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Open access peer-reviewed chapter

Alternative Medicine for Hair Loss

Written By

Gurkan Yardimci

Submitted: 13 June 2016 Reviewed: 27 October 2016 Published: 03 May 2017

DOI: 10.5772/66593

Hair and Scalp Disorders IntechOpen
Hair and Scalp Disorders Edited by Zekayi Kutlubay

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Hair and Scalp Disorders

Edited by Zekayi Kutlubay and Server Serdaroglu

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Abstract

In recent years, people have begun to give further emphasis to the external beauty, especially for their hair. Except drugs with proven effectiveness, complementary and alternative treatment options that have not yet been clarified of their effectiveness and side effect profiles have been used for centuries. Many plants or their extracts are widely used to prevent hair loss and treat alopecia (e.g., androgenetic alopecia, alopecia areata, or traction alopecia) worldwide, especially in Far Eastern countries. The mechanisms of action of these plants are still unknown. Although there are little randomized-controlled studies investigating the effectiveness in the treatment of hair loss, reported results have demonstrated that complementary and alternative medicine will become much more popular in the near future.

Keywords

  • hair loss
  • complementary
  • alternative
  • medicine
  • herbal
  • acupuncture
  • hypnosis

1. Introduction

The social and sexual communication roles of hair as well as its protective function have absolutely undeniable for both sexes for many years [1, 2]. Although the loss of hair is not a life-threatening condition, the loss of hair at an early age or sudden onset hair loss may cause serious psychological distress, thus it may directly affect the quality of life negatively [1, 3]. For this reason, patients with suffering from hair loss should be considered finically in order to distinguish ordinary hair shedding from pathologic hair loss. A loss of 100 or less hair falling per day should not be considered as pathological hair loss. But in case of hair loss more than 100 per day, a pathological condition should be mentioned [3].

Hair loss is a common dermatological problem that has been estimated to affect between 0.2 and 2% of the world’s population. There are several factors leading to hair loss including major physical-emotional stress, chemotherapy, genetic predisposition, dihydrotestosterone (DHT), excessive sebum, cardiovascular diseases, smoking, and endogenous substances [3]. The common hair diseases that dermatologists are often faced in daily practice are androgenetic alopecia (AGA), alopecia areata (AA), telogen effluvium, anagen effluvium, and traumatic alopecia such as trichotillomania and traction alopecia [1]. AGA, known as male pattern hair loss in men and as female pattern hair loss in women, is the most common form of hair loss in adults [1, 4, 5]. Approximately 60% of males between the ages 30 and 50 years and 17% of women under 50 years of age suffer from AGA [4]. The role of DHT which is reduced from testosterone by enzyme 5α-reductase is clearly known in the mechanism of AGA [6]. In early stage, the process begins with shortening of the anagen phase and continuous miniaturization of sensitive follicles [1]. During this process, terminal hairs are replaced by vellus hairs which are shorter, finer and nonpigmented in the frontal and vertex regions of the scalp [3, 4]. Year after year, permanent baldness occurs at the site of miniaturized hair [1]. AA is a common, chronic inflammatory disease that is characterized by non-scarring alopecic patches on the scalp. It affects approximately 2% of the United States (US) population [7, 8]. Although the mechanism of AA is exactly unknown, it is thought that a necessary secondary event or cofactor such as febrile illness, pregnancy, or a major life crisis in addition to genetic predisposition [8, 9]. Even though AA may regress spontaneously, the disease may remain stable or even may spread to the entire scalp (known as alopecia totalis) or body (known as alopecia universalis). Telogen effluvium is a disease that occurs as a result of passing of a portion of hair from anagen phase to telogen phase. It is characterized by diffuse hair shedding. While trichotillomania is an impulse control disorder, traction alopecia is association with patients’ hairstyle. These two diseases that occur after recurrent and chronic trauma are frequently seen in females than males. Both of them can result with permanent scarring [9].

In recent years, complementary and alternative medicine (CAM) is becoming increasingly popular all over the world. In fact, CAM is still the only option to cure and treat some diseases in some regions of Africa, Asia, and South America [10]. Alternative medicine refers to the use of CAM in place of conventional medicine, while complementary medicine refers to the use of CAM along with conventional medicine [11]. According to The National Center for Complementary and Alternative Medicine (NCCAM) in the United States, CAM is defined as ‘a group of diverse medical and health-care system, practices, and products that are not presently considered to be a part of conventional medicine’ [12]. In some countries like Korea, oriental medicine has been officially approved and has gained support from legal system using the licensing system [13]. The number of visits to alternative care practitioners increased by about 1.5 times in 7 years (from 427 billion in 1990 to 629 billion in 1997) in the United States [14]. The National Health Interview Survey estimated that in 2007 alone, 38% of adults in the United States used CAM [15].

CAM is separated by NNCAM into four categories: alternative medical systems, biologically based therapies, manipulative and body-based therapies, and mind-body therapies. The details of these therapies are shown in Table 1 [16]. In a survey study conducted in the United Kingdom (UK) in 2010, the most popular CAM therapies were reported as acupuncture, hypnotherapy, and chiropractic, while the least preferred CAM were noted as aromatherapy, reflexology, and medical herbalism [17]. The annual expenditure on CAM is about $30 billion in the United States and £1.6 billion in the UK [18, 19].

Alternative medical systemAcupuncture
Ayurveda
Homeopathy
Naturopathy
Biologically based therapiesChelation
Folk medicine
Nonvitamin nonmineral natural products
Diet-based therapies
Megavitamin therapy
Manipulative and body-based therapiesChiropractic care
Massage
Mind-body therapiesBiofeedback
Relaxation techniques
Hypnosis
Yoga
Tai Chi
Qi Gong
Healing rituals
Energy healing
Reiki

Table  1.

Various treatments used in complementary and alternative medicine.

Similarly, using of CAM is quite often among patients suffering from dermatologic disorders such as acne, atopic dermatitis, psoriasis, dermatophytes, actinic keratosis, vitiligo, hair loss, cosmetic indications, melanoma, and lupus erythematosus [20–27]. A survey data from UK indicated that 35–69% of patients who have various skin diseases have used CAM in their lifetime [27]. The prevalence of CAM use by dermatology patients were 25.7 and 41% in Singapore [28] and Taiwan [29], respectively, while it ranges from 33.5 [30] to 43.7% in Turkey [31]. As the most frequently complementary medicines used by patients to treat their dermatological diseases have been reported as homeopathy, herbalism, diets, and food supplements in the UK [19, 27], the most used types of CAM have been recorded as herbal remedies, special diet, and megavitamin in Taiwan [29]. In one study, positive feedbacks from patients using CAM, especially herbal therapies, were noteworthy for both skin-related and non-skin-related conditions. Approximately 85% of patients with skin-related conditions, many of those with chronic diseases such as acne and eczema, noted improvement with CAM use [32]. To treat hair loss, the first two groups shown in Table 1 are more preferred than the others.

Ideal treatment of hair loss should include the drugs that have both 5α-reductase inhibition effect and hair growth promoter substances, together. The most used conventional treatments are topical minoxidil, finasteride, dutasteride, combination of cyproterone acetate and estrogen, spironolactone, flutamide, topical progesterone, cimetidine, zinc sulfate, topical niacin, topical aminexil, topical ketoconazole, and cyclosporine-A [2]. In particular, minoxidil and finasteride are widely used for treating hair loss. But adverse effects of all of these agents have limited to their usage [1, 2]. Hence, patients suffer from hair loss have begun to turn to alternative therapies, even though there is little scientific evidence to prove their effectiveness.

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2. Complementary and alternative medicines for hair loss

2.1. Herbal drugs

Herbal medicine is extremely popular since ancient times in Ayurveda, Siddha, Chinese, and Unani systems of medicine [3, 33]. Many plants and/or their extracts have been used to prevent hair loss and treat alopecia. These plants and their properties are summarized in Table 2.

Botanical nameFamilyPossible mechanisms of action
Thuja orientalisCupressaceaeInhibition of 5α-reductase enzyme
Citrullus colocynthisCucurbitaceaeAntiandrogenic effect
Rosmarinus officinalisLamiaceaeIncreasing the circulation of the scalp
Camellia sinensisTheaceaeInhibition of 5α-reductase enzyme
Asiasari radixAristolochiaceaeInducing early telogen-to-anagen conversion
Allium cepa L.LiliaceaeUnknown
Polygonum multiflorumPolygonaceaeProliferation of dermal papilla cells, expression of FGF-7, up-regulating Shh and β-catenin expression
Allium tuberosum Rottler ex SprengLiliaceaeStimulating expression of IGF-1
Cucurbita pepoCucurbitaceaeInhibition of 5α-reductase enzyme
Serenoa repensArecaceaeInhibition of 5α-reductase enzyme, decreasing DHT uptake by hair follicle, decreasing the binding of DHT to androgenetic receptors
Panax ginseng C.A. MeyerAraliaceaeExpression of VEGF, antiapoptotic activity
Eclipta albaAsteraceaeAnagen phase induction, reducing level of TGF-β1
Zizyphus jujubaRhamnaceaeUnknown
Allium sativumLiliaceaeUnknown
Avicennia marinaAcanthaceaeInhibition of 5α-reductase enzyme
Phyllanthus niruriEuphorbiaceaeInhibition of 5α-reductase enzyme
Oryza sativaInhibition of 5α-reductase enzyme
Sophora flavescens AitonLeguminosaeInhibition of 5α-reductase enzyme, vasodilator and antiandrogen effects
Chrysanthemum zawadskii var. latilobumAsteraceaeAnti-inflammatory effect
Scutellaria baicalensisLamiaceaeInhibiting nuclear translocation of the androgen receptor, enhance proliferation of human dermal papilla cells
Cuscuta reflexa RoxbConvulvulaceaeInhibition of 5α-reductase enzyme
Pueraria thomsoniiLeguminosaeInhibition of 5α-reductase enzyme
Curcuma aeruginosaZingiberaceaeInhibition of 5α-reductase enzyme
Hura crepitansEuphorbiaceaeInhibition the neurotrophin (NT)-4 activation
Tobacco leavesSolanaceaeInhibition of 5α-reductase enzyme
Tectona grandis LinnVerbinaceaeUnknown
Boehmeria nipononiveaUrticaceaeInhibition of 5α-reductase enzyme

Table 2.

Some plants used for hair loss and their properties.

2.1.1. Thuja orientalis

Thuja orientalis (T. orientalis, family Cupressaceae), also known as T. occidentalis in Eastern or Arbor vitae or white cedar, is a plant that is widely distributed in East Asia [34, 35]. In addition to grown as an ornamental tree in Europe, it has been used to treat various diseases concerning respiratory system, skin disorders, and urinary system. Nowadays, it is often used in homeopathy and evidence-based phytotherapy [35]. It has also been traditionally used to promote hair growth in the oriental medicine. Although T. orientalis has a strong 5α-reductase inhibitor effect, the exact mechanism of hair-promoting effect of T. orientalis is still unknown. In the literature, there are few studies investigating the association between T. orientalis and hair growth. In animal studies, it was demonstrated that topically application of T. orientalis extract induced an earlier anagen phase and prolonged the mature anagen phase. In immunohistochemistry analysis, it was also shown that the expression levels of β-catenin and sonic hedgehog (Shh) were upregulated in T. orientalis extract-treated group at 14 days, compared to those in the control or 1% minoxidil-treated group. In mice treated with T. orientalis, authors observed an increase in both the number and size of hair follicles [34, 36]. Even, cubosomal suspension of T. orientalis extract was found to be more effective due to increased skin penetration of the T. orientalis [37].

2.1.2. Citrullus colocynthis

Citrullus colocynthis (C. colocynthis) Shrad (family Cucurbitaceae), known as Indrayan, is one of the numerous herbal drugs recommended by the traditional system of medicine for hair growth promotion in India [38, 39]. It contains β-sitosterol, campesterol, stigmasterol, α-spinasterol, and cucurbitacin glycosides. It has several pharmacological effects such as immunostimulating, antiandrogenic, antibacterial, and hypoglycaemic in addition to hair-promoting effect [39]. There are few animal studies evaluating hair growth-promoting activities of the C. colocynthis. Roy et al. reported that topical application of C. colocynthis plant, especially petroleum ether extracts, had an astonishing effect on hair growth initiation time, complete hair growth, and the length of hair follicle in albino rats. In qualitative studies, hair growth was initiated in the denuded area on the 4th day and 5th day with 5 and 2% ointment of petroleum ether extract of C. colocynthis, respectively. But, hair growth initiation was noted on the 6th day and the second week in minoxidil-treated standard group and in control group, respectively. Complete hair growth was recorded on the 16th, 18th, 19th, and 24th days in the 5% petroleum ether extract group, 2% petroleum ether extract group, minoxidil group, and control group, respectively. In quantitative studies, at 30 days after treatments with extracts of C. colocynthis, anagenic population were recorded as 67 and 47% in the minoxidil group and control group, whereas it was noted as 75 and 72% in the 5 and 2% petroleum ether extract groups, respectively. In both 2 and 5% petroleum ether extract groups, approximately 50% of hair population had length of 0.5 mm and above at 30 days after treatment [38]. In another study, Dhanotia et al. evaluated the hair growth-promoting activities of the petroleum ether extract from the fruit of C. colocynthis on albino mice using a testosterone-induced alopecia model. As a result of both qualitative and quantitative studies on hair growth, they suggested to present the inhibition of androgenic activity and altered anagen/telogen ratio and follicular density [39]. Polyherbal formulation including C. colocynthis was also shown to present hair growth-promoting activity on rats. Hair growth initiation time was markedly reduced to one-third on treatment with the prepared formulation compared to control group. The time required for complete hair growth was also reduced by 32%. Quantitative analysis of hair growth cycle after treatment with formulations and 2% minoxidil solution (positive control group) exhibited greater number of hair follicles in anagenic phase compared with control [40].

2.1.3. Rosmarinus officinalis

Rosmarinus officinalis (R. officinalis), commonly known as Rosemary, is a plant that belongs to family Lamiaceae and naturally grows in all Mediterranean countries [41, 42]. It has antiandrogenic effect and hair growth-promoting activity apart from antioxidative, anti-inflammatory, antibacterial, and antitumor effects [43]. In CAM, R. officinalis is often used in aromatherapy to treat anxiety-related conditions and increase alertness, although it has occasionally been used to stimulate hair growth [41]. The exact mechanism of hair growth is still unclear, but it is believed to act by increasing the circulation of the scalp. Murata et al. showed that topical administration of R. officinalis extracts solution (2 mg/day/mouse) improved hair regrowth in the testosterone-treated C57BL/6NCrSIc mice. They also showed significant promotion of hair growth after 16 days of topical administration. Among the some constituents of R. officinalis [i.e., rosmarinic acid, ursolic acid, 12-methoxycarnosic acid (12-MCA)], it was demonstrated that inhibitory activity of 12-MCA on 5α-reductase was higher than rosmarinic acid and ursalic acid (82.4, 14.2, and 2.5% inhibition at 200 μg/ml, respectively) [43].

2.1.4. Green tea

Green tea (Camellia sinensis, family Theaceae) is a well-known plant since ancient times, especially in China. It has been regarded to possess numerous pharmacological effects such as antimetastatic, anticancer, hepatoprotective, antidiabetic, antiobesity, anti-atherosclerotic, antibacterial, antiviral, anti-inflammatory, and antioxidant effects. It has been preferred in various dermatological diseases due to its mentioned beneficial effects worldwide. Human papilloma virus (HPV)-induced cervical cancer, genital warts, acne, rosacea, wound healing, atopic dermatitis, and keloids are diseases that green tea is commonly used. Apart from these diseases, it can be used to prevent or treat AGA by selectively inhibiting 5α-reductase activity. Catechins, a group of very active flavonoids, are a major component of green tea representing 60–80% of all polyphenols [44, 45]. There are four major catechins in green tea: epigallocatechin-3-gallate (ECGC), epigallocatechin (EGC), epicatechin gallate, and epicatechin [46, 47]. ECGC is the most highly bioactive catechin among these constituents [45]. In a study, EGCG was found to cause significant human hair follicle elongation ex vivo. Indeed, it was also shown proliferative and antiapoptotic effects of ECGC on dermal papilla cells through the upregulations of phosphorylated Erk and Akt and by an increase in the ratio of Bcl-2/Bax ratio [48]. Esfandiari et al. also reported that 33% of the mice that received 50% fraction of polyphenol extract from dehydrated green tea in their drinking water had significant hair regrowth within a period of 6 months compared with control group received regular drinking water [49].

2.1.5. Asiasari radix

Asiasari radix (A. radix, family Aristolochiaceae) or the radix of Asiasarum heterotropoides var. mandshuricum F. Maekawa usually grows in Korea, Japan, and China. A. radix is also called as ‘seshin’ in Korea, as ‘saishin’ in Japan, or Chinese wild ginger in English [50, 51]. It is used to treat various oral mucosal diseases such as aphthous stomatitis, gingivitis, local pain, and toothache apart from hair loss. A study from Korea showed its potent hair growth effect in mice. Though A. radix had not inhibitory effect on 5α-reductase enzyme, authors suggested that the extract of the plants induced early telogen-to-anagen conversion. They also demonstrated expression of vascular endothelial growth factor (VEGF) in human dermal papilla cells cultured in vitro [52].

2.1.6. Allium cepa L

Onion juice (Allium cepa L., family Liliaceae) may be used in patients with AA because of garlic-like activity. Both herbal medicines have similar chemical constituents, especially Allicin. The exact mechanism of onion juice in the treatment of AA is still unknown [53, 54]. In the study by Sharquie and Al-Obaidi, at 4 and 6 weeks after topical application of onion juice twice a day, hair regrowth was observed as 73.9 and 86.9% of patients with AA, respectively. Patients should be informed about skin irritation on the skin surface in contact with the onion juice [53].

2.1.7. Polygonum multiflorum

Polygonum multiflorum (P. multiflorum, family Polygonaceae) is a very popular plant that has been widely used to treat various diseases in traditional Chinese medicine due to its different pharmacological effects such as antiaging, immunomodulating, antihyperlipidemia, hepatoprotective, anticancer, and anti-inflammatory. Besides these pharmacological effects, some studies have been reported related to hair growth promotion activity and hair-blacking effect [55, 56]. An active component of P. multiflorum, known as 2,3,5,4′-tetrahydroxystilbene-2-O-β-d-glucoside (THSG), has melanogenesis-stimulating effect in melanocytes [55]. A new compound isolated from P. multiflorum, known as torachrysone-8-O-β-d-glucoside, induces a strong increase in the proliferation of dermal papilla cells and significantly increases the hair-fiber length of rat vibrissa follicles [57]. Li et al. investigated hair growth promotion activities and their possible mechanism of P. multiflorum Radix (PMR) and P. multiflorum Radix Preparata (PMRP), both of them originated from P. multiflorum, in C57BL/6J mice. While hair covered skin ratio was higher in oral PMR groups than in PMRP groups, hair covered skin ratio was lower in topical PMR groups compared with topical PMRP groups. It was also demonstrated that the most possible cytokines regarding hair growth-promoting activity were fibroblast growth factor-7 (FGF-7) and Shh [58]. Another animal study suggested that anagen phase was induced in resting hair follicles through upregulating Shh and β-catenin expression after topical application of P. multiflorum [55].

2.1.8. Allium tuberosum Rottler ex Spreng

Allium tuberosum Rottler ex Spreng (ATRES, family Liliaceae) is one of the Allium species like Allium tuberosum and Allium cepa L. It is widely distributed in East Asia and has been used for treating abdominal pain, diarrhea, hematemesis, and asthma in traditional medicine. Choline acetyltransferase activity of ATRES was also reported [54, 59]. In the first study, evaluating the hair growth-promoting activity and its mechanism of action, ATRES has strong hair-promoting activity through stimulating expression of insulin-like growth factor-1 (IGF-1). Especially, the n-butanol extract of ATRES was found to have most hair growth-promoting activity among the other compared groups including minoxidil, ethanol, n-hexane, distilled water groups on telogenic C57BL6/N mice [59].

2.1.9. Pumpkin seed oil

Pumpkin seed oil (PSO, family Cucurbitaceae) has been used for treating symptomatic benign prostatic hyperplasia through its inhibitory effect on 5α-reductase and antiandrogenic effect [60, 61]. In a randomized, double-blind, placebo-controlled study, self-rated improvement score, and self-rated satisfaction scores in the PSO-treated group were higher compared with the placebo group after oral administration of PSO at dosage of 400 mg/day for 24 weeks. At 24 weeks, mean hair count was recorded as increase of 40 and 10% in the PSO-treated group and placebo group, respectively. But, there was no significant difference in hair thickness between groups [60].

2.1.10. Serenoa repens

Serenoa repens (S. repens, family Arecaceae) is a native plant in West India and is grown in large quantities on the Atlantic southeast coast of North America. Saw palmetto is extracted from the berries of this plant. It is one of the herbal medicines that have inhibitory effect on both types 1 and 2 of 5α-reductase enzyme. In addition to inhibitory effect on 5α-reductase, S. repens may also decrease DHT uptake by hair follicle and decrease the binding of DHT to androgenetic receptors [62, 63]. Anti-inflammatory effect has been demonstrated with a composition containing saw palmetto, carnitine, and thioctic acid in hair follicle keratinocytes [64]. Both oral and topical use of S. repens could be effective for treating androgen-induced alopecia in both sexes [63]. In an open label study, 50 male patients with mild to moderate AGA were treated with S. repens 320 mg/day for 24 months. After this period, only 38% of patients had an increase in hair growth. But, this improvement was lower than the group treated with finasteride (68% of patients) [62]. Satisfactory results were also observed after application of topical products containing S. repens extract for 24 weeks in male patients with AGA [65]. Recommended dose is 320 mg/day orally [63]. Side effects of S. repens are minimal. The most known side effects are related to gastric symptoms, although contact dermatitis, feeling of coldness, mild burning sensation, undesirable smell, itching, and acne are the reported adverse events after topical application [63, 65, 66].

2.1.11. Ginseng

Ginseng (family Araliaceae) is traditionally used as an important herbal medicine in East Asian countries such as China, Korea, and Japan. It is divided into three categories: fresh ginseng, red ginseng, and white ginseng [67, 68]. Red ginseng is extracted from the steamed root of Panax ginseng C.A. Meyer, or known as Korean ginseng, and has various effects such as antiaging, antidiabetic, immunoregulatory, anticancer, neuroregulation, lipid-regulating and antithrombotic activities, and wound- and ulcer-healing activity [68, 69]. In addition to these properties, it has also been used for treating numerous hair diseases such as AGA and AA due to its promoting hair growth activity [70, 71]. There are very important chemical constitutes such as polysaccharides, ginsenosides (or known as saphonins), alkaloids, glucosides, and phenolic acid in ginseng [68]. Ginsenosides are the major pharmacologically active ingredients of ginseng. To date, approximately 70 ginsenosides have been isolated from ginseng. In a study, it has been demonstrated that ginsenoside Rg3 had upregulated the expression of VEGF in human dermal papilla cells and mouse hair follicles [72]. Antiapoptotic activity of fructus panax ginseng was also shown in human dermal papilla cells [73].

2.1.12. Eclipta alba (L.) Hassk

Eclipta alba (L.) Hassk. (E. alba, family Asteraceae) is a medicinal plant commonly used for treating gastrointestinal disorders, respiratory tract disorders, fever, liver disorders, skin disorders, spleen enlargement, and cuts and wounds as well as hair loss and graying of hair. Numerous pharmacological activities including hepatoprotective, hair growth-promoting activity, antidiabetic, analgesic, anti-inflammatory, neuropharmacological activities, antioxidant, antimicrobial, antimalarial, cardiovascular effects, immunomodulatory, antiepilepsy, anticancer, antiulcer, and antihelmintic activities have been demonstrated. E. alba phytoconstituents including wedelolactone, eclalbasaponins, α-amyrin, oleanolic acid, ursolic acid, luteolin, and apigenin are responsible from main medicinal effects [74]. Hair growth-promoting activity has been investigated on animals. The methanol extract of E. alba has been tested for its efficacy for hair growth in pigmented C57/BL6 mice. While the transition of telogen phase to anagen phase of hair growth was observed in approximately 87.5% animals treated with 3.2 mg/15 cm2 of methanol extract of E. alba, 50% of the animals treated with 1.6 mg/15 cm2 of methanol extract of E. alba was observed transition from telogen phase to anagen phase of hair growth. The rate of anagen induction was dependent on concentration of methanol extract of E. alba [75]. The petroleum ether extract of E. alba was also investigated for its hair growth stimulatory effects in nude mice. This fraction of E. alba significantly reduced the levels of transforming growth factor-β1 (TGF-β1) expression during early anagen and anagen-catagen transition, so that authors suggested that the duration of terminal differentiation was extended [76]. Roy et al. also reported that the petroleum ether and ethanol extracts of E. alba (incorporated into ointment base in concentration of 2 and 5%, respectively) significantly reduced the time taken for hair growth initiation and completion in albino rats treated with the extracts [77].

2.1.13. Zizyphus jujuba

The plant, Zizyphus jujuba (Z. jujuba, family Rhamnaceae), is a widely distributed both in the Mediterranean regions and in the tropical and subtropical region of Asia and America. It can be used for several diseases such as diabetes, diarrhea, skin infections, liver complaints, urinary disorders, obesity, fever, pharyngitis, bronchitis, anemia, insomnia, and cancer [78]. There is no sufficient data related to its hair growth-promoting effect. In a study by Yoon et al., a greater effect on length of hair was reported in mice treated with 1 and 10% of Z. jujuba essential oil after 21 days of treatment as compared to control group. Although the length of hair was measured as 9.96 mm with 1% of oil and 10.02 mm with 10% of oil, respectively, the length of hair was measured as 8.94 mm in the control group [79].

2.1.14. Allium sativum

Allium sativum (family Liliaceae), known as garlic, is one of the most popular herbal medicine and can be used in the treatment of various dermatologic conditions such as psoriasis, AA, keloid scar, wound healing, cutaneous corn, viral and fungal infection, leishmaniasis, and skin-aging and rejuvenation. Constituents of garlic include enzymes (e.g., alliinase), sulfur-containing compounds (e.g., alliin), compounds produced enzymatically from alliin (e.g., allicin), arginine, oligosaccharides, flavanoids, and selenium [80]. In a double-blind randomized-controlled study, Hajheydari et al. reported that combination of topical garlic gel and betamethasone valerate cream was more effective than betamethasone valerate cream alone in patients with localized AA at the 3rd month. The number of total and terminal hairs in the group treated with garlic gel was significantly higher than those of the control group at the third months [81].

2.1.15. Avicennia marina

Avicennia marina (A. marina), also known as grey or white mangrove, is a traditional herbal plant belonging to family of Acanthaceae. However, it is traditionally used to treat various skin diseases in Egypt, antiandrogenic activity of A. marina and a compound, avicequinone C, isolated from the hearthwood of A. marina was firstly reported by Jain et al. [82]. The results revealed that A. marina was a potent 5α-reductase type 1 inhibitor, reducing the 5α-DHT production by 52% at the final concentration of 10 μg/mL [82]. Moreover, among the thirty different extracts, the highest inhibitory activity was observed from the crude extract of A. marina at a final concentration of 10 g/ml through the reduction in 5α-DHT formation by more than 50% [83].

2.1.16. Phyllanthus niruri

Phyllanthus ninuri (P. niruri, family Euphorbiaceae) is a widely used plant of genus Phyllanthus in traditional medicine. It is also known as ‘chanka piedra,’ ‘bhuiamlki,’ ‘zhuzicao,’ ‘dukung anak,’ ‘quebra-pedra,’ and ‘chanca piedra.’ P. niruri usually grows in tropical and subtropical regions in Central and South American countries, India and East Asia and has several biologic activities such as antidiabetic, analgesic, wound healing, and immunomodulatory effects. It is traditionally used to cure of jaundice, fever, malaria, stomachache, urolithiasis, vaginal candidiasis, varicella, and tuberculosis by people living in these countries [84, 85]. Newly, inhibitory activity of petroleum ether extract of P. niruri on 5α-reductase type 2 enzyme was shown, and it has been suggested to be useful in the treatment testosterone-induced alopecia [85].

2.1.17. Rice bran

It has been believed that rice bran extract, which is produced by milled rice (Oryza sativa), has antioxidant, anticancer, and antihyperlipidemic effects as well as 5α-reductase inhibitory activity [86]. The compounds having antioxidant activity are phenolic acids, flavonoids, anthocyanins, proanthocyanidins, tocopherols, tocotrienols, γ-oryzanol, and phytic acid [87]. Very few studies exist to support the claims of the efficacy of rice bran. The hair growth-promoting activity of rice bran supercritical CO2 extract (RB-SCE) and its two components (linoleic acid and γ-oryzanol) were shown using real-time reverse transcriptase-polymerase chain reaction in C57BL/6 mice by Choi et al. [86]. In a double-blinded randomized-controlled study, dermal application of 0.5% of RB-SCE (8 ml/day) to the head skin significantly increased hair density and hair diameter in male patients with alopecia for 16 weeks [88].

2.1.18. Sophora flavescens Aiton

Sophora flavescens Aiton (S. flavescens, family Leguminosae) is one of the important plants used in traditional Chinese medicine [89, 90]. It has been used for treating viral hepatitis, cancer, viral myocarditis, heat dysentery, hemafecia, jaundice, anuresis, leucorrhoea with reddish discharge, vulval swelling, pruritus vulvae, eczema, and trichomonas vaginalis [90, 91]. It is a strong inhibitor of 5α-reductase enzyme in addition to its vasodilatory and antiandrogen effects. Despite lack of proper clinical trials to support its efficacy for hair loss, the mechanism of affect on hair loss treatment is thought to be through these activities. It was demonstrated that the isolated two pterocarpans, L-maackiain and medicarpin, promoted the proliferation of human hair keratinocytes [89].

2.1.19. Laminaria japonica

Laminaria japonica (L. japonica) is a kind of brown algae and called as ‘kombu’ in Japanese, ‘dashima’ in Korean, and ‘haidai’ in Chinese. The most consumed countries of L. japonica are Far Eastern countries such as Korea, Japan, and China. L. japonica is believed to have beneficial effects for health; however, the mechanism of beneficial effects is not fully understood [92, 93]. The combination of L. japonica extract and Cistanche tubulusa extract has the potential to promote hair growth. Oral administration of both L. japonica extract at dosage of 54 mg/kg and Cistanche tubulusa extract at dosage of 162 mg/kg exhibited an excellent hair regrowth activity on mice. It has been thought that anti-inflammatory activities of the both plant extracts could play an important role to prevent hair loss and improve alopecia [94].

2.1.20. Chrysanthemum zawadskii var. latilobum

Chrysanthemum zawadskii var. latilobum (C. zawadskii, family Asteraceae) has been used for the treatment of pneumonia, bronchitis, cough, common cold, pharyngitis, bladder-related disorders, gastrointestinal disorders, and hypertension in traditional medicine for ages. Essential oil of the plant contains 27 hydrocarbons, 12 alcohols, 7 ketones, 4 esters, 1 aldehyde, 1 amine, and 3 miscellaneous components [95, 96]. Although recent studies have expressed anti-inflammatory effect and protective effects from liver damage of C. zawadskii, there is little experimental evidence suggesting that the extract stimulates hair growth in humans and animals. In mice study, topical methanol extract of C. zawadskii was more effective compared to minoxidil-treated group. In the C. zawadskii-treated and minoxidil-treated groups, while the maximum hair scores in the first hair-growth generation were recorded as 2.5 ± 0.29 and 2.5 ± 0.28, hair coverage scores in the second hair-growth generation were noted as 2 ± 0.41 and 1.5 ± 0.29, respectively. Rapid hair loss seen in minoxidil-treated mice was not observed in C. zawadskii-treated group after the first hair growth generation [95].

2.1.21. Scutellaria baicalensis

Scutellaria baicalensis (S. baicalensis, family Lamiaceae), also known as Huang Qin, mostly grows in China, Japan, Korea, Mongolia, and Russia [97, 98]. S. baicalensis is likely to have hair growth-promoting effect by means of its active substances. It has been reported that the compound possessing this activity is an active flavonoid isolated from S. baicalensis named ‘Baicalin’. In recent years, it has also suggested that both the extract of S. baicalensis and baicalin inhibit nuclear translocation of the androgen receptor stimulated by DHT in human dermal papilla cells and enhance proliferation of human dermal papilla cells in vitro [98].

2.1.22. Cuscuta reflexa Roxb

Cuscuta reflexa Roxb. (C. reflexa, family Convulvulaceae) is a parasitic plant that is used as herbal medicine. It is also known as ‘Tukhm-e-Kasoos (dodder),’ ‘Aftimoon,’ or ‘Kasoos’ in Unani Tibbi, ‘Akashabela,’ or ‘Amarabela’ in Hindi, ‘Swarnalata’ in Bengali, and ‘Akakhilata’ in Assamese, in vernacular [99, 100]. It commonly grows on different host plants, mostly thorny herbs in all geographical regions of India [99, 101]. Many pharmacological activities such as relaxant and spasmolytic action, positive inotropic and cardiotonic activities, cholinergic action, anti-HIV, antioxidant, anti-steroidogenic, antibacterial, hepatoprotective, hypoglyceamic, diuretic, anticonvulsant, anti-inflammatory and anticancer activities as well as hair growth activity have been previously reported [100]. A number of experimental observations have indicated that C. reflexa has hair growth-promoting and 5α-reductase inhibitory activities. Hair growth was shown after treatment of the petroleum ether extract solution (250 mg/kg, orally) of C. reflexa and the ethanolic extract solution (250 mg/kg, orally) of C. reflexa in male albino rats with cyclophosphamide-induced alopecia at 19 days [99]. In another animal study by Pandit et al. suggested that petroleum ether extract of C. reflexa reversed androgen-induced alopecia by inhibiting conversion of testosterone to DHT [101]. Polyherbal formulation including C. reflexa was also shown to present hair growth-promoting activity on rats. Hair growth initiation time was markedly reduced to one-third on treatment with the prepared formulation compared to control group. The time required for complete hair growth was also reduced by 32%. Quantitative analysis of hair growth cycle after treatment with formulations and 2% minoxidil solution (positive control group) exhibited greater number of hair follicles in anagenic phase compared with control [40].

2.1.23. Ishige sinicola

Ishige sinicola (I. sinicola) is a brown alga that has antibacterial and anti-inflammatory effects against acne. In 2013, a study firstly demonstrated that I. sinicola extract and its component, octaphlorethol A, have the potential to promote hair growth via the proliferation of dermal papilla cells followed by the activation of β-catenin pathway, and the 5α-reductase inhibition [102].

2.1.24. Grateloupia elliptica

G. elliptica is the edible seaweed in some Asian countries. Although it is thought that potential anticancer activity, there is no enough evidence investigating the protective effect against hair loss and hair growth-stimulating effect of G. elliptica [103, 104]. Possible mechanisms including the proliferation of dermal papilla cells, inhibition of 5α-reductase enzyme, increase in prostaglandin E2 (PGE2) production, decrease in pro-inflammatory cytokine production, and inhibitory activity against Pityrosporum ovale (P. ovale) have been shown in the prevention of hair loss. A study showed that G. elliptica extract promoted the proliferation of dermal papilla cells by 169.5% at the concentration of 100 μg/ml compared with the vehicle-treated control group. The study also indicated that G. elliptica extract inhibited 5α-reductase enzyme and this activity increased with dosage [104].

2.1.25. Puerariae flos

Puerariae flos (the flowers of Pueraria thomsonii, family Leguminosae) extract (PF-ext) has inhibitory activity on testosterone 5α-reductase. The two major compounds, soyasaponin I and kaikasaponin III, are responsible for this inhibitory activity. In addition to inhibitory activity on testosterone 5α-reductase of both compounds, soyasaponin I possesses hepatoprotective, sialyltransferase inhibitory, and renin inhibitory activities, while kaikasaponin III possesses anti-hepatotoxic, hypoglycemic, hypolipidemic, and anti-herpes virus activities [105, 106]. Inhibitory activity of PF-ext on 5α-reductase is stronger than Puerariae Radix extract (PR-ext). In testosterone-sensitive male mice, hair regrowth was improved after the application of PF-ext solution in a dose-dependent manner via antiandrogenic activity. PF-ext can stimulate the induction of the hair cycle to anagen phase, but this mechanism has not been proven definitely [105].

2.1.26. Curcuma aeruginosa

Curcuma aeruginosa (C. aeruginosa, family Zingiberaceae) is a native plant of India and Southeast Asia. The rootstock of C. aeruginosa has long been used in traditional medicine for various indications such as dysmenorrhea, exanthemas and fungal infections. The oils derived from this plant consist of 1,8-cineole, curserenone, furanogermenone, camphor, (Z)-3-hexenol, zedoarol, furanodienone, curcumenol, isocurcumenol, β-alemene, curzerene, and germacrone, among others. C. aeruginosa hexane extract effects by inhibiting 5α-reductase activity, consecutively impairing the conversion of testosterone to DHT [107, 108]. Pumthong et al. investigated the effect of C. aeruginosa hexane extract on male-pattern baldness with a randomized, double-blind, placebo-controlled study. The study has shown that 5% hexane extract of C. aeruginosa especially combined with 5% minoxidil increased hair growth and decreased hair shedding [107].

2.1.27. Hura crepitans

Hura crepitans (H. crepitans, family Euphorbiaceae) has been used as a traditional medicine to treat some diseases such as Hansen’s disease and syphilis in the Amazon region. A compound in H. crepitans, daphne factor F3, can play an effective role the mechanism of the hair growth. But, interestingly, the amount of daphne factor F3 is very important for hair growth. While H. crepitans from Peru possesses hair regrowth activity, H. crepitans from Brazil is not affect hair growth. Because, the daphne factor F3 content of H. crepitans from Peru is about 30 times more than H. crepitans from Brazil [109, 110]. It has been suggested that H. crepitans inhibits the retardation of hair regrowth by DHT through inhibition the neurotrophin (NT)-4 activation induced by DHT [109].

2.1.28. Tobacco leaves

Tobacco leaves (family Solanaceae) are used in traditional medicine for promoting of hair growth. The leaves also used to treat bronchitis, asthma, skin diseases, headache, etc. Alkaloid nicotine is the main constituent of tobacco leaves. Alkaloids such as nicotine, nicotianin, nicotinine, nicoteine, and nicoteline, which are the constituent parts of tobacco leaves, selectively inhibit 5α-reductase activity. The microbial bio transformed extract of tobacco leaves in cow urine has been investigated to treat AGA, and it has been found that it promotes hair growth at concentration dependent manner. The study confirms that 30% concentrated lotion treatment is at par with 2% minoxidil treatment in potentiating hair growth promotion in male albino Wister rats [111, 112].

2.1.29. Tectona grandis Linn

Tectona grandis Linn. (T. grandis, family Verbinaceae) (teak tree) has been used to cure many diseases in traditional Indian medicine. T. grandis is called as ‘saka’ in Sanskrit, ‘sagun’ in Hindi, ‘sagwan’ in Marathi, and teak tree in English. It has also been used as a hypoglycaemic agent. According to the traditional Indian medicine, T. grandis roots are useful in anuria and urinary retention. The flowers have used to treat bronchitis, biliousness, and urinary discharge. The oil from the seeds is useful in scabies. The wood is used to relax and sedate the gravid uterus, heal headache and burning pains, cure liver problems, and even dysentery. T. grandis has been investigated in some studies for its anti-inflammatory and wound healing effects and is used as a topical treatment for burn wounds [113, 114]. Jaybhaye et al. investigated the effect of petroleum ether extract of T. grandis Linn. seeds on hair growth activity of albino mice. According to this study, topical application of the petroleum ether extract of T. grandis induced hair growth initiation and was superior to standard therapy with minoxidil 2% solution. The combination of the petroleum ether extract (5%) with 2% minoxidil has the strongest effect on hair growth initiation [113].

2.1.30. Boehmeria nipononivea

Boehmeria nipononivea (B. nipononivea, family Urticaceae) is a Japanese plant and the use of acetone extract derived from this plant has been investigated for treatment of androgen-dependent alopecia. One study indicates that the acetone extract of B. nipononivea has 5α-reductase inhibitory activity. The acetone extract derived from B. nipononivea was investigated on mice for its hair growth effect, and it resulted with a significant hair regrowth starting on 15th day and continues until 22th day. The 5α-reductase inhibitory activity of the acetone extract of B. nipononivea is attributed to fatty acids contains such as α-linolenic acid, palmitic acid, oleic acid, elaidic acid, and stearic acid. The study reveals that both the acetone extract of B. nipononive and three fatty acids (α-linolenic, elaidic, and stearic acids) have 5α-reductase activity and stimulates hair regrowth [115].

2.2. Acupuncture

Acupuncture is an ancient holistic system of Chinese medicine and has been practiced there so many years. China had the cultural and traditional exchange with its neighbors, and therefore, it spread to all over the world in time. Today, it is one of the most frequently used forms of complementary medicine [116].

Acupuncture aims to bring a complete cure, not only managing the outstanding symptom but to heal the whole body. Even though various acupuncture techniques are available, the fundamental techniques are needling, moxibustion, cupping, suction, and acupressure. Over the centuries, acupuncture has been used to treat a wide variety of diseases including skin disorders such as acne, alopecia, eczema and dermatitis, pruritus, pityriasis, psoriasis, rosacea, systemic lupus, urticaria, herpes zoster, chicken pox, impetigo, leprosy, and vitiligo. The exact mechanism of action of acupuncture treatment in skin disorders is not clear but investigations revealed that acupuncture stimulation effects on three key points: the hypothalamus-pituitary-adrenal axis, the autonomic nervous system, and brain-derived neurotrophic factor. There may be an increase on serum levels of cortisol by the effect of acupuncture. It has also been demonstrated by functional MRI that manual needle acupuncture distinctively activates the hypothalamus-limbic system [116].

Degranulation of mast cells significantly increases in autoimmune diseases such as AA and chronic inflammation. A mouse model for AA study has shown that severe mast cell degranulation and accumulation around the anagen hair follicle cause a self-attack of the hair follicle cells by migration of the inflammatory cells. This attack induces the hair matrix cell phase to the telogen phase that results with hair loss. Acupuncture treatment reduces T1-cell attacks on hair bulb and activates blood circulation by warming the local collaterals; therefore, it may help to reduce hair loss. The same mouse study indicated that electro-acupuncture reduces mast cell degranulation in the dermis. It is reported that may be the cause of the pathological changes causing AA but reliable evidence is not yet available [117, 118].

Even though acupuncture treatment in dermatological diseases is safe and inexpensive, improperly performed acupuncture can cause potentially serious adverse effects such as vasovagal events, local infections, damage to internal organs, pneumothorax, spinal cord injury, and hepatitis B infection [116].

2.3. Hypnotherapy

The hypnotic phenomenon has been used over thousands of years, and it is a form of trance induction. Recently, the use of hypnotic therapy in somatic medicine has been supported by the British Medical Association in 1955 and the American Medical Association in 1958. A hypnotic trance can be described as an altered state of consciousness with “inward focus.” It can be differed from other states of consciousness by electroencephalography (EEG) and imaging modalities. A hypnotic state can be induced by a therapist or an individual can induce hypnotic trace in himself or herself (self-hypnosis) [119, 120].

Hypnosis has been used for several indications such as induction of anesthesia or to heal irritable bowel syndrome and psychosomatic diseases as well as a variety of skin disorders including AA and trichotillomania. Nowadays, medical hypnosis is performed by physicians whom have received appropriate training in many countries all over the world. For some selected skin disorders, with proper training and selection of appropriate patients, medical hypnosis can relieve symptoms and in some cases can cure the illness [119, 120].

Hypnosis is a cost-effective and nontoxic therapy and can be used in dermatological treatment especially in patients with psychosomatic component [119, 120]. In a preliminary study, hypnotic sessions including relaxing suggestions and symptoms-oriented suggestions were held as a complementary or the only treatment once every 3 weeks in patients with severe AA, alopecia totalis, or alopecia universalis. Twelve of 21 patients showed significant improvement after 4–13 (mean 5.5) sessions of hypnosis, while treatment success could not be achieved in 9 patients. But also, minimal relapses were observed in all patients responded well [121]. In another prospective cohort study, it has been suggested that hypnosis had no significant contribution on hair regrowth in patients with refractory AA [122].

Despite confusing conclusions have been reported about the efficacy in the treatment of AA, hypnosis seems to be salubrious in the treatment of both children and adolescents with trichotillomania. Cohen et al. reported that complete resolution of their complaints was seen in two children after 7–8 weeks and in one child after 16 weeks. Even if just a recurrence was observed in one patient during follow-up, the patient completely recovered again with hypnotic retreatment [123]. Iglesias A observed that three pediatric cases completely disappeared to their trichotillomania behavior after 7 or less hypnotic sessions [124]. In addition to children, hair pulling was significantly reduced with imaginative techniques in adolescents with trichotillomania [125]. According to these results, hypnotherapeutic approach can be considered as a quite effective and preferred option in both children and adolescents with trichotillomania.

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3. Side effects

The side effects reported after CAM is often minimal. Contact dermatitis was reported with onion juice in patients with AA, thus patients should be informed about skin irritation on the skin surface in contact with the onion juice (Figure 1) [53]. S. repens that can be used as both orally and topically may cause undesirable adverse effects such as mild stomach discomfort, contact dermatitis, feeling of coldness, mild burning sensation, undesirable smell, itching, and acne [63, 65, 66]. Vasovagal events, local infections, damage to internal organs, pneumothorax, spinal cord injury, and hepatitis B infection are some of the side effects that can be encountered after acupuncture therapy [116]. Prurigo nodularis also reported on extremities of a patient shortly after acupuncture [126].

Figure 1.

Contact dermatitis developed after topical application of onion and garlic on face of a patient with AA.

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4. Conclusion

In recent years, although the increasingly widespread use of CAM, scientific data are still not enough. The observed results with herbal medicine are promising in the treatment of hair loss, especially AGA and AA. According to acceptable results, hypnosis may be an effective and safe alternative option in patients with hair loss, especially AA and trichotillomania. Even so, there is need for more scientific data proving its effectiveness and reliability.

References

  1. 1. Patel S, Sharma V, Chauhan NS, Thakur M, Dixit VK. Hair growth: focus on herbal therapeutic agent. Curr Drug Discov Technol. 2015;12:21–42.
  2. 2. Lourith N, Kanlayavattanakul M. Hair loss and herbs for treatment. J Cosmet Dermatol. 2013;12:210–222. doi:10.1111/jocd.12051
  3. 3. Semalty M, Semalty A, Joshi GP, Rawat MS. Hair growth and rejuvenation: an overview. J Dermatolog Treat. 2011;22:123–132. doi:10.3109/09546630903578574
  4. 4. Higgins CA, Christiano AM. Regenerative medicine and hair loss: how hair follicle culture has advanced our understanding of treatment options for androgenetic alopecia. Regen Med. 2014;9:101–111. doi:10.2217/rme.13.87
  5. 5. Huang M, Zhou X. Appraisal of guidelines for androgenetic alopecia using the Appraisal of Guidelines for Research and Evaluation II instrument. J Eval Clin Pract. 2015;21:1089–1094. doi:10.1111/jep.12474
  6. 6. Prager N, Bickett K, French N, Marcovici G. A randomized, double-blind, placebo-controlled trial to determine the effectiveness of botanically derived inhibitors of 5-alpha-reductase in the treatment of androgenetic alopecia. J Altern Complement Med. 2002;8:143–152. doi:10.1089/acm.2002.8.143
  7. 7. Papadopoulos AJ, Schwartz RA, Janniger CK. Alopecia areata. Pathogenesis, diagnosis, and therapy. Am J Clin Dermatol. 2000;1:101–105.
  8. 8. Meidan VM, Touitou E. Treatments for androgenetic alopecia and alopecia areata: current options and future prospects. Drugs. 2001;61:53–69.
  9. 9. Harrison S, Sinclair R. Optimal management of hair loss (alopecia) in children. Am J Clin Dermatol. 2003;4:757–770.
  10. 10. Barikani A, Beheshti A, Javadi M, Yasi M. Knowledge, attitude and practice of general practitioners toward complementary and alternative medicine: a cross-sectional study. Acta Med Iran. 2015;53:501–506.
  11. 11. Kalaaji AN, Wahner-Roedler DL, Sood A, Chon TY, Loehrer LL, Cha SS et al. Use of complementary and alternative medicine by patients seen at the dermatology department of a tertiary care center. Complement Ther Clin Pract. 2012;18:49–53. doi:10.1016/j.ctcp.2011.05.003
  12. 12. National Institutes of Health, National Center for Complementary and Alternative Medicine (NCCAM). Complementary, alternative, or integrative health: what’s in a name? Available from: https://nccih.nih.gov/health/integrative-health. [Accessed November 14, 2014.]
  13. 13. Kim GW, Park JM, Chin HW, Ko HC, Kim MB, Kim JY et al. Comparative analysis of the use of complementary and alternative medicine by Korean patients with androgenetic alopecia, atopic dermatitis and psoriasis. J Eur Acad Dermatol Venereol. 2013;27:827–835. doi:10.1111/j.1468-3083.2012.04583.x
  14. 14. Neldner KH. Complementary and alternative medicine. Dermatol Clin. 2000;18:189–193.
  15. 15. Landis ET, Davis SA, Feldman SR, Taylor S. Complementary and alternative medicine use in dermatology in the United States. J Altern Complement Med. 2014;20:392–398. doi:10.1089/acm.2013.0327
  16. 16. Fuhrmann T, Smith N, Tausk F. Use of complementary and alternative medicine among adults with skin disease: updated results from a national survey. J Am Acad Dermatol. 2010;63:1000–1005. doi:10.1016/j.jaad.2009.12.009
  17. 17. Perry R, Dowrick C, Ernst E. Complementary medicine and general practice in an urban setting: a decade on. Prim Health Care Res Dev. 2014;15:262–267. doi:10.1017/S1463423613000182
  18. 18. Mainardi T, Kapoor S, Bielory L. Complementary and alternative medicine: herbs, phytochemicals and vitamins and their immunologic effects. J Allergy Clin Immunol. 2009;123:283–924. doi:10.1016/j.jaci.2008.12.023
  19. 19. Baron SE, Goodwin RG, Nicolau N, Blackford S, Goulden V. Use of complementary medicine among outpatients with dermatologic conditions within Yorkshire and South Wales, United Kingdom. J Am Acad Dermatol. 2005;52:589–954. doi:10.1016/j.jaad.2004.11.058
  20. 20. Malhi HK, Tu J, Riley TV, Kumarasinghe SP, Hammer KA. Tea tree oil gel for mild to moderate acne; a 12 week uncontrolled, open-label phase II pilot study. Australas J Dermatol. 2016 Mar 21. doi:10.1111/ajd.12465
  21. 21. Goddard AL, Lio PA. Alternative, complementary, and forgotten remedies for atopic dermatitis. Evid Based Complement Alternat Med. 2015;2015:676897. doi:10.1155/2015/676897
  22. 22. Bartosińska JP, Pietrzak A, Szepietowski J, Dreiher J, Maciejewski R, Chodorowska G. Traditional Chinese medicine herbs-are they safe for psoriatic patients? Folia Histochem Cytobiol. 2011;49:201–205.
  23. 23. Chen YJ, Chen YY, Wu CY, Chi CC. Oral Chinese herbal medicine in combination with phototherapy for vitiligo: a systematic review and meta-analysis of randomized controlled trials. Complement Ther Med. 2016;26:21–27. doi:10.1016/j.ctim.2016.02.009
  24. 24. Reuter J, Wölfle U, Korting HC, Schempp C. Which plant for which skin disease? Part 2: Dermatophytes, chronic venous insufficiency, photoprotection, actinic keratoses, vitiligo, hair loss, cosmetic indications. J Dtsch Dermatol Ges. 2010;8:866–873. doi:10.1111/j.1610-0387.2010.07472.x
  25. 25. Huebner J, Mohr P, Simon JC, Fluck M, Berking C, Zimmer L et al. Use of complementary medicine in metastatic melanoma patients treated with ipilimumab within a clinical trial. J Dtsch Dermatol Ges. 2016;14:508–513. doi:10.1111/ddg.12750
  26. 26. Loquai C, Dechent D, Garzarolli M, Kaatz M, Kaehler KC, Kurschat P et al. Risk of interactions between complementary and alternative medicine and medication for comorbidities in patients with melanoma. Med Oncol. 2016;33:52. doi:10.1007/s12032-016-0764-6
  27. 27. Ernst E. The usage of complementary therapies by dermatological patients: a systematic review. Br J Dermatol. 2000;142:857–861.
  28. 28. See A, Teo B, Kwan R, Lim R, Lee J, Tang MB et al. Use of complementary and alternative medicine among dermatology outpatients in Singapore. Australas J Dermatol. 2011;52:7–13. doi:10.1111/j.1440-0960.2010.00709.x
  29. 29. Chen YF, Chang JS. Complementary and alternative medicine use among patients attending a hospital dermatology clinic in Taiwan. Int J Dermatol. 2003;42:616–621.
  30. 30. Gönül M, Gül U, Cakmak SK, Kiliç S. Unconventional medicine in dermatology outpatients in Turkey. Int J Dermatol. 2009;48:639–644. doi:10.1111/j.1365-4632.2009.04043.x
  31. 31. Bilgili SG, Ozkol HU, Karadag AS, Calka O. The use of complementary and alternative medicine among dermatology outpatients in Eastern Turkey. Hum Exp Toxicol. 2014;33:214–221. doi:10.1177/0960327113494904
  32. 32. Sivamani RK, Morley JE, Rehal B, Armstrong AW. Comparative prevalence of complementary and alternative medicine use among outpatients in dermatology and primary care clinics. JAMA Dermatol. 2014;150:1363–1365. doi:10.1001/jamadermatol.2014.2274
  33. 33. Thas JJ. Siddha medicine—background and principles and the application for skin diseases. Clin Dermatol. 2008;26:62–78. doi:10.1016/j.clindermatol.2007.11.010
  34. 34. Zhang NN, Park DK, Park HJ. Hair growth-promoting activity of hot water extract of Thuja orientalis. BMC Complement Altern Med. 2013;13:9. doi:10.1186/1472-6882-13-9
  35. 35. Naser B, Bodinet C, Tegtmeier M, Lindequist U. Thuja occidentalis (Arbor vitae): a review of its pharmaceutical, pharmacological and clinical properties. Evid Based Complement Alternat Med. 2005;2:69–78. doi:10.1093/ecam/neh065
  36. 36. Park WS, Lee CH, Lee BG, Chang IS. The extract of Thujae occidentalis semen inhibited 5alpha-reductase and androchronogenetic alopecia of B6CBAF1/j hybrid mouse. J Dermatol Sci. 2003;31:91–98.
  37. 37. Seo SR, Kang G, Ha JW, Kim JC. In vivo hair growth-promoting efficacies of herbal extracts and their cubosomal suspensions. J Ind Eng Chem. 2013;19:1331–1339. doi:10.1016/j.jiec.2012.12.037
  38. 38. Roy RK, Thakur M, Dixit VK. Effect of Citrullus colocynthis on hair growth in albino rats. Pharm Biol. 2007;45:739–744. doi:10.1080/13880200701585709
  39. 39. Dhanotia R, Chauhan NS, Saraf DK, Dixit VK. Effect of Citrullus colocynthis Schrad fruits on testosterone-induced alopecia. Nat Prod Res. 2011;25:1432–1443. doi:10.1080/14786410802632820
  40. 40. Roy RK, Thakur M, Dixit VK. Development and evaluation of polyherbal formulation for hair growth-promoting activity. J Cosmet Dermatol. 2007;6:108–112. doi:10.1111/j.1473-2165.2007.00305.x
  41. 41. Ulbricht C, Abrams TR, Brigham A, Ceurvels J, Clubb J, Curtiss W et al. An evidence-based systematic review of rosemary (Rosmarinus officinalis) by the Natural Standard Research Collaboration. J Diet Suppl. 2010;7:351–413. doi:10.3109/19390211.2010.525049
  42. 42. Angioni A, Barra A, Cereti E, Barile D, Coïsson JD, Arlorio M et al. Chemical composition, plant genetic differences, antimicrobial and antifungal activity investigation of the essential oil of Rosmarinus officinalis L. J Agric Food Chem. 2004;52:3530–3535. doi:10.1021/jf049913t
  43. 43. Murata K, Noguchi K, Kondo M, Onishi M, Watanabe N, Okamura K et al. Promotion of hair growth by Rosmarinus officinalis leaf extract. Phytother Res. 2013;27:212–217. doi:10.1002/ptr.4712
  44. 44. Suzuki Y, Miyoshi N, Isemura M. Health-promoting effects of green tea. Proc Jpn Acad Ser B Phys Biol Sci. 2012;88:88–101.
  45. 45. Zink A, Traidl-Hoffmann C. Green tea in dermatology—myths and facts. J Dtsch Dermatol Ges. 2015;13:768–775. doi:10.1111/ddg.12737
  46. 46. Barbosa NS, Kalaaji AN. CAM use in dermatology. Is there a potential role for honey, green tea, and vitamin C? Complement Ther Clin Pract. 2014;20:11–15. doi:10.1016/j.ctcp.2013.11.003
  47. 47. Baumann LS. Less-known botanical cosmeceuticals. Dermatol Ther. 2007;20:330–342. doi:10.1111/j.1529-8019.2007.00147.x
  48. 48. Kwon OS, Han JH, Yoo HG, Chung JH, Cho KH, Eun HC et al. Human hair growth enhancement in vitro by green tea epigallocatechin-3-gallate (EGCG). Phytomedicine. 2007;14:551–555. doi:10.1016/j.phymed.2006.09.009
  49. 49. Esfandiari A, Kelly AP. The effects of tea polyphenolic compounds on hair loss among rodents. J Natl Med Assoc. 2005;97:1165–1169.
  50. 50. Sinn BT, Kelly LM, Freudenstein JV. Phylogenetic relationships in Asarum: effect of data partitioning and a revised classification. Am J Bot. 2015;102:765–779. doi:10.3732/ajb.1400316
  51. 51. Oh SM, Kim J, Lee J, Yi JM, Oh DS, Bang OS et al. Anticancer potential of an ethanol extract of Asiasari radix against HCT-116 human colon cancer cells in vitro. Oncol Lett. 2013;5:305–310. doi:10.3892/ol.2012.1012
  52. 52. Rho SS, Park SJ, Hwang SL, Lee MH, Kim CD, Lee IH, Chang SY, Rang MJ. The hair growth promoting effect of Asiasari radix extract and its molecular regulation. J Dermatol Sci. 2005;38:89–97. doi:10.1016/j.jdermsci.2004.12.025
  53. 53. Sharquie KE, Al-Obaidi HK. Onion juice (Allium cepa L.), a new topical treatment for alopecia areata. J Dermatol. 2002;29:343–346.
  54. 54. Sengupta A, Ghosh S, Bhattacharjee S. Allium vegetables in cancer prevention: an overview. Asian Pac J Cancer Prev. 2004;5:237–245.
  55. 55. Park HJ, Zhang N, Park DK. Topical application of Polygonum multiflorum extract induces hair growth of resting hair follicles through upregulating Shh and β-catenin expression in C57BL/6 mice. J Ethnopharmacol. 2011;135:369–375. doi:10.1016/j.jep.2011.03.028
  56. 56. Lin L, Ni B, Lin H, Zhang M, Li X, Yin X et al. Traditional usages, botany, phytochemistry, pharmacology and toxicology of Polygonum multiflorum Thunb.: a review. J Ethnopharmacol. 2015;159:158–183. doi:10.1016/j.jep.2014.11.009
  57. 57. Sun YN, Cui L, Li W, Yan XT, Yang SY, Kang JI et al. Promotion effect of constituents from the root of Polygonum multiflorum on hair growth. Bioorg Med Chem Lett. 2013;23:4801–4805. doi:10.1016/j.bmcl.2013.06.098
  58. 58. Li Y, Han M, Lin P, He Y, Yu J, Zhao R. Hair growth promotion activity and its mechanism of polygonum multiflorum. Evid Based Complement Alternat Med. 2015;2015:517901. doi:10.1155/2015/517901
  59. 59. Park KM, Kim DW, Lee SH. Extract of Allium tuberosum Rottler ex Spreng promoted the hair growth through regulating the expression of IGF-1. Evid Based Complement Alternat Med. 2015;2015:413538. doi:10.1155/2015/413538
  60. 60. Cho YH, Lee SY, Jeong DW, Choi EJ, Kim YJ, Lee JG et al. Effect of pumpkin seed oil on hair growth in men with androgenetic alopecia: a randomized, double-blind, placebo-controlled trial. Evid Based Complement Alternat Med. 2014;2014:549721. doi:10.1155/2014/549721
  61. 61. Khalaf EM, Raizada MN. Taxonomic and functional diversity of cultured seed associated microbes of the cucurbit family. BMC Microbiol. 2016;16:131. doi:10.1186/s12866-016-0743-2
  62. 62. Rossi A, Mari E, Scarno M, Garelli V, Maxia C, Scali E et al. Comparitive effectiveness of finasteride vs Serenoa repens in male androgenetic alopecia: a two-year study. Int J Immunopathol Pharmacol. 2012;25:1167–1173.
  63. 63. Murugusundram S. Serenoa Repens: Does it have any role in the management of androgenetic alopecia? J Cutan Aesthet Surg. 2009;2:31–32. doi:10.4103/0974-2077.53097
  64. 64. Chittur S, Parr B, Marcovici G. Inhibition of inflammatory gene expression in keratinocytes using a composition containing carnitine, thioctic acid and saw palmetto extract. Evid Based Complement Alternat Med. 2011;2011:985345. doi:10.1093/ecam/nep102
  65. 65. Wessagowit V, Tangjaturonrusamee C, Kootiratrakarn T, Bunnag T, Pimonrat T, Muangdang N et al. Treatment of male androgenetic alopecia with topical products containing Serenoa repens extract. Australas J Dermatol. 2016;57:76–82. doi:10.1111/ajd.12352
  66. 66. Sinclair RD, Mallari RS, Tate B. Sensitization to saw palmetto and minoxidil in separate topical extemporaneous treatments for androgenetic alopecia. Australas J Dermatol. 2002;43:311–312.
  67. 67. Shin BK, Kwon SW, Park JH. Chemical diversity of ginseng saponins from Panax ginseng. J Ginseng Res. 2015;39:287–298. doi:10.1016/j.jgr.2014.12.005
  68. 68. Ru W, Wang D, Xu Y, He X, Sun YE, Qian L et al. Chemical constituents and bioactivities of Panax ginseng (C. A. Mey.). Drug Discov Ther. 2015;9:23–32. doi:10.5582/ddt.2015.01004
  69. 69. Park GH, Park KY, Cho HI, Lee SM, Han JS, Won CH et al. Red ginseng extract promotes the hair growth in cultured human hair follicles. J Med Food. 2015;18:354–362. doi:10.1089/jmf.2013.3031
  70. 70. Ryu HJ, Yoo MG, Son SW. The efficacy of 3% minoxidil vs. combined 3% minoxidil and Korean red ginseng in treating female pattern alopecia. Int J Dermatol. 2014;53:340–342. doi:10.1111/ijd.12359
  71. 71. Oh GN, Son SW. Efficacy of korean red ginseng in the treatment of alopecia areata. J Ginseng Res. 2012;36:391–395. doi:10.5142/jgr.2012.36.4.391
  72. 72. Shin DH, Cha YJ, Yang KE, Jang IS, Son CG, Kim BH et al. Ginsenoside Rg3 up-regulates the expression of vascular endothelial growth factor in human dermal papilla cells and mouse hair follicles. Phytother Res. 2014;28:1088–1095. doi:10.1002/ptr.5101
  73. 73. Park S, Shin WS, Ho J. Fructus panax ginseng extract promotes hair regeneration in C57BL/6 mice. J Ethnopharmacol. 2011;138:340–344. doi:10.1016/j.jep.2011.08.013
  74. 74. Jahan R, Al-Nahain A, Majumder S, Rahmatullah M. Ethnopharmacological significance of Eclipta alba (L.) Hassk. (Asteraceae). Int Sch Res Notices. 2014;2014:385969. doi:10.1155/2014/385969
  75. 75. Datta K, Singh AT, Mukherjee A, Bhat B, Ramesh B, Burman AC. Eclipta alba extract with potential for hair growth promoting activity. J Ethnopharmacol. 2009;124:450–456. doi:10.1016/j.jep.2009.05.023
  76. 76. Begum S, Lee MR, Gu LJ, Hossain J, Sung CK. Exogenous stimulation with Eclipta alba promotes hair matrix keratinocyte proliferation and downregulates TGF-β1 expression in nude mice. Int J Mol Med. 2015;35:496–502. doi:10.3892/ijmm.2014.2022
  77. 77. Roy RK, Thakur M, Dixit VK. Hair growth promoting activity of Eclipta alba in male albino rats. Arch Dermatol Res. 2008;300:357–364. doi:10.1007/s00403-008-0860-3
  78. 78. Tahergorabi Z, Abedini MR, Mitra M, Fard MH, Beydokhti H. “Ziziphus jujuba”: a red fruit with promising anticancer activities. Pharmacogn Rev. 2015;9:99–106. doi:10.4103/0973-7847.162108
  79. 79. Yoon JI, Al-Reza SM, Kang SC. Hair growth promoting effect of Zizyphus jujuba essential oil. Food Chem Toxicol. 2010;48:1350–1354. doi:10.1016/j.fct.2010.02.036
  80. 80. Pazyar N, Feily A. Garlic in dermatology. Dermatol Rep. 2011;3:e4. doi:10.4081/dr.2011.e4
  81. 81. Hajheydari Z, Jamshidi M, Akbari J, Mohammadpour R. Combination of topical garlic gel and betamethasone valerate cream in the treatment of localized alopecia areata: a double-blind randomized controlled study. Indian J Dermatol Venereol Leprol. 2007;73:29–32.
  82. 82. Jain R, Monthakantirat O, Tengamnuay P, De-Eknamkul W. Avicequinone C isolated from Avicennia marina exhibits 5α-reductase-type 1 inhibitory activity using an androgenic alopecia relevant cell-based assay system. Molecules. 2014;19:6809–6821. doi:10.3390/molecules19056809
  83. 83. Jain R, Monthakantirat O, Tengamnuay P, De-Eknamkul W. Identification of a new plant extract for androgenic alopecia treatment using a non-radioactive human hair dermal papilla cell-based assay. BMC Complement Altern Med. 2016;16:18. doi:10.1186/s12906-016-1004-5
  84. 84. Mao X, Wu LF, Guo HL, Chen WJ, Cui YP, Qi Q et al. The genus Phyllanthus: an ethnopharmacological, phytochemical, and pharmacological review. Evid Based Complement Alternat Med. 2016;2016:7584952. doi:10.1155/2016/7584952
  85. 85. Patel S, Sharma V, S Chauhan N, Thakur M, Dixit VK. Evaluation of hair growth promoting activity of Phyllanthus niruri. Avicenna J Phytomed. 2015;5:512–519.
  86. 86. Choi JS, Jeon MH, Moon WS, Moon JN, Cheon EJ, Kim JW et al. In vivo hair growth-promoting effect of rice bran extract prepared by supercritical carbon dioxide fluid. Biol Pharm Bull. 2014;37:44–53.
  87. 87. Goufo P, Trindade H. Rice antioxidants: phenolic acids, flavonoids, anthocyanins, proanthocyanidins, tocopherols, tocotrienols, γ-oryzanol, and phytic acid. Food Sci Nutr. 2014;2:75–104. doi:10.1002/fsn3.86
  88. 88. Choi JS, Park JB, Moon WS, Moon JN, Son SW, Kim MR. Safety and efficacy of rice bran supercritical CO2 extract for hair growth in androgenic alopecia: a 16-week double-blind randomized controlled trial. Biol Pharm Bull. 2015;38:1856–1863. doi:10.1248/bpb.b15-00387
  89. 89. Takahashi T, Ishino A, Arai T, Hamada C, Nakazawa Y, Iwabuchi T et al. Improvement of androgenetic alopecia with topical Sophora flavescens Aiton extract, and identification of the two active compounds in the extract that stimulate proliferation of human hair keratinocytes. Clin Exp Dermatol. 2016;41:302–307. doi:10.1111/ced.12753
  90. 90. Zheng K, Li C, Shan X, Liu H, Fan W, Wang Z. A study on isolation of chemical constituents from Sophora flavescens Ait. and their anti-glioma effects. Afr J Tradit Complement Altern Med. 2013;11:156–160.
  91. 91. Wang L, Li F, Lu J, Li G, Li D, Zhong XB et al. The Chinese herbal medicine Sophora flavescens activates pregnane X receptor. Drug Metab Dispos. 2010;38:2226–2231. doi:10.1124/dmd.110.035253
  92. 92. Park MJ, Han JS. Protective effects of the fermented Laminaria japonica extract on oxidative damage in LLC-PK1 cells. Prev Nutr Food Sci. 2013;18:227–233. doi:10.3746/pnf.2013.18.4.227
  93. 93. Park SK, Park SJ, Park SM, Cho IJ, Park CI, Kim YW et al. Inhibition of acute phase inflammation by Laminaria japonica through regulation of iNOS-NF- κ B pathway. Evid Based Complement Alternat Med. 2013;2013:439498. doi:10.1155/2013/439498
  94. 94. Shin K, Kim TS, Kyung J, Kim D, Park D, Choi EK et al. Effectiveness of the combinational treatment of Laminaria japonica and Cistanche tubulosa extracts in hair growth. Lab Anim Res. 2015;31:24–32. doi:10.5625/lar.2015.31.1.24
  95. 95. Begum S, Gu LJ, Lee MR, Li Z, Li JJ, Hossain MJ et al. In vivo hair growth-stimulating effect of medicinal plant extract on BALB/c nude mice. Pharm Biol. 2015;53:1098–1103. doi:10.3109/13880209.2014.959614
  96. 96. Chang KM, Kim GH. Volatiles of Chrysanthemum zawadskii var. latilobum K. Prev Nutr Food Sci. 2012;17:234–238. doi:10.3746/pnf.2012.17.3.234
  97. 97. Guo X, Wang X, Su W, Zhang G, Zhou R. DNA barcodes for discriminating the medicinal plant Scutellaria baicalensis (Lamiaceae) and its adulterants. Biol Pharm Bull. 2011;34:1198–203.
  98. 98. Kim AR, Kim SN, Jung IK, Kim HH, Park YH, Park WS. The inhibitory effect of Scutellaria baicalensis extract and its active compound, baicalin, on the translocation of the androgen receptor with implications for preventing androgenetic alopecia. Planta Med. 2014;80:153–158. doi:10.1055/s-0033-1360300
  99. 99. Patel S, Sharma V, Chauhan NS, Dixit VK. A study on the extracts of Cuscuta reflexa Roxb. in treatment of cyclophosphamide induced alopecia. Daru. 2014;22:7. doi:10.1186/2008-2231-22-7
  100. 100. Patel S, Sharma V, Chauhan NS, Dixit VK. An updated review on the parasitic herb of Cuscuta reflexa Roxb. Zhong Xi Yi Jie He Xue Bao. 2012;10:249–255.
  101. 101. Pandit S, Chauhan NS, Dixit VK. Effect of Cuscuta reflexa Roxb on androgen-induced alopecia. J Cosmet Dermatol. 2008;7:199–204. doi:10.1111/j.1473-2165.2008.00389.x
  102. 102. Kang JI, Kim EJ, Kim MK, Jeon YJ, Kang SM, Koh YS et al. The promoting effect of Ishige sinicola on hair growth. Mar Drugs. 2013;11:1783–1799. doi:10.3390/md11061783
  103. 103. Cho M, Park GM, Kim SN, Amna T, Lee S, Shin WS. Glioblastoma-specific anticancer activity of pheophorbide a from the edible red seaweed Grateloupia elliptica. J Microbiol Biotechnol. 2014;24:346–353.
  104. 104. Kang JI, Kim SC, Han SC, Hong HJ, Jeon YJ, Kim B et al. Hair-loss preventing effect of Grateloupia elliptica. Biomol Ther (Seoul). 2012;20:118–124. doi:10.4062/biomolther.2012.20.1.118
  105. 105. Murata K, Noguchi K, Kondo M, Onishi M, Watanabe N, Okamura K et al. Inhibitory activities of Puerariae Flos against testosterone 5α-reductase and its hair growth promotion activities. J Nat Med. 2012;66:158–165. doi:10.1007/s11418-011-0570-6
  106. 106. Shin JE, Bae EA, Lee YC, Ma JY, Kim DH. Estrogenic effect of main components kakkalide and tectoridin of Puerariae Flos and their metabolites. Biol Pharm Bull. 2006;29:1202–1206.
  107. 107. Pumthong G, Asawanonda P, Varothai S, Jariyasethavong V, Triwongwaranat D, Suthipinittharm P et al. Curcuma aeruginosa, a novel botanically derived 5α-reductase inhibitor in the treatment of male-pattern baldness: a multicenter, randomized, double-blind, placebo-controlled study. J Dermatolog Treat. 2012;23:385–392. doi:10.3109/09546634.2011.568470
  108. 108. Hossain CF, Al-Amin M, Sayem AS, Siragee IH, Tunan AM, Hassan F et al. Antinociceptive principle from Curcuma aeruginosa. BMC Complement Altern Med. 2015;15:191. doi:10.1186/s12906-015-0720-6
  109. 109. Uchiyama C, Ishida K, Tsutsui T, Naito A, Kurita K, Hanihara H et al. Effects of Hura crepitans and its active ingredient, daphne factor F3, on dihydrotestosterone-induced neurotrophin-4 activation and hair retardation. Biol Pharm Bull. 2012;35:42–47.
  110. 110. Barbieri L, Falasca A, Franceschi C, Licastro F, Rossi CA, Stirpe F. Purification and properties of two lectins from the latex of the euphorbiaceous plants Hura crepitans L. (sand-box tree) and Euphorbia characias L. (Mediterranean spurge). Biochem J. 1983;215:433–439.
  111. 111. Murkute AV, Sahu MS, Mali PY, Rangari VD. Development and evaluation of formulations of microbial biotransformed extract of tobacco leaves for hair growth potential. Pharmacognosy Res. 2010;2:300–303. doi:10.4103/0974-8490.72328
  112. 112. Talianova M, Janousek B. What can we learn from tobacco and other Solanaceae about horizontal DNA transfer? Am J Bot. 2011;98:1231–1242. doi:10.3732/ajb.1000370
  113. 113. Jaybhaye D, Varma S, Gagne N, Bonde V, Gite A, Bhosle D. Effect of Tectona grandis Linn. seeds on hair growth activity of albino mice. Int J Ayurveda Res. 2010;1:211–215. doi:10.4103/0974-7788.76783
  114. 114. Nayeem N, Karvekar M. Anti microbial and anti-oxidant properties of the isolated compounds from the methanolic extract from the leaves of Tectona grandis. J Basic Clin Pharm. 2011;2:163–165.
  115. 115. Shimizu K, Kondo R, Sakai K, Shoyama Y, Sato H, Ueno T. Steroid 5alpha-reductase inhibitory activity and hair regrowth effects of an extract from Boehmeria nipononivea. Biosci Biotechnol Biochem. 2000;64:875–877.
  116. 116. Tan EK, Millington GW, Levell NJ. Acupuncture in dermatology: an historical perspective. Int J Dermatol. 2009;48:648–652. doi:10.1111/j.1365-4632.2009.03899.x
  117. 117. Lee HW, Jun JH, Lee JA, Lim HJ, Lim HS, Lee MS. Acupuncture for treating alopecia areata: a protocol of systematic review of randomised clinical trials. BMJ Open. 2015;5:e008841. doi:10.1136/bmjopen-2015-008841
  118. 118. Maeda T, Taniguchi M, Matsuzaki S, Shingaki K, Kanazawa S, Miyata S. Anti-inflammatory effect of electroacupuncture in the C3H/HeJ mouse model of alopecia areata. Acupunct Med. 2013;31:117–119. doi:10.1136/acupmed-2012-010240
  119. 119. Shenefelt PD. Hypnosis in dermatology. Arch Dermatol. 2000;136:393–399.
  120. 120. Häuser W, Hagl M, Schmierer A, Hansen E. The efficacy, safety and applications of medical hypnosis. Dtsch Arztebl Int. 2016;113:289–296. doi:10.3238/arztebl.2016.0289
  121. 121. Willemsen R, Vanderlinden J, Deconinck A, Roseeuw D. Hypnotherapeutic management of alopecia areata. J Am Acad Dermatol. 2006;55:233–237. doi:10.16/j.jaad.2005.09.025
  122. 122. Willemsen R, Haentjens P, Roseeuw D, Vanderlinden J. Hypnosis in refractory alopecia areata significantly improves depression, anxiety, and life quality but not hair regrowth. J Am Acad Dermatol. 2010;62:517–518. doi:10.1016/j.jaad.2009.06.029
  123. 123. Cohen HA, Barzilai A, Lahat E. Hypnotherapy: an effective treatment modality for trichotillomania. Acta Paediatr. 1999;88:407–410.
  124. 124. Iglesias A. Hypnosis as a vehicle for choice and self-agency in the treatment of children with Trichotillomania. Am J Clin Hypn. 2003;46:129–137. doi:10.1080/00029157.2003.10403583
  125. 125. Zalsman G, Hermesh H, Sever J. Hypnotherapy in adolescents with trichotillomania: three cases. Am J Clin Hypn. 2001;44:63–68. doi:10.1080/00029157.2001.10403457
  126. 126. Almazan TH, Jung JY. Prurigo nodularis after acupuncture. JAAD Case Rep. 2015;1:345–347. doi:10.1016/j.jdcr.2015.08.004

Written By

Gurkan Yardimci

Submitted: 13 June 2016 Reviewed: 27 October 2016 Published: 03 May 2017

© 2017 The Author(s). Licensee IntechOpen. This chapter is distributed under the terms of the Creative Commons Attribution 3.0 License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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