In the search for healthier, fuller hair, more and more people are turning to natural remedies. Natural options are often not studied as much as FDA-approved medications. They may have different doses and might not give the same results.
Saw palmetto is a plant-based alternative to traditional medications. It is thought to block dihydrotestosterone (DHT) and help to treat hair loss. Let`s dive into the most frequently asked questions about saw palmetto.
What is saw palmetto?
Saw palmetto is a natural extract from the small, dark berries of the Serenoa repens plant. This plant is a type of dwarf palm that grows in the warm, humid areas of the Southeastern United States. You can get the extract by grinding the berries into a fine powder. You can also use advanced methods like hot water infusion or carbon dioxide extraction.
Historically, saw palmetto has been valued for its hormone-modulating properties. Its use dates back to ancient civilizations, including early records from Egypt. It has gained medical attention for helping with benign prostatic hyperplasia (BPH). This is due to its ability to affect androgens, the hormones linked to pattern hair loss.
How does saw palmetto work for hair loss?
Researchers believe that saw palmetto works by targeting the same hormonal pathway involved in pattern hair loss. It works as a non-selective blocker of 5-alpha-reductase. This enzyme changes testosterone to DHT. DHT is the main hormone that causes hair follicles to shrink in androgenetic alopecia.
By reducing the activity of this enzyme, saw palmetto helps lower DHT levels in the scalp.
What type of hair loss may be treated with saw palmetto?
Saw palmetto is often used for androgenetic alopecia (AGA). This condition is also called pattern hair loss. It is the most common cause of hair thinning in both men and women.
This form of hair loss is driven by elevated sensitivity to DHT, a hormone that causes hair follicles to thin over time. Saw palmetto affects the DHT pathway. This may help reduce hair loss and support healthier regrowth for those with this condition.
There is also emerging interest in its use for telogen effluvium, especially when stress or hormonal fluctuations are contributing factors, though the evidence is far more limited. It’s important to note that saw palmetto is not effective for scarring alopecias or autoimmune conditions like alopecia areata.
How Effective Is Oral Saw Palmetto for Pattern Hair Loss?
Oral saw palmetto is not as strong as FDA-approved drugs like finasteride. However, it has shown some benefits for treating AGA. This is especially true for people looking for a more natural and gentle option.
In the largest randomized controlled trial so far, 100 men with AGA were treated daily. They received either 320 mg of saw palmetto or 1 mg of finasteride for 24 months. The results?
68% of finasteride users saw improvement in hair density
38% of saw palmetto users experienced similar improvement
Saw palmetto helped stop hair loss in more than 50% of users. This is an important result for conditions like AGA.
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Is Topical Saw Palmetto Effective for Hair Loss?
Topical saw palmetto products have become popular. They are a possible alternative for people who do not want to use oral DHT blockers. Early research shows that topical saw palmetto may help improve hair density and quality. This is especially true if used regularly and with other treatments.
In a 50-week study, 60 men and women with hair loss were divided into five groups. They received either a lotion with saw palmetto, a gelatin-cystine supplement, or both. The topical saw palmetto group showed:
- A 27% increase in hair count by week 50 (vs. 14% in the placebo group);
- A 30% increase in hair mass and thickness from baseline (vs. 8% in placebo);
- The combination of topical and oral therapy resulted in up to 50% improvement in all measured hair growth parameters.
Another 24-week study followed 50 men. They used a saw palmetto lotion every day. They also used a strong scalp serum for the first 4 weeks.
- Total hair count increased by 3.4% at 12 weeks and 4.9% at 24 weeks;
- Terminal hair count improved dramatically—by 21.4% at 12 weeks and 74.1% at 24 weeks;
- Vellus and medium hairs decreased, indicating a shift toward stronger, more mature follicles.
Participants also experienced improvements in hairline and crown density, and reported high satisfaction with treatment results
Are There Any Side Effects of Saw Palmetto?
Saw palmetto is usually safe and well tolerated. This is especially true when compared to prescription hair loss medications. However, it is not completely free of side effects.
Oral Saw Palmetto
The most frequently reported side effects from oral supplements are mild gastrointestinal symptoms—including nausea, constipation, abdominal discomfort, and diarrhea. These effects are typically self-limited and may improve with food or dosage adjustment.
Nevertheless, because of its hormonal effects, saw palmetto can sometimes cause vasomotor symptoms, like hot flashes, in women. Although uncommon, there have been instances of early puberty-like signs in young girls before puberty.
There has been one report of liver enzyme problems after using a hair supplement with saw palmetto (Nutrafol). The patient also had obesity and other risk factors.
A case report documented increased bleeding during surgery in a patient taking saw palmetto.
Topical Saw Palmetto
Topical formulations are typically well tolerated but may cause mild local reactions, including:
- Scalp itching or tingling
- Cold or burning sensation
- Forehead acne
- Unpleasant odor
- Rarely, allergic contact dermatitis
Can Saw Palmetto Increase Testosterone Levels?
Many people believe that blocking the change of testosterone to DHT, like saw palmetto does, may raise testosterone levels. But when it comes to saw palmetto specifically, the evidence is limited and inconclusive.
Unlike finasteride, a well-studied prescription DHT blocker that has shown slight increases in circulating testosterone in some cases, no high-quality clinical trials have evaluated whether oral or topical saw palmetto raises testosterone in a meaningful or sustained way.
So, can it boost testosterone? Possibly—but we simply don’t know.
Can Saw Palmetto Cause Impotence or Sexual Side Effects?
Prescription DHT blockers like finasteride can cause sexual side effects in some users. These side effects include low libido, erectile dysfunction, and less ejaculate volume. In contrast, saw palmetto seems to have a much lower risk of these issues. However, the available data on saw palmetto is still limited.
In clinical studies on benign prostatic hyperplasia (BPH), where saw palmetto is commonly used, the incidence of sexual side effects has been low and often comparable to placebo.
However, unlike finasteride, there are no large-scale studies linking saw palmetto directly to impotence. Most users tolerate it well, and erectile dysfunction is not a commonly reported side effect.
Can Saw Palmetto Be Used in Women?
Yes, saw palmetto can be used by women. It is especially helpful for those with female pattern hair loss (FPHL).
Early clinical data and small studies have shown good results. Women using oral saw palmetto supplements had less shedding, better hair density, and improved overall hair quality.
However, because saw palmetto may influence hormone pathways, it should be used cautiously in women of childbearing potential. There are no formal guidelines or big safety studies for this group. So, use should be guided by a board-certified dermatologist. This is especially important for those who are pregnant, breastfeeding, or trying to conceive.
Saw Palmetto vs. Finasteride: What’s the Difference?
Both saw palmetto and finasteride help treat androgenetic alopecia, or pattern hair loss. They work by targeting the hormone DHT. However, they differ a lot in strength, regulation, and clinical evidence.
Mechanism of Action
Finasteride is a prescription medication that selectively inhibits Type II 5-alpha reductase, the enzyme that converts testosterone into DHT.
Saw palmetto, a plant-based supplement, is thought to block both Type I and II 5-alpha reductase, but less potently and less predictably than finasteride.
Effectiveness
Finasteride has been extensively studied in large clinical trials and is FDA-approved for male pattern hair loss. Around 65–70% of men see improvement in hair density.
Saw palmetto has shown milder results in smaller studies. One study found 38% of users improved, compared to 68% with finasteride, but it may help stabilize hair loss and improve quality in a complementary role.
Onset of Results
Finasteride typically shows results within 3–6 months, with peak effects at 1 year.
Saw palmetto may require 6 months or more of consistent use for visible benefits.
Side Effects
Finasteride carries a known risk of sexual side effects (libido changes, erectile dysfunction) in a small percentage of users.
Saw palmetto is generally well tolerated, with mild gastrointestinal symptoms being the most common complaint. Rare hormonal effects have been reported, especially in women or adolescents.
Availability & Regulation
Finasteride is prescription-only and regulated.
Saw palmetto is available over the counter as a dietary supplement and is not FDA-regulated for quality, consistency, or dosage.
How We Incorporate Saw Palmetto Into a Personalized Hair Loss Treatment Plan
At Dermatology Circle, we never take a one-size-fits-all approach to hair loss. Before we suggest any supplement or medicine, we first conduct a complete medical check-up. This includes natural options like saw palmetto.
We use advanced tools like AI-powered trichogram analysis and digital scalp imaging. This allows us to precisely assess your hair density, follicle health, growth phase ratios, and scalp condition, so we understand the why behind your hair loss before creating a hair loss plan.
If a doctor finds androgenetic alopecia (pattern hair loss), they may suggest saw palmetto. This is often part of a personalized plan that includes a mix of:
- Medical treatments (such as minoxidil or finasteride)
- Regenerative therapies (like PRP, exosome therapy, or Keralase)
- Lifestyle optimization
- Evidence-supported natural supplements, such as saw palmetto
We recommend only verified, high-quality supplements. This ensures that what you take is safe and comes from a trusted manufacturer. Supplements are not regulated by the FDA for quality. We help you by guiding you to products we trust and have researched.
Every natural option we suggest is based on science. It is tailored to your needs and tracked with data follow-ups.
