How Does it Compare?
For men with balding (androgenetic alopecia) there is no argument that oral antiandrogens are the most effective non-surgical treatment. However the potential side effects of antiandrogens means that for some patients (and physicians) other options can be considered. These options include topical and oral minoxidil, topical finasteride, laser, PRP, topical rosemary, ketoconazole, zinc pyrithione, and others.
Saw palmetto, known medically as sernenoa repens, is frequently added to the list of options. Unfortunately there are very few good studies of the use of saw palmetto in male balding. Rossi and colleagues performed a two year study comparing daily use of 320 mg saw palmetto to 1 mg finasteride in 100 patients with balding. Overall, saw palmetto helped 38% of patients whereas finasteride helped 68% of patients. Finasteride helped both the front and crown/vertex whereas saw palmetto tended to be mainly helpful for the crown.
We still have a long way to go to really understand the benefits of saw palmetto. A well conducted randomized double blind study is needed. However the Rossi study is encouraging that saw palmetto may have some benefits.
Rossi et al. Comparitive effectiveness of finasteride vs Serenoa repens in male androgenetic alopecia: a two-year study.Randomized controlled trial. Int J Immunopathol Pharmacol. 2012 Oct-Dec.
Dr. Jeff Donovan is a Canadian and US board certified dermatologist specializing exclusively in hair loss. To schedule a consultation, please call the Whistler office at 604.283.1887