Estetologia Medyczna i Kosmetologia

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An occurrence analysis of ingredients declared as active in anti-hair loss products and systematic review of studies on their effectiveness

Magdalena Pyzik, Danuta Plichta, Radoslaw Spiewak

Department of Experimental Dermatology and Cosmetology, Jagiellonian University Medical College, Krakow, Poland

Recommended citation format: Pyzik M, Plichta D, Spiewak R: An occurrence analysis of ingredients declared as active in anti-hair loss products and systematic review of studies on their effectiveness. Estetol Med Kosmetol 2020; 10: 006.en. DOI: https://dx.doi.org/10.14320/EMK.2020.006.en

Abstract

Due to the increasing problem of baldness in modern society, we are increasingly hearing declarations from manufacturers who describe their products as a "remedy" for hair loss. Both from a consumer and purely cognitive point of view, the issue of the scientific basis for the declarations of manufacturers of hair loss preparations about the alleged effectiveness of ingredients that are listed on the labels as "active" is interesting. Aim: The aim of the study was to analyze the occurrence of ingredients defined as "active" in anti-hair loss preparations and to systematically review published studies on their actual effect on hair. Materials and methods: In pharmacies, drugstores, cosmetic wholesalers, beauty salons and on manufacturers' websites, preparations were found whose labels contained a declaration that they act against hair loss, and then a list of declared ingredients was compiled for each product. In the next stage, ingredients were singled out which were advertised by manufacturers as "active", i.e., implying that that would have an effect preventing hair loss or stimulating hair growth. Then, a systematic review of scientific literature indexed in the Pubmed, Scopus, Web of Science, Google Scholar, and Polish Medical Bibliography was conducted using the combination of key words "hair AND X", where "X" were the names of "active" substances in the INCI nomenclature along with common and chemical synonyms. The identified articles were analyzed in terms of the content of data on the possible effect of a given ingredient on hair loss or growth. Results: During the study period (October 2018 - August 2019), 92 anti-hair loss products were identified, most common were shampoos (33.7% of the analyzed preparations), followed by "ampoules" (18.5%), lotions (12.0%), serums (8.7%) and conditioners (7.6%). 448 unique substances were identified in the analyzed products, of which 207 (46.1%) were indicated as "active substances" by at least one manufacturer. The most frequently mentioned "active ingredients" were glycerin (73.9% of the analysed preparations), Achillea millefolium extract (60.9%), PEG-40 hydrogenated castor oil (41.3%), biotin (40.2%), niacinamide (30.4%), lactic acid (23.9%), panthenol (23.9%), arginine (20.7%), menthol (19.6%) and tocopheryl acetate (17.4%). Out of 207 such "active ingredients" in hair products, only for eight (3.9%) the results of published scientific studies indicated their beneficial effect on hair. The ingredients with activity confirmed in human, mouse or in vitro studies were zinc pyrithione, caffeine, oleanolic acid, ginseng root extract, placental proteins, Polygonum multiflorum extract and Thuja orientalis leaf extract. Only 35 (38.0%) of the products analyzed contained at least one ingredient with confirmed beneficial effects on hair, including 8 (8.7%) containing two such ingredients. Most of the anti-hair loss products (57 products; 62.0%) did not contain any such ingredient. Furthermore, available scientific studies indicate that niacinamide (present in 27 products) and ginger extract (Zingiber officinale, in 5 products) presented as "beneficial for hair" may actually inhibit hair growth, which is the opposite effect to that declared. Conclusions: The vast majority of ingredients in hair loss products indicated by manufacturers as "active" have no scientific confirmation of their effectiveness. Some ingredients declared as "active" in hair loss products (niacinamide, Panax ginseng root extract) may in fact have an adverse effect on hair in the light of scientific evidence.

Keywords: hair loss, alopecia, effluvium, active ingredients, cosmetic products

| Polish version |

Hair has a significant cultural, social and even religious significance. In addition to its protective and thermoregulatory functions, it also plays an aesthetic role and is an important element of the image as one of the key factors determining attractiveness and beauty, and to a large extent also health and well-being. The problem of baldness affects an increasing number of people around the world. In the USA, the proportion of men with moderate to extensive hair loss increases with age, ranging from 16% at 18 - 29 years of age to 53% among those aged 40 - 49 years [Rhodes et al. 1998]. In Australia, hair loss of varying severity occurred in 12.3% of women aged 30 years and 57.4% of women aged 80 years or older [Desmond et al. 2005]. . Hair loss is associated with great discomfort and is not only an aesthetic problem but also a psychological one. Trüeb indicates that baldness is most often a sign of disease or a disorder of internal homeostasis [Trüeb 2013]. Hair problems may be the first symptom of internal diseases (e.g. hypothyroidism, hypoparathyroidism, Addison's disease, acrodynia), indicate genetic or metabolic abnormalities or poisoning (e.g. thallium, colchicine) or drugs (cytostatics) [Rushton 2002; Lin et al. 2016; Phillips el al. 2017].

Customers of pharmacies, drugstores or websites struggling with the problem of hair loss are faced with a wide range of products that are advertised by manufacturers as "golden remedies" for their problem. The most popular ingredients of cosmetics, apart from vitamins (vitamins A, B, C, D) and micro- and macroelements (e.g. zinc, phosphorus, magnesium, calcium, carbon), are plant extracts (e.g. saw palmetto extract, ginseng root extract, knotweed root extract, etc.). The issue of whether the "active ingredients" declared by manufacturers in specialist preparations (shampoos, lotions, serums, ampoules, etc.) against hair loss are able to penetrate the skin barrier and act at the site of the disorder requires separate consideration [Qi and Garza 2014]. Another important issue is whether the "active ingredients" declared by manufacturers have proven their effectiveness in scientific literature and whether consumers who trust the effectiveness of the product they buy can count on a successful solution to the problem by purchasing pharmacy or drugstore products that prevent hair loss on the scalp.

Aim

The aim of the study was to analyze the occurrence of ingredients defined as "active" in anti-hair loss preparations and to systematically review published studies on their actual effect on hair.

Material and methods

This analysis was conducted between October 2018 and August 2019. The products included in the analysis were obtained from pharmacies (Dr. Max, Danfarm, DOZ, Hygieia, Ziko), drugstores (Hebe, Pigment, Rossmann), cosmetic wholesalers (hairstore.pl), beauty salons (Centrum Zdrowego Włosa Trycholog Kraków, Instytut Trychologii EsteticDerm) and from the websites of manufacturers of individual preparations. In total, data was collected for 92 products available on the Polish market, including: 31 shampoos, 17 ampoules for mesotherapy, 11 lotions, 8 serums, 7 conditioners, 5 fluids, 4 masks, 3 tonics, 2 conditioners, 1 balm, 1 extract, 1 mist, 1 milk. Polish products predominated (55), followed by Italian (13), French and Spanish (8 each), Ukrainian (3) and 1 each from Slovenia, Estonia, Russia, Korea and Germany. Data documentation for the analysis consisted of taking photos of labels with the name, type and purpose of the product and its composition according to International Nomenclature of Cosmetics Ingredients (INCI). In relation to products found on the manufacturer's websites, only cosmetics for which a full list of ingredients (INCI) and a photo of the product were available were included in the analysis. Products that contained the terms "against hair loss", "hair loss treatment", "inhibits hair loss", "hair-loss prevention" and "for weakened and falling hair" on the label were included in the analysis. The remaining terms and their frequency are collated in Table 1. The next stage was a tabular compilation of products with the name of the cosmetic, the manufacturer's name and type of preparation, the INCI composition declared by the manufacturer and the volume. Then, the ingredients declared by the manufacturer were singled out, which according to the manufacturer's declarations, possessed the activity to prevent hair loss or stimulate hair growth ("active substances").

Table 1. The wording on product packaging that was the criterion for inclusion in the analysis

The next stage of the work was a systematic review of scientific of publications presenting the results of studies on the effectiveness of ingredients that, according to the manufacturers' declarations, were to prevent hair loss ("active substances"). For this purpose, Pubmed, Scopus, Web od Science, Google Scholar, Polish Medical Bibliography were searched using the keyword combination "hair AND X", where "X" were the names of "active" substances in the INCI nomenclature along with common and chemical synonyms. The identified articles were analyzed in terms of the content of data on the possible effect of a given ingredient on hair loss or growth. A manual search of the literature cited in the found scientific publications was also performed. This review included original publications describing preclinical and clinical efficacy studies of substances (possible strength of evidence from very low to high), experimental studies on animals (by definition very low strength of evidence), as well as experimental studies in vitro (cultures of keratinocytes, fibroblasts or isolated hair units on artificial medium; by definition very low strength of evidence). The credibility of the conclusions from the studies was assessed using the GRADE scale (Polish-language compilation in [Spiewak and Plichta 2014]). Full documentation of the collected data and conducted analyses, including photos of labels, composition tables, reports of statistical analyses, was deposited in the archives of the Department of Experimental Dermatology and Cosmetology, Jagiellonian University Medical College.

Results

92 cosmetic products against hair loss offered on the Polish market during the preparation of this paper were identified. Of these, there were 55 Polish products, 13 Italian, 8 French and Spanish, 3 Ukrainian and 1 each Estonian, Slovenian, Russian, German and Korean. The most common forms of the analysed cosmetics offered were shampoos (33.7%), followed by ampoules for mesotherapy (18.5%), lotions (12.0%), serums (8.7%) and conditioners (7.6%). The frequency of product occurrence in the form of liquids (5.4%), masks (4.4%) tonics (3.3%), conditioners (2.2%), balms (1.1%), extracts (1.1%), mists (1.1%) and lotions (1.1%) was significantly lower. All analysed products were introduced to the market as cosmetics. In the 92 hair care products analyzed, 448 unique substances were identified, including 207 (46.1%) active ingredients that manufacturers listed on their packaging as active substances. Among the substances declared as "active", glycerin and yarrow extract were most frequently mentioned in this context in the analyzed products (Table 2). Of the 207 ingredients listed as "active" in the analyzed hair products, for only eight (3.9%) published scientific studies could be found, the results of which suggested a beneficial effect of a given substance on hair, however, according to the GRADE system, all of these studies were characterized by a very low strength of evidence (Table 3). Table 4 summarizes the substances declared as "active" for which there are studies suggesting their beneficial effect on hair. Ingredients supported by scientific evidence were present in a minority of the products analyzed: caffeine was present in 14.1% of the products, oleanolic acid in 12.0%, ginseng root extract in 7.8%, placental proteins in 6.5%, Polygonum multiflorum root extract in 3.3%, , and individual products (1.1% each) contained zinc pyrithione and Thuja orientalis leaf extract. Only 35 (38.0%) of the analyzed products contained at least one ingredient with proven beneficial effects on hair, including 8 (8.7%) containing two such ingredients. The majority of anti-hair loss products (57 products; 62.0%) did not contain any such ingredient. Moreover, available scientific research indicates that niacinamide (present in 27 products) and ginger extract (in 2 products) presented as "beneficial for hair" may actually inhibit hair growth, which is the opposite effect to that declared (Table 5).

Table 2. Ingredients most frequently reported as "active" in hair products included in this review. Due to the large number of such ingredients (207), only those ingredients that were reported as "active" in at least 9 products (10%) of the total are listed in the table, and among the less common ingredients, only those are listed for which scientific studies were available

Table 3. Analysis of the literature for scientific evidence of the effectiveness of "active ingredients" declared by manufacturers in anti-hair loss cosmetics analyzed in this paper

Table 4. The presence of ingredients in the hair loss products included in this analysis for which scientific research suggests a beneficial effect on hair

Table 5. Summary of studies that did not confirm the beneficial effect or showed an unfavourable effect on the hair of "active ingredients" declared by manufacturers in anti-hair loss cosmetics analysed in this paper

Table 6. The presence of ingredients in the hair loss products included in this review for which scientific research suggests an adverse effect on hair

Discussion

The present analysis revealed that out of 448 unique substances contained in 92 anti-hair loss cosmetics, as many as 207 (46.2%) were "active ingredients" according to the manufacturers' declarations. Only for 8 of them was it possible to find scientific studies confirming their effectiveness: zinc pyrithione [Berger et al. 2003], caffeine [Fischer et al. 2007], oleanolic acid [Liu et al. 2017], ginseng root extract [Park et al. 2011], placental protein [Yoon et al. 2014], Polygonum multiflorum root extract [Li et al. 2015] and Thuja orientalis leaf extract [Zhang et al. 2013]. However, it should be emphasized that the strength of scientific evidence is very low. To confirm the effectiveness of ingredients in topical preparations, scientific studies are necessary that are properly conducted in terms of methodology - studies of a sufficiently large group of people with a clearly defined type of alopecia, randomization, a control group of people with the same disease but applying a placebo, for example an identical-looking product without the substance of interest.

It seems that some ingredients are added because of good associations in potential buyers. This can be illustrated with the example of turmeric (turmeric). The genus Curcuma includes several dozen species, including yellow turmeric (Curcuma longa), whose multifaceted health effects have been confirmed in numerous scientific studies. However, the effect of yellow turmeric on hair has not been studied so far. It is known, however, that another species of turmeric, Curcuma aeruginosa, inhibits testosterone 5-alpha-reductase in experimental conditions [Suphrom et al. 2012], and more importantly, it was effective in the treatment of androgenetic alopecia in a randomized, double-blind clinical trial [Pumthong et al. 2012]. On the other hand, another randomized, double-blind clinical trial showed that Curcuma aeruginosa inhibits the growth of axillary hair [Srivilai2017]. This discrepancy may be due to physiological differences between head hair and axillary hair. However, it is not of major importance in the context of this work, because out of the 92 products analyzed, turmeric was found in the declared composition of 3 preparations, but it was a different species of turmeric - spotted turmeric (Curcuma zedoaria), and in two products it was cited as an "active" ingredient. Meanwhile, there is no data in the scientific literature on the effects of products from this species on hair, apart from a marginal mention that it was added to traditional hair oils in India [Kanase and Khan 2018]. However, for the average consumer, who usually knows that "turmeric is healthy", information about the presence of turmeric in the product will probably be an incentive to buy without much deliberation about the multitude and diversity of plant species hidden under the name Curcuma.

For the vast majority of the analyzed "active ingredients", no published studies could be found that would confirm the effectiveness declared by the manufacturers. A quick glance at Table 4 shows that substances with even partially confirmed beneficial effects on hair are not among the most frequently added ingredients to anti-hair loss products. The most frequently used caffeine from this group was an ingredient in 13 out of 92 analyzed products (14.1%), of which in 7 (7.6%) it was specifically indicated by the manufacturer as an active substance. Comparing the quoted numbers with Table 2 does not inspire much confidence in the anti-hair loss products offered on the market. Moreover, for two ingredients presented as "active" - ginger (Zingiber officinale) extract and niacinamide - the results of the studies suggest their adverse effect on hair growth. On the other hand, the positive effect of another substance on hair growth - adenosine - has been quite well documented in the literature [Watanabe et al. 2015], which, however, was not present in any of the hair loss preparations available on the Polish market between October 2018 and August 2019. A significant limitation of this work was the lack of information on the concentrations of individual substances in the analyzed preparations. It cannot therefore be ruled out that ingredients with proven beneficial effects on hair may have been present in some products in concentrations too low to achieve this effect. Moreover, some of the products offered on the market could not be included in this analysis, because the manufacturers did not provide information completed and consistent with the INCI nomenclature on the composition of the preparation. The distribution of some hair loss preparations is limited to beauty or trichological salons, so information about them may not have been available on the Internet during the period of data collection for the presented work.

Conclusions

1. The vast majority of ingredients in anti-hair loss products indicated by manufacturers as "active" have no scientific confirmation of their effectiveness.
2. Some ingredients advertised as "active" in hair loss preparations (niacinamide, Zingiber officinale extract) may in fact have an adverse effect on hair in the light of scientific research.

References

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Financing and conflict of interest

The presented research and preparation of this publication was financed entirely from the authors' own funds. The authors declare that there is no conflict of interest in relation to the content of this work.

Submitted: 20 February 2020
Accepted: 31 March 2020

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Document created: 22 October 2020, last updated: 11 June 2025
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