The Herbs Used Externally in Hair Loss Treatment

Today let's look at the herbs used externally in hair loss treatment.

The herbs most often applied externally for hair loss include arborvitae leaf, sophora root, mulberry root bark, houttuynia, scutellaria, pinellia, prickly ash, safflower, angelica, fo-ti vine, honeysuckle flower, dahurian angelica, dictamnus, veratrum, ginger, ginkgo leaf, moutan bark, salvia, dryopteris, cinnamon twig, asarum, peony root, ginseng and goji berry.

In practice there is no hard line between external and internal herbs, so herbs traditionally taken internally, such as ginseng, angelica, goji berry and fo-ti vine, are used externally as well.

That said, when an herb that works well taken internally is applied to the skin, you cannot simply carry its internal effects over. Goji berry, for example, is often used in hair loss treatment because taken internally it tonifies liver and kidney qi and replenishes essence and blood. But rubbing goji extract on the scalp does not, by any logic, improve liver and kidney function or replenish essence and blood.

The reason is that the concentration absorbed differs between internal and external use. Internal doses are generally much larger than what is applied topically, and what the body absorbs systemically is not the same as what passes through the skin. So when an internal herb is used externally, its effect should be understood through specific active compounds rather than through its traditional internal properties.

Herbs used externally for hair loss can be grouped by their main action:

1) Clearing heat, reducing inflammation and relieving itching: arborvitae leaf, sophora root, mulberry root bark, veratrum, dahurian angelica, dictamnus, peony root, honeysuckle flower, houttuynia and others.

2) Producing a blistering or counter-irritant effect: pinellia, prickly ash, asarum, ginger, cinnamon twig and others.

3) Invigorating the blood: moutan bark, cinnamon twig, salvia, safflower, angelica, ginkgo leaf and others.

The heat-clearing, anti-inflammatory, anti-itch herbs have long been used in external treatment of skin conditions, and they carried over to hair loss because poor scalp condition so often comes with it. They calm inflammation on the scalp, bring down inflammatory heat, and ease itching and discomfort, which helps especially with an oily scalp or seborrheic dermatitis.

Arborvitae leaf can be taken internally, but its cold nature can cause stomach pain or diarrhea, so external use is preferred. The historical record shows it used mainly externally for hair loss. Veratrum works well on severe scaly dermatitis but is toxic, so only small amounts should be used.

The blistering herbs are better understood as promoting hair growth than as slowing hair loss. Blistering therapy creates deliberate microtrauma to the skin; the damaged cells speed up their repair activity four to five times, clearing out damaged cells and replacing them with new ones. Originally applied to scar treatment, the method is now used for hair loss, prompting follicles to differentiate as the skin regenerates. Modern MTS therapy works on the same principle, using needle stimulation instead of chemical irritation.

Used carelessly or too heavily, though, blistering herbs can damage the scalp, worsen hair loss and cause serious problems. With hair loss that comes alongside seborrheic dermatitis, even mild blistering can intensify the inflammation and leave patients uncomfortable and anxious.

In actual practice we do not aim to raise blisters. We adjust the concentration so the stimulation stays mild, dilating the vessels and modestly increasing blood supply.

Invigorating the blood means exactly what it sounds like: getting the blood moving. Everything the follicle needs, oxygen included, arrives through the blood, so an adequate supply to the follicle is essential for hair growth. Including blood-invigorating herbs in hair loss treatment is therefore meaningful.

These herbs stimulate the vessels in the affected area, increase the volume of circulation, dilate the vessels and improve the blood supply.

Most of the herbs used externally for hair loss fall into the categories above. There are others with more specialized effects, but they generally belong to one of these groups.

Understanding the categories makes it easier to follow the ingredients and mechanisms behind the growing range of products, and it gives you the grounding you need when advising patients and customers.

Over these two columns we have looked at the herbs used internally and externally in hair loss treatment. There are more than the ones named here, and some deserve a fuller explanation, which I will continue in future installments.