Dear Nicki,

I’ve heard a lot about skin care supplements like Viviscal recently. Is there any proof that they work?

-Hairless

Dear Hairless,

There are currently several different hair supplements on the market in the U.S., which can be broken down into four main groups: marine protein, biotin, Chinese medical treatments, and L-arginine. I will discuss the efficacy of each below:

Marine Protein: Best Overall

Viviscal, a marine protein supplement, is the reportedly the best-selling supplement worldwide (Amazon.com, 2011). Although it has been around for years, it recently gained popularity as Hollywood stylists started using it on celebrities like Kate Hudson (In Style Makeover, 2011). Viviscal has shown to treat alopecia areata and androgen-related hair loss in a 1992 study in the Journal of International Medical Research. A similar product from Scandanavia, Nourkin, also features marine protein and has also been found in clinical studies to have solid efficacy in treating hair loss (The Hair Loss Cure: A Self Help Guide, 2009). Changes in dietary protein have been found to create corresponding changes in the level of protein within the hair within six to twelve months of the dietary adjustments (American Journal of Physical Anthropology, 1999).

The mechanism by which marine protein works is not known. However, due to the fact that Vivida®, a fish protein extract, resulted in similarly improved hair growth, it has been suggested marine protein may provide missing amino acids to the hair follicle that aid in hair growth (Journal of International Medical Research, 1992). It has also been suggested the silica compound component of Viviscal® may be important, as silica supplements have been associated with increased hair growth, though there are few studies to substantiate this (Hair Savers for Women, 2000).

The Vitamin Biotin: Best if You Have a Lousy Diet

While biotin has no documented benefits for the skin, it is still a dermatologist’s friend because of its tremendous benefits for the hair and nails. According to Dr. Audrey Kunin, board-certified Kansas City dermatologist and founder of DERMADoctor.com, biotin deficiencies lead to hair loss and fragility. It’s difficult to determine if you are biotin-deficient; there is not a good laboratory test to determine a deficiency. Therefore, if you are not eating much spinach, salad, brewer’s yeast, corn, barley, soybeans, walnuts, peanuts, molasses, cauliflower, milk, egg yolks, and fortified cereals, you may want to consider taking a biotin supplement.

Two great products that contain biotin are DermaVite Dietary Supplement ($19.75 for 60-day supply of 600 mg/day,DermaDoctor.com) and GNC Hair, Skin, and Nails Formula with biotin and lutein for the skin ($17.99 for 60-day supply of 300 mg/day, Drugstore.com).

Another bonus of taking biotin? It has also been found daily supplementation of 2.5 mg biotin leads to 25% thicker nails over the course of 15 months (Journal of the American Academy of Dermatology, 2005).

Shen Min and L-arginine: May improve greying hair (Shen min), or be used as a natural alternative to Rogaine (L-arginine)

Shen min is used in Chinese medicine because it contains fu ti, an herb believed to stimulate hair follicles and reduce the graying of hair since the Tonjj dynasty. Despite its long-standing use in eastern medicine, I cannot find the proposed mechanism of action or any studies supporting this claim. (I do, however, welcome anyone who has such information to please pass it along to me at nicki[at]futurederm[dot]com)!

L-arginine supplements increase nitric oxide levels, causing a relaxation of the hair follicle that has been called a natural Rogaine (Better Nutrition, 2003). Nitric oxide and minoxidil (the active ingredient in Rogaine) both open potassium channels, and is therefore believed to be the reason why L-arginine is associated with hair growth. Unfortunately, I could not find any studies comparing the efficacy of L-arginine supplements to minoxidil topical hair treatments. It is my educated guess that minoxidil treatments are still superior because they act directly on the hair follicle, and do not require a chemical reaction for their effect, while L-arginine must stimulate nitric oxide production physiologically. Still, so long as your doctor gives you the go-ahead, L-arginine appears to be a solid option. L-arginine is commonly found in dairy, beef, poultry, fish and nuts, though supplements are also common.

Bottom Line

There is currently the greatest scientific evidence to support supplementation with a marine protein-based supplement, such as Viviscal. Other options, such as biotin, Shen Min, and L-arginine have more limited support, but may still be viable choices if you have a poor diet (i.e., biotin, L-arginine) or are a candidate for minoxidil/Rogaine (i.e., L-arginine). As always, talk to your physician before beginning this or any other supplement regimen!

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