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Reviewed by Sara Harcharik Perkins, MD
Written by Sheryl George
Published 10/24/2018
Updated 01/25/2024
Listen, if there’s a miracle cure for hair loss, the person who invented it would be very (and we mean very) rich. Hair loss affects a ton of peeps — more than half of all women will experience hair loss in their lifetime.
If you’ve noticed a lot more hair in the drain or on your brush — or simply see more of your scalp under bright lighting — you could have some degree of female hair loss. While shedding is a normal part of the hair growth cycle, it could be hair loss if you’re seeing bald patches or thinning hair.
And it could be due to various reasons. Sometimes, it’s diet-related, with a lack of key vitamins, minerals and nutrients, such as protein and iron, hurting your hair’s thickness and health. In other cases, hair loss can be caused by stress, whether physical or psychological.
But the most common form of hair loss is androgenetic alopecia, also known as female pattern hair loss. Though it’s not totally understood yet, it’s thought that hormones — namely, androgenic hormones — play a role in female pattern hair loss.
However, it is known that the hormone responsible for hair loss is dihydrotestosterone (DHT). It’s naturally produced in the body as a byproduct of testosterone, and for those sensitive to it, it can make the follicles shrink and produce thinner hairs.
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We’re guessing you’ve been trying to figure out how to stop hair loss. While there are many (questionable) treatments out there, some actually work. You may have wondered, Does saw palmetto work for hair loss? Heck, you may have even thought, What is saw palmetto? In any case, we got you.
Saw palmetto is a botanical extract with reported antiandrogenic properties. The fruit of the saw palmetto plant is used for medicinal purposes — often called a "saw palmetto berry" because of its size and appearance.
Though there’s been some research on men, very little data exists on female participants. Due to its antiandrogen-like properties, saw palmetto has purported benefits for issues like hair loss, hirsutism (dark, coarse hairs) and acne.
Saw palmetto is available in a variety of forms, with lipid/sterol extracts being the most common. A lipid/sterol extract (LESP) can be made in a 100 percent pure form or an extraction mixed with ethanol.
The dried powder extract of this herbal supplement can also be made into capsules, tablets, liquid tinctures or teas. All this to say, saw palmetto comes in so many forms, so you could likely find one that works for your lifestyle.
Want to learn what other supplements may be helpful for hair loss? Our hair vitamins and supplements guide covers several options.
Like a Jack of all trades, saw palmetto has been used for numerous issues, from hair loss and benign prostatic hyperplasia (a condition in which the prostate gland is enlarged) to prostate cancer and general health, immunity and well-being.
More recently, saw palmetto has gained popularity due to its alleged benefits for hair regrowth.
Some studies have demonstrated that saw palmetto can block the activity of 5a-reductase, an enzyme responsible for the conversion of testosterone into dihydrotestosterone (DHT).
DHT is the hormone responsible for hair loss. For those who are DHT-sensitive, this process can create hair follicle miniaturization, which leads to thinner hair (also known as vellus-like follicles) over time. It’s believed that the fatty acid content in saw palmetto helps inhibit this enzyme activity to androgen receptors.
Essentially, saw palmetto acts as a natural shield against the hormone DHT, which is known to cause hair loss. By preventing DHT production, the levels of this hormone in your body are lowered, resulting in less hair loss and a healthier, fuller head of hair.
While there isn’t research on saw palmetto and DHT in women, studies on men show that the botanical supplement actually works as a hormonal hair loss treatment. In a 2012 study, 60 percent of patients treated with Serenoa repens (aka saw palmetto) for androgenetic alopecia saw improvements.
In a more recent Australian study, the use of saw palmetto correlated with an increase in hair count after 12 and 24 weeks.
It’s worth pointing out that these studies aren’t perfect. First, they were performed on an exclusively male sample — an understandable flaw, given that male hair loss is more common than female hair loss. But it still leaves us wondering how exactly it might work on females.
Second, the Australian study lacked a placebo control group. So unfortunately, it’s not possible to compare the results of the patients given saw palmetto to a non-treatment group.
Both of these are frustrating limitations, but they don’t mean the study data is entirely worthless.
On the whole, studies of saw palmetto as a hair loss treatment show that it may work, albeit with less of an effect than pharmaceutical hair loss treatments such as minoxidil.
If you’re dealing with hormonal hair loss, you can learn more about DHT blockers in our guide.
Supplements are not regulated by the FDA (U.S. Food and Drug Administration), so you kind of have to proceed with caution. When it comes to herbal supplements, there isn’t a lot of information out there about safety and potential side effects in women, but it seems to have a low risk profile.
While no severe incidents have been reported, most studies on saw palmetto have only been done on men. Though saw palmetto seems to be generally safe for women, definitely discuss it with your healthcare provider before taking it.
It’s also worth mentioning that if you’re pregnant or breastfeeding, you should avoid using saw palmetto because we don’t know what kind of risks it might pose to a developing fetus.
For most women, there tend to be generally mild risks associated with taking saw palmetto supplements.
Some adverse effects may include:
Abdominal pain
Diarrhea
Nausea
Fatigue
Decreased libido
Hepatitis
Pancreatitis
Intraoperative hemorrhage (substantial blood loss)
Reduced prostate serum antigen (PSA) levels
Gynecomastia (enlarged breast tissue)
More research is needed to determine the long-term safety of this treatment. And in general, it’s always best to talk to your healthcare provider to make sure any supplements you take won’t interfere with your health conditions or cause drug interactions with other medications.
Again, the research is limited when it comes to female usage and saw palmetto supplements. But around 200 to 300 milligrams seems to be the amount that’s shown improvements in hair loss in clinical trials.
In a small randomized controlled trial, researchers evaluated the effectiveness of an oral tablet containing 200 milligrams of saw palmetto extract and an additional 50 milligrams of β-sitosterol (also called beta-sitosterol, which has also been studied for its antiandrogenic effects) compared to a placebo.
The study involved 26 men with mild to moderate androgenetic alopecia over a period of 25 weeks. The findings showed that saw palmetto demonstrated a 60 percent improvement in hair loss arrest and overall quality compared to only 11 percent among the placebo group.
In another study with 15 males and 15 females, a nutritional supplement containing 300 milligrams of saw palmetto taken twice daily for six months was found to increase hair density in 83 percent of participants. Among women, 33 percent reported a "greatly increased" density. Additionally, 93 percent of study participants reported a general reduction in hair loss.
We think this sounds pretty promising, even though the studies were small.
While the jury is still out on saw palmetto for hair growth, there are several science-backed hair loss treatments for women with reported efficacy.
You can pick the best treatment when you know what the underlying cause of your hair loss is. Learn more about female pattern hair loss and other types of hair loss in women in our comprehensive guides.
Here are a few science-backed treatments you might consider.
Minoxidil. If hair thinning is an issue, minoxidil will likely be your BFF. This gold standard treatment is FDA-approved for female pattern hair loss and is sometimes used off-label to treat issues like traction alopecia and telogen effluvium. Commonly sold under the brand name Rogaine®, minoxidil is thought to amp up microcirculation near the hair follicle and help extend the anagen (growth) phase of the hair growth cycle. Available in 2% minoxidil drops and 5% strength minoxidil foam, regrowth typically occurs after eight weeks and peaks around four months.
Oral minoxidil. If you’re looking for an option that won’t interfere with your styling routine, this once-daily pill might be your best bet. Though oral minoxidil hasn’t been FDA-approved for hair loss, clinical trials have shown that it’s effective at various doses ranging from 0.25 to 2.5 milligrams daily.
Topical finasteride and minoxidil spray. Get at DHT from a clinical route with this two-in-one spray. It contains both finasteride (a 5-alpha-reductase inhibitor) and minoxidil, which work together to combat hair loss from different angles. The solution is easy to apply and can help reduce DHT levels, making it a good choice for postmenopausal women or those with PCOS (polycystic ovary syndrome) experiencing hormonal hair loss.
Spironolactone. Consider this the clinical version of saw palmetto. Spironolactone is a medication that can be effective in treating androgen-related hair loss, such as androgenic alopecia. It can also be prescribed for other conditions like androgenic alopecia, hirsutism and acne. However, it’s important to note that if you take spironolactone, you should also be on a reliable form of birth control, as it has a Category C pregnancy rating from the FDA and could potentially cause birth defects. Learn everything about spironolactone in our guide, including deets on how it’s used for acne and hirsutism.
Biotin gummies. If it’s a nutritional deficiency that’s causing hair loss, supplementing may help if a balanced diet just ain’t cuttin’ it. Biotin, the queen B (literally) of vitamins, is one of the most popular supplements for hair loss. While biotin deficiency has been linked to hair loss, supplementing is only helpful if you’re actually deficient.
Volumizing shampoo and conditioner. Don’t underestimate the power of good hair care. A volumizing shampoo can help remove the oils and sebum that weigh down fine strands, while a lightweight conditioner will help boost moisture.
Hair loss can feel complicated — and TBH, natural supplements can be kinda complicated, too. While you may see some benefits when using saw palmetto to regrow thinning hair, results can vary, and lots of research still needs to be done.
Here’s the deal:
Consult a pro. Before you start taking any dietary supplements, check with your healthcare provider to make sure they’re safe for your medical conditions and won’t interact with any other medications you’re on. A pro can also check your hormone levels to see if they might be the culprit behind your hair loss.
Give it a try. While saw palmetto can’t be considered a complete solution for hair loss, it does have some impact on hair loss caused by high levels of DHT and hormonal imbalances. No single hair loss treatment is 100 percent effective, but saw palmetto could be a worthwhile addition to your hair care routine. In the meantime, the right hair care products can help add instant volume and body.
Back it up. For more effective hair loss treatments, try an option with solid clinical trials and research behind it for the best results, like minoxidil or spironolactone.
Hair loss may be tough, but dealing with it shouldn’t be. Start a consultation today if you’re ready for an expert-recommended regimen.
Sara Harcharik Perkins, MD, FAAD is a board-certified dermatologist and Assistant Professor in the Department of Dermatology at the Yale School of Medicine. She is the director of the Teledermatology Program, as well as the Associate Program Director of the Yale Dermatology Residency Training Program. Her research focuses on telemedicine and medical education. Her practice includes general medical dermatology, high-risk skin cancer, and procedural dermatology.
Dr. Perkins completed her undergraduate education at the University of Pennsylvania and obtained her medical degree at the Icahn School of Medicine at Mount Sinai. She completed her medical internship at the Massachusetts General Hospital, followed by residency training in dermatology at Yale University, after which she joined the faculty.
Dr. Perkins has been a member of the Hims & Hers Medical Advisory Board since 2018. Her commentary has been featured in NBC News, Real Simple, The Cut, and Yahoo, among others.
Ahmad, M., Christensen, S. R., & Perkins, S. H. (2023). The impact of COVID-19 on the dermatologic care of nonmelanoma skin cancers among solid organ transplant recipients. JAAD international, 13, 98–99. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10518328/
Ahmad, M., & Perkins, S. H. (2023). Learning dermatology in medical school: analysis of dermatology topics tested in popular question banks. Clinical and experimental dermatology, 48(4), 361–363. https://academic.oup.com/ced/article-abstract/48/4/361/6869515?redirectedFrom=fulltext&login=false
Belzer, A., Leasure, A. C., Cohen, J. M., & Perkins, S. H. (2023). The association of cutaneous squamous cell carcinoma and basal cell carcinoma with solid organ transplantation: a cross-sectional study of the All Of Us Research Program. International journal of dermatology, 62(10), e564–e566. https://onlinelibrary.wiley.com/doi/10.1111/ijd.16700
Ahmad, M., Marson, J. W., Litchman, G. H., Perkins, S. H., & Rigel, D. S. (2022). Usage and perceptions of teledermatology in 2021: a survey of dermatologists. International journal of dermatology, 61(7), e235–e237. https://onlinelibrary.wiley.com/doi/10.1111/ijd.16209
Asabor, E. N., Bunick, C. G., Cohen, J. M., & Perkins, S. H. (2021). Patient and physician perspectives on teledermatology at an academic dermatology department amid the COVID-19 pandemic. Journal of the American Academy of Dermatology, 84(1), 158–161. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7491373/
Belzer, A., Olamiju, B., Antaya, R. J., Odell, I. D., Bia, M., Perkins, S. H., & Cohen, J. M. (2021). A novel medical student initiative to enhance provision of teledermatology in a resident continuity clinic during the COVID-19 pandemic: a pilot study. International journal of dermatology, 60(1), 128–129. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7753449/
Cohen, J. M., Bunick, C. G., & Perkins, S. H. (2020). The new normal: An approach to optimizing and combining in-person and telemedicine visits to maximize patient care. Journal of the American Academy of Dermatology, 83(5), e361–e362. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7316470/