An Approach to Hair Loss and its Management in Persian Medicine

  • Narjes Gorji Traditional Medicine and History of Medical Sciences Research Center, Institute of Health, Babol University of Medical Science, Babol, Iran
  • Maryam Naeimi Student Research Committee, Babol University of Medical Sciences, Babol, Iran
  • Reihaneh Moeini Traditional Medicine and History of Medical Sciences Research Center, Institute of Health, Babol University of Medical Science, Babol, Iran
  • Zahra Memariani Traditional Medicine and History of Medical Sciences Research Center, Institute of Health, Babol University of Medical Science, Babol, Iran
  • Fatemeh Kolangi Student Research Committee, Babol University of Medical Sciences, Babol, Iran
Keywords: Hair loss; Medicinal plants; Persian Medicine


Hair loss is a common problem among more than half of the world's population. The present study aimed to review and assess the etiologies, symptoms and basics of its treatment according to Persian medicine (PM). The main PM books including  the Canon of Medicine, Zakhireh Kharazmshahi, Moalejat-e Aghili, Exir-e A’zam, Teb-e Akbari and Makhzan al-adviyah were searched and the related content on hair loss have been extracted. According to PM textbooks, the causes of hair loss can be divided into four categories: skin and hair nutrition disorders (low quality and quantity of nutrients, basal metabolism disorder, circulation of nutrients and skin absorption), skin pore problems (dilation and obstruction), inflammation, and environmental damage. To differentiate the above causes, several symptoms such as hair strand diameters, greasy or dry hair, the scalp condition at the affected area and general symptoms such as weakness and exhaustion were considered. In modern medicine sources, several causes are mentioned to be involved in the process of hair loss including nutritional disorders and anemia, hormonal disorders like thyroid problems, genetics and environmental factors. Applying topical oils of Myrtle, Emblic myrobalan, Myrobalan, Acacia, Oak gall, Lotus, and Violet, as well as the mucilage of marshmallow, common mallow, Psyllium and also labdanum along with nutrition correction and consumption of nutritious foods such as almond, currant and walnut based on the type of hair loss have been recommended. Considering that the causes of hair loss in PM and modern medicine are similar, it seems that therapeutic recommendations of PM provide a suitable ground for future studies.


[1] Vary Jr JC. Selected disorders of skin appendages-acne, alopecia, hyperhidrosis. Med Clin North Am 2016;99:1195-1211.
[2] Biondo S, Goble D, Sinclair R. Women who present with female pattern hair loss tend to underestimate the severity of their hair loss. Br J Dermatol 2004;150:750-752.
[3] Paus R, Cotsarelis G. The biology of hair follicles. N Engl J Med 1999;341:491-497.
[4] Rile N, Liu Z, Gao L, Qi J, Zhao M, Xie Y, Su R, Zhang Y, Wang R, Li J, Xiao H. Expression of Vimentin in hair follicle growth cycle of inner Mongolian Cashmere goats. BMC genomics 2018;19:38.
[5] Sinclair R, Torkamani N, Jones L. Androgenetic alopecia: new insights into the pathogenesis and mechanism of hair loss. F1000Research 2015;4:585.
[6] Duverger O, Morasso MI. To grow or not to grow: hair morphogenesis and human genetic hair disorders. Semin Cell Dev Biol 2014;25-26:22-33.
[7] Blaydon DC, Biancheri P, Di WL, Plagnol V, Cabral RM, Brooke MA. Inflammatory skin and bowel disease linked to ADAM17 deletion. N Engl J Med 2011;365:1502-1508.
[8] Shimomura Y, Agalliu D, Vonica A, Luria V, Wajid M, Baumer A. APCDD1 is a novel Wnt inhibitor mutated in hereditary hypotrichosis simplex. Nature 2010;464:1043-1047.
[9] Bal E, Baala L, Cluzeau C, El Kerch F, Ouldim K, Hadj-Rabia S. Autosomal dominant anhidrotic ectodermal dysplasias at the EDARADD locus. Hum Mutat 2007;28:703-709.
[10] Kishimoto J, Burgeson RE, Morgan BA. Wnt signaling maintains the hair-inducing activity of the dermal papilla. Genes & development 2000;14:1181-1185.
[11] Kitagawa T, Matsuda K-I, Inui S, Takenaka H, Katoh N, Itami S, et al. Keratinocyte growth inhibition through the modification of Wnt signaling by androgen in balding dermal papilla cells. J Clin Endocrinol Metab 2009;94:1288-1294.
[12] Zimber MP, Ziering C, Zeigler F, Hubka M, Mansbridge JN, Baumgartner M. Hair regrowth following a Wnt-and follistatin containing treatment: safety and efficacy in a first-in-man phase 1 clinical trial. J Drug Dermatol 2011;10:1308-1312.
[13] Heilmann S, Kiefer AK, Fricker N, Drichel D, Hillmer AM, Herold C. Androgenetic alopecia: identification of four genetic risk loci and evidence for the contribution of WNT signaling to its etiology. J Invest Dermatol 2013;133:1489-1496.
[14] Su L-H, Chen L-S, Chen H-H. Factors associated with female pattern hair loss and its prevalence in Taiwanese women: a community-based survey. J Am Acad Dermatol 2013;69:e69-e77.
[15] Cheshti MA. Exir-e Azam (Azam’s Elixir). Iran University of Medical Science, Institute for Islamic and Complementary Medicine. Tehran 2007.
[16] Aghili Khorasani MH. Moalejat-e Aghili. 2nd ed. Research Institute for Islamic and Complementary Medicine. Tehran 2009 (in Persian).
[17] Sundberg JP, McElwee KJ, Carroll JM, Oliver RF, Shapiro J, Bissonnette R, McLean DI, Tang L, Lui H. Alopecia areata-like hair loss in C3H/HeJ mice and DEBR rats can be reversed using topical diphencyprone. J Investig Dermatol Symp Proc 1999;4:239.
[18] Arzani MA. Akbari Medicine (Tebbe Akbari). Jalal al-Din. Qom 2008.
[19] Gowda D, Premalatha V, Imtiyaz D. Prevalence of nutritional deficiencies in hair loss among Indian participants: Results of a cross-sectional study. Int J Trichology 2017;9:101.
[20] Rushton D. Nutritional factors and hair loss. Clin Exp Dermatol 2002;27:396-404.
[21] Del Campo R, Zhang Y, Wakeford C. Effect of Miracle Fruit (Synsepalum dulcificum) Seed Oil (MFSO®) on the Measurable Improvement of Hair Breakage in Women with Damaged Hair: A Randomized, Double-blind, Placebo-controlled, Eight-month Trial. J Clin Aesthet Dermatol 2017;10:39.
[22] Minae MB, Soltani S, Besharat M, Karimi F, Nazem E. Temperament determination for melatonin: a bridge from Iranian traditional to modern sleep medicine. Afr J Tradit Complement Altern Med 2013;10:340-342
[23] Moeini R, Memariani Z, Pasalar P, Gorji N. Historical root of precision medicine: an ancient concept concordant with the modern pharmacotherapy. Daru 2017;25:7.
[24] Rezadoost H, Karimi M, Jafari M. Proteomics of hot-wet and cold-dry temperaments proposed in Iranian traditional medicine: a Network-based Study. Sci Rep 2016;6:30133.
[25] Parvinroo S, Zahediasl S, Sabetkasaei M, Kamalinejad M, Naghibi F. The effects of selected hot and cold temperament herbs based on Iranian traditional medicine on some metabolic parameters in normal rats. Iran J Pharm Res 2014;13:177.
[26] Parvizi MM, Salehi A, Nimroozi M, Hajimonfarednejad M, Amini F, Parvizi Z. The relationship between body mass index and temperament, based on the knowledge of traditional Persian medicine. Iran J Med Sci 2016;41:S14.
[27] Rexbye H, Petersen I, Iachina M, Mortensen J, McGue M, Vaupel JW. Hair loss among elderly men: etiology and impact on perceived age. J Gerontol A Biol Sci Med Sci 2005;60:1077-1082.
[28] Leyden J, Dunlap F, Miller B, Winters P, Lebwohl M, Hecker D. Finasteride in the treatment of men with frontal male pattern hair loss. J Am Acad Dermatol 1999;40:930-937.
[29] Messenger A, Rundegren J. Minoxidil: mechanisms of action on hair growth. Br J Dermatol 2004;150:186-194.
[30] Jabbari A, Sansaricq F, Cerise J, Chen J, Bitterman A, Ulerio G, et al. An Open-Label Pilot Study to Evaluate the Efficacy of Tofacitinib in Moderate to Severe Patch Type Alopecia Areata, Totalis and Universalis. J Invest Dermatol 2018;138:1539-1545.
[31] Porter D, Burton J. A comparison of intra‐lesional triaminolone hexa‐cetonide and triamcinolone acetonide in alopecia areata. Br J Dermatol 1971;85:272-273.
[32] Joshi S, Thatte U. Pharmacological Evaluation of Cytoprotective Potential of Phyllanthus Emblica (PE) and Asparagus Racemosus (AR) in Preventing Gastric Erosions, Ulcerations and Inflammation induced in Rats. Natl J Physiol Pharm Pharmacol 2012;2:18-22.
[33] Hosseinzadeh H, Khoshdel M, Ghorbani M. Antinociceptive, anti-inflammatory effects and acute toxicity of aqueous and ethanolic extracts of Myrtus communis L. aerial parts in mice. J Acupunct Meridian Stud 2011;4:242-247.
[34] Jarrahi M. An experimental study of the effects of Matricaria chamomilla extract on cutaneous burn wound healing in albino rats. Nat Prod Res 2008;22:422-427.
[35] Burke B, Cunliffe W. Oral spironolactone therapy for female patients with acne, hirsutism or androgenic alopecia. Br J Dermatol 1985;112:124-125.
[36] Garza LA, Liu Y, Yang Z, Alagesan B, Lawson JA, Norberg SM, et al. Prostaglandin D2 inhibits hair growth and is elevated in bald scalp of men with androgenetic alopecia. Sci Transl Med 2012;4:126ra34-ra34.
[37] Pierard-Franchimont C, De Doncker P, Cauwenbergh G, Pierard G. Ketoconazole shampoo: effect of long-term use in androgenic alopecia. Dermatology 1998;196:474-477.
[38] Fischer T, Burmeister G, Schmidt H, Elsner P. Melatonin increases anagen hair rate in women with androgenetic alopecia or diffuse alopecia: results of a pilot randomized controlled trial. Br J Dermatol 2004;150:341-345.
[39] Georgala S, Katoulis A, Georgala C, Moussatou V, Bozi E, Stavrianeas N. Topical estrogen therapy for androgenetic alopecia in menopausal females. Dermatology 2004;208:178-179.
[40] Marschner H. Marschner's mineral nutrition of higher plants: Academic press 2011.
[41] Foster GD, Wyatt HR, Hill JO, Makris AP, Rosenbaum DL, Brill C. Weight and metabolic outcomes after 2 years on a low-carbohydrate versus low-fat diet: a randomized trial. Ann Intern Med 2010;153:147-157.
[42] Sánchez P, Serrano-Falcón C, Torres J, Serrano S, Ortega E. 5α-Reductase isozymes and aromatase mRNA levels in plucked hair from young women with female pattern hair loss. Arch Dermatol Res 2018;310:77-83.
[43] Trüeb RM. Serum biotin levels in women complaining of hair loss. Int J Trichology 2016;8:73.
[44] Patel DP, Swink SM, Castelo-Soccio L. A review of the use of biotin for hair loss. Skin Appendage Disord 2017;3:166-169.
[45] Haslam IS, Jadkauskaite L, Szabó IL, Staege S, Hesebeck-Brinckmann J, Jenkins G. Oxidative damage control in a human (mini-) organ: Nrf2 activation protects against oxidative stress-induced hair growth inhibition. J Invest Dermatol 2017;137:295-304.
[46] Jadkauskaite L, Coulombe PA, Schäfer M, Dinkova‐Kostova AT, Paus R, Haslam IS. Oxidative stress management in the hair follicle: Could targeting NRF2 counter age‐related hair disorders and beyond. Bioessays 2017;39:43-45.
[47] Çatal T. Efficacy of antioxidant vitamins (vitamin C, vitamin E, beta-carotene) and selenium supplement on D-galactosamine-induced lung injury. Eur J Biol 2016;75:11-18.
[48] Tsai CC, Chou CH, Liu YC, Hsieh CW. Ultrasound‐assisted extraction of phenolic compounds from Phyllanthus emblica L. and evaluation of antioxidant activities. Int J Cosmet Sci 2014;36:471-476.
[49] Afsar V, Reddy YM, Saritha K. Invitro antioxidant activity and anti-inflammatory activity of methanolic leaf extract of Boswellia serrata. Int J LifeSc Bt & Pharm Res 2012;4:15-23.
[50] Gardeli C, Vassiliki P, Athanasios M, Kibouris T, Komaitis M. Essential oil composition of Pistacia lentiscus L. and Myrtus communis L.: Evaluation of antioxidant capacity of methanolic extracts. Food Chem 2008;107:1120-1130.
How to Cite
Gorji N, Naeimi M, Moeini R, Memariani Z, Kolangi F. An Approach to Hair Loss and its Management in Persian Medicine. JTIM. 3(3):127-3.
Short Communication(s)