Pathophysiology, conventional treatments, and evidence-based herbal remedies of hair loss with a systematic review of controlled clinical trials

Hair loss is a distressing problem that affects the self-image and quality of life of many people. The increasing demand for alternative treatments has led to growing interest in using herbal medicine for hair loss management. This literature review is divided into two main parts: a narrative overview and a systematic synthesis, evaluating the efficacy of herbal remedies, gathering findings from recent clinical studies, and traditional practices. The narrative section explores the pathophysiology of hair loss, contributing factors, and conventional pharmacological treatments, including their limitations and adverse effects. The second part presents a systematic review of sixteen randomized controlled trials evaluating the clinical efficacy and safety of herbal remedies for hair loss. Natural products such as rosemary, green tea, ginseng, Aloe vera, olive, and saw palmetto have shown promising efficacy in promoting hair growth, improving hair density, reducing hair shedding, and enhancing patient satisfaction through mechanisms involving anti-inflammatory, hormonal, and enhanced scalp circulation. However, study design limitations and outcome variability necessitate further rigorous, standardized research. This review aims to offer an integrative, evidence-informed perspective on the therapeutic potential of herbal medicine for hair loss in clinical evidence.