看了第一期有雄激素脱发顾虑的小伙伴们可能会想：治疗或者缓解雄脱直接上药治疗会有风险，还有只是想要用来护发养发、防止脱发，有哪些非药物无不良反应的产品来使用。本期介绍6种治疗雄脱的天然成分，并给出含有该成分的成熟产品。
目录
1.咖啡因
2.锯棕榈
3.褪黑素
4.南瓜籽油
5.海洋提取物
6.迷迭香油
1.咖啡因
看到咖啡因各位兄弟萌是不是虎躯一震：喝咖啡还能治脱发？？？咖啡因确实有对抗睾酮的作用，还有增强发轴的伸长，延长生长期，促进毛基质角质细胞的增殖，同时可以增加毛发生长促进剂胰岛素样生长因子（IGF）-1 的表达，减少毛发生长抑制剂睾酮诱导的转化生长因子（TGF）-β1 的表达。
但是吧，文献中治疗雄脱是外用0.2%咖啡因溶液，疗效与5%米诺地尔相差无几。意思是不是我抹点咖啡到头上也行呐？（bushi）
而且按照1%咖啡因溶液、5%米诺地尔和1.5%壬二酸的搭配3个月的治疗效果竟然赶上了单纯用5%米诺地尔治疗8个月。
相关产品有咖啡因防脱生发液，感兴趣的可以看看。
“An open-label, multicentre study randomized 210 male AGA patients aged between 18 and 55years into two groups (Table 1).14 The first group applied 2 ml of 0.2% caffeine-based solution bid to the scalp, while the second group applied 1 ml of 5% minoxidil solution bid.14 The study found 0.2% topical caffeine-based solution not inferior to 5% topical minoxidil solution in treating male AGA.14 At 6months, the caffeine solution arm had a 10.59±12.02% improvement in anagen ratio compared to 11.68±12.44% in the 5% minoxidil arm—the difference between the two arms was not statistically significant (p = 0.574).14”（一项开放标签、多中心研究将 210 名年龄在 18 岁至 55 岁之间的男性 AGA 患者随机分为两组（表 1）。14 第一组每次在头皮上涂抹 2 毫升 0.2% 咖啡因溶液，第二组每次涂抹 1 毫升 5% 米诺地尔溶液。 研究发现，在治疗男性 AGA 方面，0.2% 咖啡因外用溶液并不比 5%米诺地尔外用溶液逊色。14 6 个月后，咖啡因溶液组的生长期比率提高了 10.59 ± 12.02%，而 5%米诺地尔组提高了 11.68 ± 12.44%，两组之间的差异无统计学意义（P = 0.574）。）
“差异无统计学意义”是指在统计分析中，如果两个或多个变量之间的差异未能通过显著性检验，表明这种差异可能由随机变差或抽样误差引起，而非总体差异的真实反映。
”A study compared the efficacy and safety of 5% minoxidil versus a combined solution (5% minoxidil, 1.5% azelaic acid, plus 1% caffeine) versus placebo in 71 male AGA patients aged 23years or more (Table 1).7, 15 The patients were treated for 32weeks (dose and frequency were not mentioned). The wash test (number of shed hairs), subjective patient self-assessment, and objective dermatologist test were used to evaluate the efficacy of the treatment.15 Both 5% minoxidil and combined solutions significantly reduced hair shedding compared to the placebo groups (p<0.05).15 The combined topical solution showed significantly higher moderate and marked response rates than the other two groups (p<0.05 vs. minoxidil 5%; p<0.001 vs. placebo) in objective dermatologist assessment and subjective patient self-assessment.15 The efficacy of the combined topical solution at week 12 was equivalent to the 5% minoxidil solution at week 32 (p<0.05).15 The combined solution and 5% minoxidil solution showed the same side effect profiles.“（一项研究比较了5%米诺地尔与联合溶液（5%米诺地尔、1.5%壬二酸和1%咖啡因）和安慰剂对71名23岁或以上男性AGA患者的疗效和安全性（表1）。 15 在皮肤科医生的客观评估和患者的主观自我评估中，联合外用溶液的中度和明显反应率明显高于其他两组（与米诺地尔 5%相比，p < 0.05；与安慰剂相比，p < 0.001）。 联合外用溶液在第 12 周的疗效与 5%米诺地尔溶液在第 32 周的疗效相当（p < 0.05）。）
2.锯棕榈
锯棕榈是从美洲矮树（锯棕榈树）的浆果中提取的一种提取物，与非那雄胺相同的方面是锯棕榈可以以竞争性和非选择性方式抑制 I 型和 II 型 5α 还原酶，从而降低 DHT 水平。不同方面是，锯棕榈可在多个部位发挥作用：阻止靶细胞对 DHT 的核吸收；将 DHT 与雄激素受体的结合减少约 50%；通过提高 3α- 羟基类固醇脱氢酶的活性，将 DHT 转化为弱代谢产物。
锯棕榈浆果
某橙色软件有锯棕榈防脱养发胶囊，价格几十到几百都有，也是长期吃的，买的人还挺多的，有兴趣的喝油可以看看相关评价。
“Saw Palmetto (SP), also known as Serona repens, is an extract obtained from the berries of the American dwarf tree (saw palmetto palm tree).7 The extract contains phytosterols (β-sitosterol), fatty acids, β-carotene, and polysaccharides.7 Saw palmetto decreases DHT level by inhibiting both type I and II 5α-reductase in a competitive and non-selective manner.7 Unlike finasteride, saw palmetto acts at multiple sites (Figure 2). It prevents DHT nuclear uptake in target cells and reduces DHT-androgen receptor binding approximately by 50%.7 In addition, saw palmetto enhances the conversion of DHT to androstanediol, a weaker metabolite of DHT, by increasing 3α-hydroxysteroid-dehydrogenase activity (Figure 2).7”(锯棕榈（SP）又名 Serona repens，是从美洲矮树（锯棕榈树）的浆果中提取的一种提取物。7 这种提取物含有植物甾醇（β-谷甾醇）、脂肪酸、β-胡萝卜素和多糖。锯棕榈以竞争性和非选择性方式抑制 I 型和 II 型 5α 还原酶，从而降低 DHT 水平， 7 与非那雄胺不同，锯棕榈可在多个部位发挥作用（图 2）。它能阻止靶细胞对 DHT 的核吸收，并将 DHT 与雄激素受体的结合减少约 50%。7 此外，锯棕榈还能通过提高 3α- 羟基类固醇脱氢酶的活性，将 DHT 转化为 DHT 的弱代谢产物雄甾烷二醇（图 2）。)
3.褪黑素
褪黑素是一种抗氧化剂，也是哺乳动物睡眠-觉醒周期的调节剂，它是一种神经激素，可防治男性 AGA。试验中用的外用褪黑素溶液，这个没找到，胶囊是用来改善睡眠的。
“In an open-label study, 0.0033% topical melatonin solution was applied to the scalp of 35 male AGA patients every night for 6months (Table 1).17 The patients were aged between 18 to 41years, with Hamilton-Norwood stage I or II AGA.17 A digital TrichoScan revealed 29.2% and 42.7% increase in hair count after 3 and 6 months compared to baseline count (p<0.001; baseline: 85.76±27.0; month 3: 110.82±31.7; month 6: 122.35±40.5).17 Hair density improved 29.1% and 40.9% after 3 and 6 months compared to baseline (p<0.001; baseline: 123.15±39.0; month 3: 159.03±46.8; month 6: 173.56±58).17 The hair count and density were measured as the number of hairs/0.7 cm2 and number of hairs/cm,2 respectively.17 Melatonin solution showed a good safety profile, with only one patient experienced infrequent pruritus.17”（在一项开放标签研究中，35 名男性 AGA 患者每晚在头皮上涂抹 0.0033% 的局部褪黑素溶液，持续 6 个月（表 1）。 数字 TrichoScan 扫描显示，与基线毛发数量相比，3 个月和 6 个月后毛发数量分别增加了 29.2% 和 42.7%（p < 0.001；基线：85.76 ± 27.0；第 3 个月：110.82 ± 31.7；第 6 个月：122.35 ± 40.5）。与基线相比，3 个月和 6 个月后头发密度分别提高了 29.1%和 40.9%（p < 0.001；基线：123.15 ± 39.0；第 3 个月：159.03 ± 46.8；第 6 个月：173.56 ± 58）。 褪黑素溶液显示出良好的安全性，只有一名患者出现了不常见的瘙痒症状。）
4.南瓜籽油
南瓜籽油的成分可抑制 5α-还原酶并促进毛发生长。
相关产品除了南瓜籽油胶囊还有南瓜籽精油用来护发。
南瓜大丰收
“Pumpkin seed oil (PSO) has been shown to block the action of 5-alpha reductase and to have antiandrogenic effects on rats. This randomized, placebo-controlled, double-blind study was designed to investigate the efficacy and tolerability of PSO for treatment of hair growth in male patients with mild to moderate androgenetic alopecia (AGA). 76 male patients with AGA received 400 mg of PSO per day or a placebo for 24 weeks. Change over time in scalp hair growth was evaluated by four outcomes: assessment of standardized clinical photographs by a blinded investigator; patient self-assessment scores; scalp hair thickness; and scalp hair counts. Reports of adverse events were collected throughout the study. After 24 weeks of treatment, self-rated improvement score and self-rated satisfaction scores in the PSO-treated group were higher than in the placebo group (P = 0.013, 0.003). The PSO-treated group had more hair after treatment than at baseline, compared to the placebo group (P < 0.001). Mean hair count increases of 40% were observed in PSO-treated men at 24 weeks, whereas increases of 10% were observed in placebo-treated men (P < 0.001). Adverse effects were not different in the two groups.”（ 南瓜籽油（PSO）已被证明能阻断 5-α 还原酶的作用，并对大鼠有抗雄激素作用。 这项随机、安慰剂对照、双盲研究旨在调查 PSO 治疗轻度至中度雄激素性脱发（AGA）男性患者毛发生长的疗效和耐受性。 76 名男性 AGA 患者每天服用 400 毫克 PSO 或安慰剂，共服用 24 周。 头皮毛发生长随时间的变化通过四项结果进行评估：由盲法研究人员对标准化临床照片进行评估；患者自我评估评分；头皮毛发厚度；头皮毛发数量。 在整个研究过程中收集不良事件报告。 治疗 24 周后，PSO 治疗组的自评改善得分和自评满意度得分均高于安慰剂组（P = 0.013，0.003）。 与安慰剂组相比，PSO 治疗组治疗后的头发数量比基线时更多（P < 0.001）。 接受 PSO 治疗的男性在 24 周时的平均毛发数量增加了 40%，而接受安慰剂治疗的男性只增加了 10%（P < 0.001）。 两组的不良反应没有差异。）
5.海洋提取物
海洋提取物部分含有来自鲨鱼和软体动物的细胞外基质。用于治疗 AGA 的产品包括海洋补充剂，如 Viviscal（头发营养系统：Lifes2good, Inc.，美国伊利诺斯州芝加哥）。 海洋补充剂可促进真皮乳头细胞增殖，提高碱性磷酸酶水平（头发生长指标）。
Viviscal属于是护发营养片，价格200-1000不等。
“In a randomized, double-blind, control trial, 60 male AGA patients received marine complex supplement tablet (Viviscal® Man; Lifes2good, Inc.) twice a day with meal or placebo for 6months (Table 1).19 The treatment arm demonstrated significant improvement in total hair count (baseline: 162.20±46.96; month 6: 174.89±44.00), total hair density (baseline: 159.71±46.26; month 6: 172.17±43.29), and terminal hair density (baseline: 121.95±40.04; month 6: 130.34±38.81) after 6months (p = 0.001).19 The placebo arm did not show any significant improvement—total hair count (baseline: 152.20±42.80; month 6: 146.92±47.42), total hair density (baseline: 150.00±42.14; month 6: 144.71±46.74), and terminal hair density (baseline: 104.72±37.84; month 6: 99.17±42.21). Although the patients did not report any side effects, marine complex formulation is contraindicated in those with shellfish allergy.7, 19 Clinicians must enquire prospective users’ allergy history before prescribing it.7”（在一项随机、双盲、对照试验中，60 名男性 AGA 患者接受了海洋复合补充剂片剂（Viviscal® Man; Lifes2good, Inc.29）和末端毛发密度（基线：121.95 ± 40.04；第 6 个月：130.34 ± 38.81）（p = 0.001）。总毛发数（基线：152. 20 ± 42.80；第 6 个月：146.92 ± 47.42）、总毛发密度（基线：150.00 ± 42.14；第 6 个月：144.71 ± 46.74）和末端毛发密度（基线：104.72 ± 37.84；第 6 个月：99.17 ± 42.21）均无明显改善。 虽然患者未报告任何副作用，但对贝类过敏者禁用海洋复合制剂。）
6.迷迭香油
迷迭香油的成分包括咖啡酸、迷迭香酸、樟脑和 12-甲氧基carnosic 酸，这些成分共同具有抗氧化、抗菌和消炎的功效。
相关产品：迷迭香头皮精华液，橙色软件上价格在一百左右。
“In a randomized, double-blind, control trial, 60 male AGA patients received marine complex supplement tablet (Viviscal® Man; Lifes2good, Inc.) twice a day with meal or placebo for 6months (Table 1).19 The treatment arm demonstrated significant improvement in total hair count (baseline: 162.20±46.96; month 6: 174.89±44.00), total hair density (baseline: 159.71±46.26; month 6: 172.17±43.29), and terminal hair density (baseline: 121.95±40.04; month 6: 130.34±38.81) after 6months (p = 0.001).19 The placebo arm did not show any significant improvement—total hair count (baseline: 152.20±42.80; month 6: 146.92±47.42), total hair density (baseline: 150.00±42.14; month 6: 144.71±46.74), and terminal hair density (baseline: 104.72±37.84; month 6: 99.17±42.21). Although the patients did not report any side effects, marine complex formulation is contraindicated in those with shellfish allergy.7, 19 Clinicians must enquire prospective users’ allergy history before prescribing it.7”（在一项随机、单盲临床试验中，100 名年龄在 18 至 49 岁之间的男性 AGA 患者接受了迷迭香油乳液（n = 50）或 2% 米诺地尔（n = 50；表 1）治疗。20 患者每天两次在头皮的前顶叶和顶点区域涂抹 1 毫升迷迭香油乳液（3.7 毫克/毫升 1,8-松油醇）或 2% 米诺地尔，持续 6 个月。 20 3 个月后，两组患者的头发数量都没有明显增加；但 6 个月后，迷迭香油组（基线：122.8 ± 48.9，第 6 个月：129.6 ± 51.2）和米诺地尔组（基线：138.米诺地尔组和迷迭香油组（基线：138.4 ± 38.03，第 6 个月：140.7 ± 38.5）的头发数量都有显著增加（p < 0.05）。 不过，两组患者都有头皮瘙痒的报告，米诺地尔组的报告频率相对较高。）
参考文献
Gupta AK, Talukder M, Bamimore MA. Natural products for male androgenetic alopecia. Dermatol Ther. 2022 Apr;35(4):e15323. doi: 10.1111/dth.15323. Epub 2022 Jan 27. PMID: 35044013.
总结
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外用党优先：咖啡因、褪黑素、迷迭香油精华。
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内服党可选：锯棕榈胶囊、南瓜籽油、海洋补充剂。
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重要提示：天然成分见效较慢（3-6个月起），严重脱发仍需就医；内服产品建议咨询医生，尤其孕妇或慢性病患者。
往期指路
https://www.xiaoheihe.cn/app/bbs/link/146144126
