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Does saw palmetto regrow hair?

Saw palmetto has been tested for hair loss in several small trials, at least two of them run or backed by companies selling an extract. The only trial that compared it directly with finasteride found that 38% of men on saw palmetto improved over two years, against 68% on finasteride. European dermatologists make no recommendation either way.

Against finasteride

In a study published in 2012, 100 men with mild to moderate androgenetic alopecia took either 320 mg of saw palmetto or 1 mg of finasteride a day for 24 months, without a placebo group and without blinding. Judged on photographs, 38% of the saw palmetto group had more hair at the end, against 68% of the finasteride group. A 2020 systematic review describes the result as inferior to finasteride.

The placebo-controlled trials

A 2002 pilot combined saw palmetto with beta-sitosterol, so it cannot isolate either; 6 of 10 men on the combination were rated improved. A 2023 Indian trial of 80 people reported less shedding and slightly higher hair density on an extract called VISPO, by mouth or on the scalp; four of its six authors work for the extract's maker, Vidya Herbs. A trial of 60 adults with self-perceived thinning, whose six-month results were published in 2026, reported more hair on Valensa's extract than on placebo; Valensa is listed as a collaborator on its registration, which was filed after the trial had started.

Saw palmetto on the scalp

A 2016 study gave 50 men topical saw palmetto products for 24 weeks and compared their hair counts with their own at the start, with no placebo. Counts rose by a few percent. Without a comparison group, the study cannot separate that from chance or seasonal change.

What dermatology guidelines say

The European S3 guideline on androgenetic alopecia says: "We cannot make a recommendation for or against treatment with Serenoa repens per os at the present time", and notes that it "showed inferior results compared to finasteride per os". The US National Center for Complementary and Integrative Health says the evidence from the few small studies "is too limited to allow conclusions to be reached."

The DHT claim

Saw palmetto is sold as a natural blocker of the enzyme that makes DHT. In a 1994 study of 32 healthy men, a saw palmetto medicine had no effect on blood DHT, while finasteride cut it by 52 to 65% within a week. The 2023 VISPO trial reported a fall in DHT with the capsules, in a trial most of whose authors work for the manufacturer. The reasoning is borrowed from prostate treatment, where a 2024 review of 27 trials concluded that saw palmetto alone "provides little to no benefits" for urinary symptoms.

Safety

The European Medicines Agency recognises saw palmetto only for urinary symptoms of an enlarged prostate, and says there is no relevant use for women, children or adolescents. It lists stomach pain and headache as common, uncommon reversible breast enlargement in men, and reports of a raised INR in people taking warfarin. A hormonal effect has been reported in a child: an 11-year-old girl given saw palmetto for hair shedding developed hot flushes.

Sources

  1. Comparitive effectiveness of finasteride vs Serenoa repens in male androgenetic alopecia: a two-year study · International Journal of Immunopathology and Pharmacology, 2012 · PMID 23298508
  2. Natural Hair Supplement: Friend or Foe? Saw Palmetto, a Systematic Review in Alopecia · Skin Appendage Disorders, 2020 · PMID 33313047
  3. 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 · Journal of Alternative and Complementary Medicine, 2002 · PMID 12006122
  4. Oral and Topical Administration of a Standardized Saw Palmetto Oil Reduces Hair Fall and Improves the Hair Growth in Androgenetic Alopecia Subjects – A 16-Week Randomized, Placebo-Controlled Study · Clinical, Cosmetic and Investigational Dermatology, 2023 · PMID 38021422
  5. The Safety and Efficacy of a Novel Saw Palmetto (Serenoa repens) Extract for Promoting Hair Growth in Adults With Self-Perceived Thinning Hair: 180-Day Results · Journal of Cosmetic Dermatology, 2026 · PMID 41652806
  6. Saw palmetto extract and hair growth in adults with self-perceived thinning hair (NCT06920758) · ClinicalTrials.gov, 2025
  7. Treatment of male androgenetic alopecia with topical products containing Serenoa repens extract · Australasian Journal of Dermatology, 2016 · PMID 26010505
  8. Evidence-based (S3) guideline for the treatment of androgenetic alopecia in women and in men – short version · Journal of the European Academy of Dermatology and Venereology, 2018 · PMID 29178529
  9. Saw Palmetto · National Center for Complementary and Integrative Health, 2025
  10. Comparison of finasteride (Proscar) and Serenoa repens (Permixon) in the inhibition of 5-alpha reductase in healthy male volunteers · European Urology, 1994 · PMID 7805711
  11. Serenoa repens for the Treatment of Lower Urinary Tract Symptoms Due to Benign Prostatic Enlargement: An Updated Cochrane Review · World Journal of Men's Health, 2024 · PMID 38164033
  12. European Union herbal monograph on Serenoa repens (W. Bartram) Small, fructus · European Medicines Agency, 2015
  13. Hot flashes in a young girl: a wake-up call concerning Serenoa repens use in children · Pediatrics, 2012 · PMID 23027164

Checked against its sources on 2026-10-01, by us, not by a doctor. A research register, not medical advice: talk to a dermatologist about your own case. See why we're not doctors.