Saw Palmetto for Hair Loss: Evron 2020 Review
This is a plain-language summary of the original published research. We do not add conclusions or opinions of our own. This is not medical advice — consult a certified healthcare practitioner before making any decision.
Original research published in Skin Appendage Disorders, 2020
Natural Hair Supplement: Friend or Foe? Saw Palmetto, a Systematic Review in Alopecia
Study conclusion
Every study reviewed reported positive results for saw palmetto supplements on hair loss, including improvements in hair quality, hair count, and hair density. However, the quality of the evidence was low overall: the studies were small, used different products and doses, and none compared saw palmetto directly against proven treatments like minoxidil or finasteride. The positive results are consistent but should be interpreted cautiously.
Strength of evidence
Based on a systematic review of 5 RCTs and 2 cohort studies. Score is low because no meta-analysis was performed, study quality varied considerably, sample sizes were small, and there is no comparison against standard treatments. All studies reported positive results, which raises some concern about publication bias.
Who it applies to
Who was studied
Patients with androgenetic alopecia and some with telogen effluvium. Studies included both men and women. Saw palmetto doses ranged from 100 to 320mg in oral supplements. Some studies used topical formulations.
Who was NOT studied
People with other types of hair loss. No study compared saw palmetto directly against minoxidil, finasteride, or dutasteride. Long-term outcomes beyond 6 months were not well studied.
What to look for when shopping
Supplements containing saw palmetto extract were taken orally (100 to 320mg daily) or applied topically. Outcomes measured included overall hair quality assessment, total hair count, hair density, and stabilisation of hair loss progression.
What research cannot help you decide
Whether saw palmetto is as effective as FDA-approved treatments. Whether the improvements seen represent a true pharmacological effect or placebo response. The optimal dose or formulation. Whether results persist with long-term use.
Key findings
- All 7 studies reported positive results for saw palmetto on hair loss outcomes.
- Across the studies, 60% improvement in overall hair quality was reported.
- Total hair count improved by 27% across studies.
- Hair density increased in 83.3% of patients in the studies that measured it.
- Disease progression was stabilised in 52% of patients.
- No serious adverse events were reported in any included study.
- No study compared saw palmetto directly against minoxidil, finasteride, or any other established treatment.
What they did
The researchers searched PubMed, Google Scholar, and the Cochrane database in January 2019 for studies on saw palmetto and hair loss in humans. 7 studies met the criteria: 5 randomised clinical trials and 2 prospective cohort studies. Results were summarised descriptively; no statistical meta-analysis was performed because the studies were too varied in design and outcome measures to combine mathematically.
What they found
| Comparison | Result | Significant? |
|---|---|---|
| Overall hair quality improvement (pooled across studies) | 60% of patients reported improvement | Yes |
| Total hair count improvement (pooled across studies) | 27% improvement in total hair count | Yes |
| Hair density increase | 83.3% of patients showed increased hair density | Yes |
| Disease stabilisation | 52% of patients showed stabilised hair loss | Yes |
| Adverse events | No serious adverse events reported across all 7 studies | No |
Limitations
- 1.No statistical meta-analysis was performed due to heterogeneity across studies.
- 2.All studies reported positive results, raising the possibility of publication bias.
- 3.Sample sizes across individual studies were small.
- 4.Studies varied considerably in product type, dose, duration, and outcome measures.
- 5.No comparison against minoxidil, finasteride, or other established treatments.
- 6.Long-term outcomes beyond 6 months were not well assessed.
Who funded it
Not reported in the study abstract. No conflicts of interest declared.
Used in these articles
Links added as fact-checks and articles citing this study are published.