CBD Oil for Hair Loss Does CBD work for hair loss, and if so, how? Hair loss can appear in various ways, depending on its cause. It can manifest suddenly or gradually and affect only the scalp or the whole body. Some types of hair loss are temporary, while others are permanent. Several factors can increase the risk of hair loss, including family history, age, significant weight loss, certain medical conditions, and stress. An individual typically loses about 100 strands of hair a day. However, it does not cause a noticeable thinning of scalp hair because new hair grows in at the same time. Hair loss happens when the natural cycle of hair growth and shedding is disrupted, or when hair follicles are replaced with scar tissues (1). Why Some People Are Turning to CBD for Hair Loss While there is no research to suggest cannabidiol (CBD) directly encourages hair growth, some of the purported therapeutic benefits of CBD oil may help with hair loss. Stress and sleep disturbances contribute to hair loss due to how they impact cortisol levels. A 2016 research published in the Journal of Drugs in Dermatology showed that cortisol, the stress hormone, is directly connected to the function of the hair follicle (2). When high levels of cortisol are present, the adrenal glands produce fewer hormones that promote hair growth. With the degradation of essential skin elements, the hair becomes weak and begins to shed. The impact on hair growth can be slowed by reducing cortisol levels in the body, and this is where CBD can help. Studies have shown that with CBD’s potential to reduce stress levels, it could also help with hair loss issues related to stress and anxiety. A study published in the Journal of Psychopharmacology showed CBD’s anti-anxiety characteristics (3). In a recent study published in The Permanente Journal, CBD was shown to be beneficial in promoting sleep and managing stress (4). CBD is preferable to use because it does not produce the mind-altering high associated with the psychoactive cannabinoid, THC (tetrahydrocannabinol), found in the cannabis plant. Considered as relatively safe and non-habit-forming, CBD may be used without the risks of intoxication or dependence. CBD “is generally well tolerated with a good safety profile,” the World Health Organization (WHO) states in a critical review (5). CBD is non-addictive, according to Nora Volkow, director of the National Institute on Drug Abuse (NIDA) in a 2015 article (6). More than reducing stress and cortisol levels, CBD oil may also be able to improve hair and scalp health. Full-spectrum CBD oil contains all phytonutrients from hemp, including trace amounts of THC, terpenes, flavonoids, and essential oils. It also contains essential vitamins A, D, and E, essential fatty acids, and amino acids that can help protect, repair, and nourish the skin on the scalp. A study published in the Proceedings of the National Academy of Sciences of the United States of America concluded that CBD, as an antioxidant, was 30%- 50% more potent than both Vitamins C and E (7). Omega-3 and omega-6 fatty acids are prevalent in nutritional supplements for hair growth. However, the body does not produce them on its own. One critical omega-6 fatty acid in CBD oil is gamma-linolenic acid (GLA), which has the potential to combat hair loss. Researchers of a 2015 study published in the Journal of Cosmetic Dermatology believe this characteristic is linked to CBD’s ability to promote blood flow to the scalp (8). CBD oil also contains antioxidants, including vitamin E, vitamin A, calcium, and magnesium. Studies have shown antioxidants keep free radicals in check to help keep hair vibrant and shiny. Hair is exposed daily to a range of harmful effects, such as sunlight, pollution, cosmetic treatments, grooming practices, and cleansing. Antioxidants protect against free radicals that cause hair loss. Researchers of a study on the efficacy of antioxidants on human hair arrived at the same conclusion (9). CBD oil may also help increase blood circulation, as suggested by a study published in Eplasty in 2016 (10). Another study, published in Neuropsychopharmacology, showed that CBD could increase cerebral blood flow (11). Increased circulation provides benefits for the body, particularly around hair follicles where hair growth can be stimulated. Thus, the probability is high that CBD oil helps deliver more nutrients to hair follicles and remove harmful toxins, allowing hair to become stronger and healthier to promote new growth. How CBD Oil Works to Help With Hair Loss The endocannabinoid system is a network of receptors and neurotransmitters (endocannabinoids) found throughout the body. Scientists are discovering the role of the ECS in regulating various biological systems. It has been found to influence mood, appetite, immune response, and even skin health (12). CBD is known to recalibrate the endocannabinoid system, as shown in a 2018 study published in the Rambam Maimonides Medical Journal (13). This characteristic helps the body maintain a healthy state of homeostasis. Results of a 2016 study showed how homeostasis, a state of balance, is essential between the body's physiological processes, including hair follicle growth (14). Alopecia areata, a common skin disease, is an example of what happens when the body’s immune system is not functioning as it should. Alopecia causes hair loss on the scalp, face, and sometimes on other areas of the body. Studies published in the journal Future Medicinal Chemistry have found CBD to possess anti-inflammatory properties (15). CBD may help calm overactive immune response, reducing inflammation. While more research is needed, this could be a powerful mechanism for addressing hair loss and skin diseases that affect the scalp. Conclusion CBD is not a complete cure for hair loss or thinning hair. However, studies with CBD and hair health have been encouraging. In itself, CBD naturally contains nutrients that may help in maintaining healthy skin and hair. CBD oil may be found infused in some CBD products for hair care, as a conditioning treatment for the scalp or as a hair-cleansing agent, like CBD shampoo. One may use CBD hair products as part of a daily haircare routine to help maintain a healthy scalp and hair. It may only take some experimentation at first to find the best CBD haircare product that is suitable to one’s preference and lifestyle. Still, before using CBD to supplement a hair loss therapy or address specific hair concerns, consult with a doctor experienced in cannabis use for advice. References 1. Mayo Clinic. (2019, Feb 12). Hair Loss. Retrieved from https://www.mayoclinic.org/diseases-conditions/hair-loss/symptoms-causes/syc-20372926. 2. Thom E. Stress and the Hair Growth Cycle: Cortisol-Induced Hair Growth Disruption. J Drugs Dermatol. 2016;15(8):1001–1004. 3. Crippa JA, Derenusson GN, Ferrari TB, et al. Neural basis of anxiolytic effects of cannabidiol (CBD) in generalized social anxiety disorder: a preliminary report. J Psychopharmacol. 2011;25(1):121–130. DOI:10.1177/0269881110379283. 4. Shannon S, Lewis N, Lee H, Hughes S. Cannabidiol in Anxiety and Sleep: A Large Case Series. Perm J. 2019;23:18–041. DOI:10.7812/TPP/18-041. 5. Expert Committee on Drug Dependence Fortieth Meeting. Cannabidiol (CBD) Critical Review Report. June 2018. https://www.who.int/medicines/access/controlled-substances/WHOCBDReportMay2018-2.pdf. 6. Nora Volkow. NIDA. Researching Marijuana for Therapeutic Purposes: The Potential Promise of Cannabidiol (CBD). National Institute on Drug Abuse website. https://www.drugabuse.gov/about-nida/noras-blog/2015/07/researching-marijuana-therapeutic-purposes-potential-promise-cannabidiol-cbd. July 20, 2015. Accessed January 31, 2020. 7. Hampson AJ, Grimaldi M, Axelrod J, Wink D. Cannabidiol and (-)Delta9-tetrahydrocannabinol are neuroprotective antioxidants. Proc Natl Acad Sci U S A. 1998;95(14):8268–8273. DOI:10.1073/pnas.95.14.8268. 8. Le Floc'h C, Cheniti A, Connétable S, Piccardi N, Vincenzi C, Tosti A. Effect of a nutritional supplement on hair loss in women. J Cosmet Dermatol. 2015;14(1):76–82. DOI:10.1111/jocd.12127. 9. Fernández E, Martínez-Teipel B, Armengol R, Barba C, Coderch L. Efficacy of antioxidants in human hair. J Photochem Photobiol B. 2012;117:146–156. DOI:10.1016/j.jphotobiol.2012.09.009. 10. Koyama T, Kobayashi K, Hama T, Murakami K, Ogawa R. Standardized Scalp Massage Results in Increased Hair Thickness by Inducing Stretching Forces to Dermal Papilla Cells in the Subcutaneous Tissue. Eplasty. 2016;16:e8. Published 2016 Jan 25. 11. Crippa JA, Zuardi AW, Garrido GE, et al. Effects of cannabidiol (CBD) on regional cerebral blood flow. Neuropsychopharmacology. 2004;29(2):417–426. DOI:10.1038/sj.npp.1300340. 12. Eagleston LRM, Kalani NK, Patel RR, Flaten HK, Dunnick CA, Dellavalle RP. Cannabinoids in dermatology: a scoping review. Dermatol Online J. 2018;24(6):13030/qt7pn8c0sb. Published 2018 Jun 15. 13. Fine PG, Rosenfeld MJ. The endocannabinoid system, cannabinoids, and pain. Rambam Maimonides Med J. 2013;4(4):e0022. Published 2013 Oct 29. DOI:10.5041/RMMJ.10129. 14. Bernard BA. Advances in Understanding Hair Growth. F1000Res. 2016;5:F1000 Faculty Rev-147. Published 2016 Feb 8. DOI:10.12688/f1000research.7520.1. 15. Nagarkatti P, Pandey R, Rieder SA, Hegde VL, Nagarkatti M. Cannabinoids as novel anti-inflammatory drugs. Future Med Chem. 2009;1(7):1333–1349. DOI:10.4155/fmc.09.93.
Summary for UKPID Finasteride Dr Alan Worsley Bsc(hons) PhD MRPharmS National Poisons Information Service (Newcastle Centre) Regional Drug & Therapeutics Centre Wolfson Building Claremont Place Newcastle upon Tyne NE1 4LP UK This monograph has been produced by staff of a National Poisons Information Service Centre in the United Kingdom. The work was commissioned and funded by the UK Departments of Health, and was designed as a source of detailed information for use by poisons information centres. Peer review group: Directors of the UK National Poisons Information Service. FINASTERIDE (Poscar(R)) Summary Type of product anti-androgen Ingredients tablets - 5 mg Toxicity Fatal dose not known Features Not known Side effects reported include impotence, decreased libido and ejaculate volume, breast tenderness and enlargement, hypersensitivity reactions (including lip swelling and rash). Management 1. If ingestion is within 2 hours 50 - 100 grams (adults) or 25 - 50 grams (children) of oral activated charcoal may be administered. Lactulose (20 ml) should be given to prevent constipation. There is no data to indicate whether this is effective in finasteride poisoning. 2. Symptomatic measures as indicated by the patients clinical condition. References ABPI Data Sheet Compendium. Datapharm Publications Limited. 1996-1997. British National Formulary. Number 32 (September 1996). British Medical Association and Royal Pharmaceutical Society. Dollery C. Therapeutic Drugs. (Suppl 2), Churchill Livingstone. 1994 FINASTERIDE Brand name Proscar(R) Generic name finasteride Chemical group/family Anti-androgen BNF 6.4 Reference number (CAS) 98319-26-7 Manufacturer/supplier Merck Sharp & Dohme Ltd Hertford Road Hoddesdon Herts EN11 9BU Tel: 01992 467272 Fax: 01992 451066 Presentation finasteride 5 mg tablets pack size 28 tablets Physicochemical properties: (Dollery) N- (1,11-Dimethyethyl)-3-oxo-4-aza-5alpha-androst-1-ene-17�- carboxamide Physical properties Off-white, crystalline solid Molecular Weight 372.6 pKa - Solubility in alcohol freely soluble in water very slightly soluble Octanol/water partition coefficient > 1.258 Melting point 250�C USES Indications Treatment and control of benign prostatic hyperplasia (BPH) to control regression of the enlarged prostate, improve urinary flow, and improve symptoms associated with BPH. Therapeutic Dosage (BNF) Adults: 5 mg daily, review treatment after 6 months Children: finasteride is contra-indicated Elderly: no dosage adjustment is required Renal failure: dosage adjustment not necessary as pharmacokinetic studies do not indicate any change in the deposition of finasteride. Hepatic failure: no data available Contraindications Hypersensitivity to any component of the product Women who are or may become pregnant Children Precautions Obstructive uropathy, prostate cancer (may decrease markers such as prostate specific antigen) As finasteride is excreted in the semen adequate contraceptive measures (barrier methods) should be taken. Women of child bearing age should avoid handling crushed or broken tablets. Pharmacokinetics: (Dollery) Oral absorption 100% Presystemic metabolism < 20% Volume of distribution 75 l Plasma protein binding 93% Plasma half life range 4.7 - 7.1 hr mean 6 hr Toxicokinetics none available Adverse effects (Data Sheet) Decreased libido (3.3%), impotence (3.7%), and decreased volume of ejaculate (2.8%) have been reported in patients receiving 5 mg of finasteride daily for 12 months. Breast tenderness and enlargement Hypersensitivity reactions including lip swelling and skin rash Pregnancy (Data Sheet) Finasteride is contra-indicated in women who are or may become pregnant. Because of the ability of 5 alpha reductase inhibitors to inhibit conversion of testosterone to dihydrotestosterone, these drugs, including finasteride, may cause abnormalities of the external genitalia of a male fetus when administered to a pregnant woman. In animal developmental studies, hypospadias were observed in the male offspring of pregnant rats given finasteride at doses ranging from 100 mcg/kg/day to 100 mg/kg/day, at an incidence of 3.6% to 100%. Additionally, pregnant rats provide male offspring with decreased prostatic and seminal vesicular weights, delayed preputial separation, transient nipple development and decreased anogenital distance when given finasteride at doses below the recommended human dose. The critical period during which these effects can be induced has been defined in rats as days 16-17 of gestation. No effects were seen in female offspring exposed in utero to any dose of finasteride. Exposure to finasteride - risk to male fetus: Crushed or broken finasteride tablets should not be handled by women who are or may become pregnant because of the possibility of absorption of finasteride and the subsequent risk to the male fetus. Similarly, small amounts of finasteride have been recovered from the semen in subjects receiving finasteride 5 mg/day. It is not known whether a male fetus may be adversely affected if his mother is exposed to semen of a patient being treated with finasteride. Therefore, the patients' sexual partner should either avoid exposure to her partners semen (e.g. by use of condom) or he should discontinue finasteride. Breast milk Finasteride is not indicated for use in women. It is not known whether finasteride is excreted in human milk. Interactions (BNF) No clinically important interactions reported EPIDEMIOLOGY OF POISONING No specific data or case reports of finasteride poisoning are available. Patients have received single doses of finasteride up to 400 mg and multiple doses of finasteride up to 80 mg daily for up to 3 months and 40 mg daily for 24 weeks without any adverse effects. (Dollery) Side effects reported at therapeutic dosage include: Decreased libido (3.3%), impotence (3.7%), and decreased volume of ejaculate (2.8%) have been reported in patients receiving 5 mg of finasteride daily for 12 months (Prod Info Proscar, 1992). Breast tenderness and enlargement Hypersensitivity reactions including lip swelling and skin rash MANAGEMENT update date: January 1997 No specific details available Decontamination If ingestion is within 2 hours 50 - 100 grams (adults) or 25 - 50 grams (children) of oral activated charcoal may be administered. Lactulose (20 ml) should be given to prevent constipation. There is no data to indicate whether this is effective in finasteride poisoning. Supportive care General supportive care should be given Monitoring As no data is available on finasteride poisoning vital signs should be monitored - pulse blood pressure, respiration Antidotes There are no specific antidotes Elimination techniques No data available. Investigations No data is available on finasteride poisoning, but routine investigations including renal function tests, urinalysis and electrolytes could be carried out. Case Data update date: January 1997 No data available Other Toxicological Data No data available Ecotoxicological Data No data available Biodegradation No data available Hazard Warnings No data available Waste disposal Data No data available Author Dr Alan Worsley Bsc(hons) PhD MRPharmS National Poisons Information Service (Newcastle Centre) Regional Drug & Therapeutics Centre Wolfson Building Claremont Place Newcastle upon Tyne NE1 4LP UK This monograph was produced by the staff of the Newcastle Centre of the National Poisons Information Service in the United Kingdom. The work was commissioned and funded by the UK Departments of Health, and was designed as a source of detailed information for use by poisons information centres. Peer review was undertaken by the Directors of the UK National Poisons Information Service. Last updated January 1997 REFERENCES ABPI Data Sheet Compendium. Datapharm Publications Limited. 1996-1997. British National Formulary. Number 32 (September 1996). British Medical Association and Royal Pharmaceutical Society. Dollery C. Therapeutic Drugs. (Suppl 2), Churchill Livingstone. 1994