Phytotherapy in Trichology: A Review

Abstract

Androgenetic alopecia (AGA) is largely mediated by dihydrotestosterone (DHT). Conventional 5-alpha-reductase inhibitors are effective but limited by adverse effects, prompting interest in phytotherapy. This review summarizes evidence on natural DHT blockers including saw palmetto, pygeum, beta-sitosterol, nettle root, quercetin, pumpkin seed oil, green tea (EGCG), licorice root, flaxseed, curcumin, astaxanthin, resveratrol, L-carnitine, spearmint, and reishi mushroom. These agents act via 5AR inhibition, androgen receptor modulation, anti-inflammatory, and antioxidant pathways. Clinical data are strongest for saw palmetto, pumpkin seed oil, and EGCG, while others remain promising but under-investigated. Most are well tolerated, though licorice and flaxseed require caution. Natural DHT blockers represent a potential adjunct or alternative to pharmaceuticals, but standardized formulations and larger clinical trials are needed.