interleukins (IL-2, IL-6, IL-12, IL-23) and interfer­ons (IFN-γ) [10]. These pathways are implicated in inammatory and autoimmune conditions:

for bone grafting procedures, noting its potential in improving bone healing.

males with AGA were compared with 108 con­trols not affected by AGA.After controlling for age, education, body mass index, family history of AGA, the researchers found there were protec­tive effects for AGA with high consumption (>3× weekly) of raw vegetables and fresh herbs (>3× weekly) [2].

Supplements represent an easier way for patients who do not want to make major lifestyle changes. A number of supplements covered here are touted for their anti-oxidant effects, which can translate to a positive effect on the hair folli­cles. Likewise, some are known for their anti­apoptotic effects, because they can slow the senescence or aging of the hair follicle. Table7.1 provides a listing of the important mechanisms affecting hair growth are described. In addition, many hair growth supplements specically touted to improve androgenetic alopecia, can block 5α-reductase, the enzyme responsible for con­verting testosterone to di-hydro testosterone (DHT). By lowering DHT levels some of these supplements can represent plant-based alterna­tives to nasteride or dutasteride. Table7.2 pro­vides a listing of plant ingredients with known 5α-reductase inhibiting properties. Most of the nutraceutical ingredients we discuss appear to have multiple mechanisms by which they exert their effect on hair follicles.

some efcacy in treating both benign prostatic hypertrophy (BPH) and hair loss. In fact, a num­ber of such supplements are already marketed over the counter either alone or in combination for the treatment of both conditions. The mecha­nism by which these ingredients work is to block 5α-reductase, the enzyme that converts testoster­one to dihydrotestosterone (DHT). Pattern hair loss develops in patients with increased sensitiv­ity to DHT, and the therapeutic lowering of DHT levels can help reverse this hair miniaturization process.

plant used in Chinese medicine that can promote conversion of telogen to anagen when applied to the backs of C57BL/6 mice. RT-PCR analysis showed that it could induce mRNA levels of growth factors such as IGF-1 and KGF in dermal papilla cells, and that the extract could inhibit type II 5α-reductase [33]. The extract of black pepper (Piper nigrum) has demonstrated anti­androgenic activity in vivo. Piperine is a major alkaloid amide found in the P. nigrum fruit and this can inhibit 5α-reductase [34].