.056
[31] Rushton DH. Nutritional factors and hair loss. Clin Exp Dermatol 2002;27:396-404. https://doi.org/10.1046/j.1365-2230.2002.01076.x
[32] Cunningham IJ. Influence of dietary iron on hair and wool growth. https://www.cabdirect.org/cabdirect/abstract/19321401596 (accessed on: April 26, 2022).
[33] Sullivan M, Nicholls J. Nutritional dermatosis in the rat. IV. Riboflavin deficiency. J Invest Dermatol 1941;4:181-91. https://doi.org/10.1038/jid.1941.17
[34] Day HG. The effects of zinc deficiency in the mouse. https://www.cabdirect.org/cabdirect/abstract/19421402451 (accessed on: April 26, 2022).
[35] Day HG, McCollum EV. Effects of Acute Dietary Zinc Deficiency in the Rat. Proc Soc Exp Biol Med 1940;45:282-4. https://doi.org/10.3181/00379727-45-11653P
[36] Lohia K, Doshi BR, Manjunathswamy B. Hair loss severity and its impact on quality of life in patients suffering from androgenic alopecia: A one-year cross-sectional study. Clin Dermatology Rev 2022;5:59. https://doi.org/10.4103/CDR.CDR_52_20
[37] Adamowicz R, Załe P, Dukiel A, Nowicka D. Association between androgenetic alopecia and psychosocial disease burden: a cross-sectional survey among polish men. 2022;2022:1845044. https://doi.org/10.1155/2022/1845044
[38] Almohanna HM, Ahmed AA, Tsatalis JP, Tosti A. The role of vitamins and minerals in hair loss: a review. Dermatol Ther (Heidelb) 2019;9:51-70. https://doi.org/10.1007/S13555-018-0278-6
[39] Mason JB. Vitamins, Trace Minerals, and Other Micronutrients. Twenty Fourth edition. Elsevier Inc. 2012. https://doi.org/10.1016/b978-1-4377-1604-7.00558-3
[40] Thompson JM, Mirza MA, Park MK, Qureshi AA, Cho E. The role of micronutrients in alopecia areata: a review. Am J Clin Dermatol 2017;18:663-79. https://doi.org/10.1007/S40257-017-0285-X
[41] Prie BE, Voiculescu VM, Ionescu-Bozdog OB, Petrutescu B, Iosif L, Gaman LE, Clatici VG, Stoian I, Giurcaneanu C. Oxidative stress and alopecia areata. J Med Life 2015;8:43. https://doi.org/10.1016/j.jaad.2009.10.0
[42] Tanumihardjo SA, Russell RM, Stephensen CB, Gannon BM, Craft NE, Haskell MJ, Lietz G, Schulze K, Raiten DJ. Biomarkers of Nutrition for Development (BOND) – Vitamin A Review. J Nutr 2016;146:1816S. https://doi.org/10.3945/JN.115.229708
[43] Duester G. Retinoic acid synthesis and signaling during early organogenesis. Cell 2008;134:921-31. https://doi.org/10.1016/J. CELL.2008.09.002
[44] Stephensen CB. Vitamin A, infection, and immune function. Annu Rev Nutr 2001;21167-92. https://doi.org/10.1146/ANNUREV.NUTR.21.1.167
[45] Yamamoto K, Sadahito K, Yoshikawa M, Nobuyuki O, Mikami O, Yamada M, Nakamura K, Yasuyuki N. Hyena disease (premature physeal closure) in calves due to overdose of vitamins A, D3, E. Vet Hum Toxicol 2003;45:85-7.
[46] Suo L, Sundberg JP, Everts HB. Dietary vitamin A regulates wingless-related MMTV integration site signaling to alter the hair cycle. Exp Biol Med 2015;240:618. https://doi.org/10.1177/1535370214557220
[47] Duncan FJ, Silva KA, Johnson CJ, King BL, Szatkiewicz JP, Kamdar SP, Ong DE, Napoli JL, Wang J, King LE, Whiting DA, McElwee KJ, Sundberg JP, Everts HB. Endogenous retinoids in the pathogenesis of alopecia areata. J Invest Dermatol 2013;133:334. https://doi.org/10.1038/JID.2012.344
[48] Everts, H.B. Endogenous retinoids in the hair follicle and sebaceous gland. Biochim Biophys Acta 2012;1821:222-9. https://doi.org/10.1016/j.bbalip.2011.08.017
[49] Cheruvattath R, Orrego M, Gautam M, Byrne T, Alam S, Voltchenok M, Edwin M, Wilkens J, Williams JW, Vargas HE. Published online in Wiley InterScience (www.interscience. wiley.com). LIVER Transplant 2006;121888-91. https://doi.org/10.1002/lt.21007
[50] Saleem F, Soos MP. Biotin Deficiency. J Nutr Educ 2021;13:96. https://doi.org/10.1016/S0022-3182(81)80040-4
[51] Zempleni J, Kuroishi T. Biotin. Adv Nutr 2012;3:213. https://doi.org/10.3945/AN.111.001305
[52] Goldberg LJ, Lenzy Y. Nutrition and hair. Clin Dermatol 2010;28:412-9. https://doi.org/10.1016/J. CLINDERMATOL.2010.03.038
[53] O’Connor K, Goldberg LJ. Nutrition and hair. Clin Dermatol 2021;39:809-18. https://doi.org/10.1016/J. CLINDERMATOL.2021.05.008
[54] Guo EL, Katta R. Diet and hair loss: effects of nutrient deficiency and supplement use. Dermatol Pract Concept 2017;7:1-10. https://doi.org/10.5826/dpc.0701a01
[55] Trüeb RM. Serum Biotin Levels in Women Complaining of Hair Loss. Int J Trichology 2016;8:73-7. https://doi.org/10.4103/0974-7753.188040
[56] Czeizel AE, Dudás I, Vereczkey A, Bánhidy F. Folate deficiency and folic acid supplementation: the prevention of neural-tube defects and congenital heart defects. Nutrients 2013;5:4760. https://doi.org/10.3390/NU5114760
[57] Pawlak R, Parrott SJ, Raj S, Cullum-Dugan D, Lucus D. How prevalent is vitamin B(12) deficiency among vegetarians? Nutr Rev 2013;71:110-7. https://doi.org/10.1111/NURE.12001
[58] Valdés F. Vitamin C. Actas Dermosifiliogr 2006;97:557-68. https://doi.org/10.1016/S0001-7310(06)73466-4
[59] Fleming JD, Martin B, Card DJ, Mellerio JE. Pain, purpura and curly hairs. Clin Exp Dermatol 2013;38:940-2. https://doi.org/10.1111/CED.12118
[60] Chhabra N, Chhabra S. A case oriented approach towards biochemistry. First edition. New Delhi: Jaypee Brothers Medical Publishers 2013.
[61] Gropper S, Smith J. Advanced human nutrition and metabolism, 6th ed. Belmont: Wadsworth, Cengage Learning 2012.
[62] D’Aurizio F, Villalta D, Metus P, Doretto P, Tozzoli R. Is vitamin D a player or not in the pathophysiology of autoimmune thyroid diseases? Autoimmun Rev 2015;14:363-9. https://doi.org/10.1016/J.AUTREV.2014.10.008
[63] Antico A, Tampoia M, Tozzoli R, Bizzaro N. Can supplementation with vitamin D reduce the risk or modify the course of autoimmune diseases? A systematic review of the literature. Autoimmun Rev 2012;12:127-36. https://doi.org/10.1016/J.AUTREV.2012.07.007
[64] Parva NR, Tadepalli S, Singh P, Qian A, Joshi R, Kandala H, Nookala VK, Cheriyath P. Prevalence of vitamin D deficiency and associated risk factors in the US population (2011-2012). Cureus 2018;10:e2741. https://doi.org/10.7759/CUREUS.2741
[65] Vupperla D, Lunge S, Elaprolu P. Vitamin D-dependent rickets type ii with alopecia: a rare case report. Indian J Dermatol 2018;63:176-9. https://doi.org/ 10.4103/IJD.IJD_434_17
[66] Chen CH, Sakai Y, Demay MB. Targeting expression of the human vitamin D receptor to the keratinocytes of vitamin D receptor null mice prevents alopecia. Endocrinology 2001;142:5386-9. https://doi.org/10.1210/ENDO.142.12.8650
[67] Forghani N, Lum C, Krishnan S, Wang J, Wilson DM, Blackett PR, Malloy PJ, Feldman D. Two new unrelated cases of hereditary 1,25-dihydroxyvitamin D-resistant rickets with alopecia resulting from the same novel nonsense mutation in the vitamin D receptor gene. J Pediatr Endocrinol Metab 2010;23:843-50. https://doi.org/10.1515/JPEM.2010.136
[68] Gerkowicz A, Chyl-Surdacka K, Krasowska D, Chodorowska G. The role of vitamin D in non-scarring alopecia. Int J Mol Sci 2017;18:2653. https://doi.org/10.3390/IJMS18122653
[69] Daroach M, Narang T, Saikia UN, Sachdeva N, Sendhil Kumaran M. Correlation of vitamin D and vitamin D receptor expression in patients with alopecia areata: a clinical paradigm. Int J Dermatol 2018;57:217-22. https://doi.org/10.1111/IJD.13851
[70] Georgieff MK. Iron deficiency in pregnancy. Am J Obstet Gynecol 2020;223:516-24. https://doi.org/10.1016/J.AJOG.2020.03.006
[71] Kantor J, Kessler LJ, Brooks DG, Cotsarelis G. Decreased serum ferritin is associated with alopecia in women. J Invest Dermatol 2003;121:985-8. https://doi.org/10.1046/J.1523-1747.2003.12540.X
[72] Trost LB, Bergfeld WF, Calogeras E. The diagnosis and treatment of iron deficiency and its potential relationship to hair loss. J Am Acad Dermatol 2006;54:824-44. https://doi.org/10.1016/J.JAAD.2005.11.1104
[73] Shrivastava S. Diffuse hair loss in an adult female: approach to diagnosis and management. Indian J Dermatol Venereol Leprol 2009;75:20-8. https://doi.org/10.4103/0378-6323.45215
[74] Du X, She E, Gelbart T, Truksa J, Lee P, Xia Y, Khovananth K, Mudd S, Mann N, Moresco EMY, Beutler E, Beutler B. The serine protease TMPRSS6 is required to sense iron deficiency. Science 2008;320:1088-92. https://doi.org/10.1126/SCIENCE.1157121
[75] Ju W, Ji M, Li X, Li Z, Wu G, Fu X, Yang X, Gao X. Relationship between higher serum selenium level and adverse blood lipid profile. Clin Nutr 2018;37:1512-7. https://doi.org/10.1016/J. CLNU.2017.08.025
[76] Bates JM, Spate VL, Steven Morris J, St Germain DL, Galton VA. Effects of Selenium Deficiency on Tissue Selenium Content, Deiodinase Activity, and Thyroid Hormone Economy in the Rat during Development. Endocrinology 2000;141:2490-500. https://doi.org/10.1210/ENDO.141.7.7571
[77] Sengupta A, Lichti UF, Carlson BA, Ryscavage AO, Gladyshev VN, Yuspa SH, Hatfield DL. Selenoproteins Are Essential for Proper Keratinocyte Function and Skin Development. PLoS One 2010;5:e12249. https://doi.org/10.1371/JOURNAL. PONE.0012249
[78] MacFarquhar JK, Broussard DL, Melstrom P, Hutchinson R, Wolkin A, Martin C, Burk RF, Dunn JR, Green AL, Hammond R, Schaffner W, Jones TF. Acute selenium toxicity associated with a dietary supplement. Arch Intern Med 2010;170:256. https://doi.org/10.1001/ARCHINTERNMED.2009.495
[79] Masumoto K, Nagata K, Higashi M, Nakatsuji T, Uesugi T, Takahashi Y, Nishimoto Y, Kitajima J, Hikino S, Hara T, Nakashima K, Nakashima K, Oishi R, Taguchi T. Clinical features of selenium deficiency in infants receiving long-term nutritional support. Nutrition 2007;23:782-7. https://doi.org/10.1016/J.NUT.2007.08.001
[80] Petru E, Petru C, Benedicic C, Sieja K, Talerczyk M. Re: “Selenium as an element in the treatment of ovarian cancer in women receiving chemotherapy.” Gynecol Oncol 2005;96:559-60. https://doi.org/10.1016/J.YGYNO.2004.09.060
[81] Uwitonze AM, Ojeh N, Murererehe J, Atfi A, Razzaque MS. Zinc Adequacy Is Essential for the Maintenance of Optimal Oral Health. Nutrients 2020;12:949. https://doi.org/10.3390/NU12040949
[82] Ogawa Y, Kawamura T, Shimada S. Zinc and skin biology. Arch Biochem Biophys 2016;611113-9. https://doi.org/10.1016/J. ABB.2016.06.003
[83] Finner AM. Nutrition and Hair. Deficiencies and Supplements. Dermatol Clin 2013;31:167-72. https://doi.org/10.1016/j. det.2012.08.015
[84] Abdel Fattah NSA, Atef MM, Al-Qaradaghi SMQ. Evaluation of serum zinc level in patients with newly diagnosed and resistant alopecia areata. Int J Dermatol 2016;55:24-9. https://doi.org/10.1111/IJD.12769
[85] Dubey P, Thakur V, Chattopadhyay M. Role of minerals and trace elements in diabetes and insulin resistance. Nutrients 2020;12:1-17. https://doi.org/10.3390/NU12061864
[86] Robberecht H, Verlaet AAJ, Breynaert A, de Bruyne T, Hermans N. Magnesium, Iron, Zinc, Copper and Selenium Status in Attention-Deficit/Hyperactivity Disorder (ADHD). Molecules 2020;25:4440. https://doi.org/10.3390/MOLECULES25194440
[87] Dodig-Curković K, Dovhanj J, Curković M, Dodig-Radić J, Degmecić D. Uloga cinka u lijecenju hiperaktivnog poremećaja u djece. The role of zinc in the treatment of hyperactivity disorder in children. Acta Med Croatica 2009;63:307-13.
[88] Kil MS, Kim CW, Kim SS. Analysis of serum zinc and copper concentrations in hair loss. Ann Dermatol 2013;25:405-9. https://doi.org/10.5021/AD.2013.25.4.405
[89] Davis C, Bryan J, Hodgson J, Murphy K. Definition of the Mediterranean Diet; A Literature Review. Nutrients 2015:7:9139-53. https://doi.org/10.3390/nu7115459
[90] Ventriglio A, Sancassiani F, Contu MP, Latorre M, Di Salvatore M, Fornaro M, Bhugra D. Mediterranean Diet and its Benefits on Health and Mental Health: A Literature Review. Clin Pract Epidemiol Ment Health 2020;16:156-64. https://doi.org/10.2174/1745017902016010156
[91] Cannataro R, Fazio A, La Torre C, Cristina Caroleo M, Cione E, Albertini C. Antioxidants Polyphenols in the Mediterranean Diet: From Dietary Sources to microRNA Modulation. Antioxidants 2021;10:328. https://doi.org/10.3390/antiox10020328
[92] Amleh A, Sharif J, Jeronimo C, López-Camarillo C, Á C-R, Carlos-Reyes Á, Sullivan López-González J, Meneses-Flores M, Gallardo-Rincón D, Ruíz-García E, Marchat LA, Astudillo-de la Vega H, Hernández de la Cruz ON. Dietary Compounds as Epigenetic Modulating Agents in Cancer. Front Genet 2019;10:79. https://doi.org/10.3389/fgene.2019.00079
[93] Ganesan K, Xu B. A critical review on polyphenols and health benefits of black soybeans. Nutrients 2017;9:455. https://doi.org/10.3390/nu9050455
[94] Bonaccio M, Pounis G, Cerletti C, Donati MB, Iacoviello L, de Gaetano G. Mediterranean diet, dietary polyphenols and low grade inflammation: results from the MOLI-SANI study. Br J Clin Pharmacol 2017;83:107-13. https://doi.org/10.1111/BCP.12924
[95] Bassino E, Gasparri F, Munaron L. Protective role of nutritional plants containing flavonoids in hair follicle disruption: a review. Int J Mol Sci 2020;21:523. https://doi.org/10.3390/IJMS21020523
[96] Bassino E, Gasparri F, Munaron L. Protective role of nutritional plants containing flavonoids in hair follicle disruption: a review. Int J Mol Sci 2020;21:523. https://doi.org/10.3390/IJMS21020523
[97] Fortes C, Mastroeni S, Mannooranparampil T, Abeni D, Panebianco A. Mediterranean diet: fresh herbs and fresh vegetables decrease the risk of Androgenetic Alopecia in males. Arch Dermatol Res 2018;31071-6. https://doi.org/10.1007/s00403-017-1799-z
[98] Murata K, Noguchi K, Kondo M, Onishi M, Watanabe N, Okamura K, Matsuda H. Promotion of hair growth by Rosmarinus officinalis leaf extract. Phytother Res 2013;27:212-7. https://doi.org/10.1002/PTR.4712
[99] Malvezzi De Macedo L, Mendes Dos Santos É, Militão L, Tundisi LL, Ataide JA, Barbosa Souto E, Gava Mazzola P. Plants Rosemary (Rosmarinus officinalis L., syn Salvia rosmarinus Spenn.) and Its Topical Applications: A Review. Plants (Basel) 2020;9:651. https://doi.org/10.3390/plants9050651
[100] Wallace TC. Health effects of coconut oil-a narrative review of current evidence. J Am Coll Nutr 2019;38:97-107. https://doi.or g/10.1080/07315724.2018.1497562
[101] Hamel AF, Menard MT, Novak MA. Fatty Acid supplements improve hair coat condition in rhesus macaques. J Med Primatol 2017;46:248-51. https://doi.org/10.1111/jmp.12271
[102] Kong J, Qiang W, Jiang J, Hu X, Chen Y, Guo YX, Liu H, Sun S, Gao H, Zhang Y, Gao Y, Liu X, Liu X, Li H. Safflower oil body nanoparticles deliver hFGF10 to hair follicles and reduce microinflammation to accelerate hair regeneration in androgenetic alopecia. Int J Pharm 2022;616121537. https://doi.org/10.1016/J.IJPHARM.2022.121537
[103] Lourith N, Kanlayavattanakul M, Chaikul P. Para rubber seed oil: The safe and efficient bio-material for hair loss treatment. J Cosmet Dermatol 2021;20:2160-7. https://doi.org/10.1111/JOCD.13843
[104] Tenore GC, Caruso D, Buonomo G, D’Avino M, Santamaria R, Irace C, Piccolo M, Maisto M, Novellino E. Annurca apple nutraceutical formulation enhances keratin expression in a human model of skin and promotes hair growth and tropism in a randomized clinical trial. J Med Food 2018;21:90-103. https://doi.org/10.1089/jmf.2017.0016
[105] Zhang Y, Ni C, Huang Y, Tang Y, Yang K, Shi X, Zhang Y, Li Z, Wang J’, Zhu Y, Li H, Ma Y, Lin J, Wang J, Liu Q, Wu W. Hair growth-promoting effect of resveratrol in mice, human hair follicles and dermal papilla cells. Clin Cosmet Investig Dermatol 2021;14:1805-14. https://doi.org/ 10.2147/CCID. S335963
[106] Katoulis AC, Liakou AI, Koumaki D, Vakirlis E, Tsantes AG, Mortaki D, Bozi E, Ioannides D. A randomized, single-blinded, vehicle-controlled study of a topical active blend in the treatment of androgenetic alopecia. Dermatol Ther 2020;33:E13734. https://doi.org/10.1111/DTH.13734
[107] Iltaf J, Noreen S, Rehman MFU, Ghumman SA, Batool F, Mehdi M, Hasan S, Ijaz B, Akram MS, Butt H. Ficus benghalensis as Potential Inhibitor of 5α-Reductase for Hair Growth Promotion: In Vitro, In Silico, and In Vivo Evaluation. Front Pharmacol 2021;12:774583. https://doi.org10.3389/fphar.2021.774583