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Does saw palmetto help with hair loss?
Short answer
Possibly a little, but nobody can say for sure. A 2020 systematic review found some positive small studies and concluded that robust, high-quality data are lacking, and the US National Center for Complementary and Integrative Health says the evidence for male pattern hair loss is too limited to draw conclusions. Saw palmetto is sold as a food supplement in the UK, not as a licensed hair loss medicine.
Key facts
- The 2020 systematic review covered 5 randomised trials and 2 cohort studies and called for larger, better trials.
- NCCIH: for hair loss, "the evidence is too limited to allow conclusions to be reached".
- Side effects in studies are mild and infrequent: digestive symptoms, dizziness and headache.
- Saw palmetto may be unsafe in pregnancy or breastfeeding (NCCIH).
- It is a food supplement in the UK. It is not licensed for hair loss and not a substitute for finasteride or minoxidil.
What saw palmetto is
Saw palmetto (Serenoa repens) is a palm whose berries are used in supplements, mainly for prostate symptoms. Laboratory work suggests extracts can inhibit 5-alpha-reductase, the enzyme that makes DHT, which is why it is promoted for hair loss. A lab effect does not prove a result in a person. For prostate symptoms, NCCIH says it is probably not helpful.
What the studies show in hair loss
2020 systematic review. Evron and colleagues pooled 5 randomised trials and 2 prospective cohort studies of oral and topical saw palmetto at 100 to 320 mg in alopecia. They reported improvements in some hair measures and no serious adverse events, but concluded that robust, high-quality data are lacking and that larger randomised trials, with long-term safety monitoring, are needed.
Newer trials. Two reports from one author (Ablon, 2025 and 2026) describe a randomised, double-blind, placebo-controlled trial of 60 adults with self-perceived thinning hair using a specific saw palmetto extract, with better hair counts than placebo at 90 and 180 days and no treatment-related adverse events. It is a small trial of one proprietary extract, so it cannot be read across to other products. A 2025 network meta-analysis of 19 supplement trials (1,658 patients) listed a saw palmetto extract among supplements scoring higher than placebo on blinded doctor assessments; its authors, too, said larger high-quality trials are needed.
NCCIH. It says a few small studies tested oral and topical saw palmetto for male-pattern hair loss but "the evidence is too limited to allow conclusions to be reached".
Safety and regulation
NCCIH describes saw palmetto as well tolerated, with mild and infrequent side effects that can include digestive symptoms, dizziness and headache, and says it does not appear to affect PSA readings. It may be unsafe in pregnancy or breastfeeding, and you should talk to a health professional before using any herbal product alongside medicines.
In the UK, supplements are regulated as food, with no approval before sale. The quality and content of a product depends on the seller. If you are having an operation, including a hair transplant, tell the surgical team about herbal supplements.
Saw palmetto and finasteride
Saw palmetto may act on the same pathway as finasteride, so taking both may duplicate the mechanism, and there is no good evidence on the combination. Tell your prescriber about it. Our guide to saw palmetto and finasteride together explains. Finasteride carries MHRA warnings on mood and sexual side effects; see finasteride side effects and what the MHRA says. Never swap a prescribed medicine for a supplement without talking to your prescriber.
For the wider picture, see natural DHT blockers and what are DHT blockers. If you want a doctor's view on your options, the free online assessment is the place to start.
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Start your free assessment →Related questions
Does saw palmetto regrow hair?
Small studies report better hair measures, but reviewers say the evidence is limited and call for larger trials. NCCIH says it is too limited to allow conclusions.
Is saw palmetto as effective as finasteride?
That has not been established. The evidence for saw palmetto in hair loss is limited, and finasteride 1 mg is a licensed medicine for male pattern hair loss with its own safety warnings. We do not compare them.
Can I take saw palmetto with finasteride?
Tell your prescriber first. No interaction is listed in the Propecia product information, but the mechanisms may overlap and there is no good evidence on the combination.
What are the side effects of saw palmetto?
NCCIH says adverse effects are mild and infrequent and may include digestive symptoms, dizziness and headache.
Is saw palmetto safe in pregnancy?
NCCIH says it may be unsafe in pregnancy or while breastfeeding. Speak to a doctor or pharmacist before using any herbal product.
Sources
- Evron E et al. Natural hair supplement: friend or foe? Saw palmetto, a systematic review in alopecia. Skin Appendage Disord 2020 (PMID 33313047)
- NCCIH: Saw palmetto
- Ablon G. Safety and efficacy of a proprietary saw palmetto extract for hair growth in adults with self-perceived thinning hair: 90-day results. J Cosmet Dermatol 2025 (PMID 41319217)
- Ablon G. Safety and efficacy of a novel saw palmetto extract: 180-day results. J Cosmet Dermatol 2026 (PMID 41652806)
- Zhou L et al. Effects of dietary supplements on androgenetic alopecia: a systematic review and network meta-analysis. Front Nutr 2025 (PMID 41561175)
- GOV.UK: Food supplements
- Propecia 1 mg: summary of product characteristics (eMC, revised 29 June 2026)
Facts checked against these sources on 22 October 2026. This page is general information, not personal medical advice. Read our editorial policy.