Viviscal: An answer for hair loss in women?

Integrative medicine

An estimated 30 million women have hair loss or alopecia, as do an additional 50 million men. By 80 years old, at least half of all women will have changes in the amount or texture of their hair. The average adult loses between 50 and 100 hairs per day, according to the American Academy of Dermatology (AAD), but other evidence suggests that the loss may be as few as 10 to 12 hairs per day. Multiple types of alopecia exist among women, with female pattern hair loss (FPHL) one of the most common.

Hair loss, although important to both sexes, can have significant adverse effects on the quality of life in women especially with respect to their self-esteem. Stresses such as childbirth and major surgery may lead to temporary hair loss in women. Conditions such as hypothyroidism, lupus, and iron deficiency, as well as many medications such as enalapril, allopurinol, and oral contraceptives may cause alopecia, according to AAD.

Possible treatments

Consumers spend about $3.5 billion annually on hair loss products. Medical treatment of FPHL commonly includes topical minoxidil or an antiandrogen such as spironolactone, which may provide some benefit when used early. Hair transplantation is also used in more advanced cases. Cosmetic approaches such as fibers that make hair appear fuller, as well as special shampoos and conditioners, are also available.

Dietary supplements promoted for their beneficial effects on hair loss include the amino acids lysine and arginine, pyridoxine and other B vitamins, magnesium, Ginkgo biloba, rosemary, horsetail, and many others. One widely promoted supplement is Viviscal (Lifes2good), which contains AminoMar marine complex, a proprietary blend of shark and mollusk powder, Equisetum (horsetail) extract, vitamin C from Malpighia emarginata (acerola), niacin, biotin, iron, zinc, and millet seed extract. Unlike many supplements, this product has been studied in multiple small studies supported by the manufacturer.

Viviscal’s evidence

In a recent randomized study published in the Journal of Clinical and Aesthetic Dermatology, Glynis Ablon, MD, assessed the effect of Viviscal versus placebo when taken orally twice daily in 15 women with self-perceived hair loss. The participants had hair loss attributed to inadequate diet, stress, hormonal imbalances, or irregular menstrual cycles. Their mean age was about 48 years, and 14 of the 15 were white.

In this study, the participants’ terminal and vellus hairs growing in a 4 cm2 area along the frontal hairline were assessed at 90 days and 180 days. Vellus hairs are thinner and shorter than the terminal hairs. Participants also completed a questionnaire that assessed their hair, nails, and skin. The group receiving Viviscal had about twice as many terminal hairs over the course of the study, while their number of vellus hairs remained constant. In the placebo group, the numbers of both terminal and vellus hairs were unchanged. Participants treated with Viviscal also subjectively reported greater improvements in several hair characteristics. There were no adverse effects reported.

In addition to the above study, a poster presented at the 7th Annual World Congress for Hair Research in May 2013 is available at the Viviscal website. This study examined 72 women—out of 96 originally enrolled—with a mean age of 44 years and subclinical hair loss or thinning. The researchers noted a 7.4% increase in vellus hair diameter noted over 6 months and an 18.3% decrease in hair shedding after 3 months, theorizing that the participants’ vellus hairs may be changing into the thicker terminal hairs.

What to tell patients

Hair loss in women can be caused by many factors, especially when a strong family history of hair loss is not present. Stress and diet may be important contributing factors. Encourage women to contact their primary care provider or a dermatologist to identify potential correctable causes and check on the use of medications that may contribute to hair loss.

Recommend that patients consume a healthy diet with adequate amounts of protein, omega-3 fatty acids, biotin, iron, and zinc. Tell patients that while several studies have shown modest benefits with Viviscal when taken for 3 months to 6 months, it is unclear if dietary changes would result in similar positive outcomes.