Nutraceuticals and nootropics for anti-aging

I am interested in [LifeLink’s] niacinamide cream or lotion as I have heard it is helpful in male pattern hair loss. What do you think?

The idea would be to apply to the scalp a niacinamide cream or gel (such as LifeLink’s Metazene) in order to counteract hair loss. In my opinion this is an idea worth trying. The medical literature seems to have nothing to say about this usage for niacinamide, but there is indirect evidence to suggest that it might work.

According to current thinking, the thinning and loss of scalp hair (‘male pattern alopecia’) is caused by various factors. Among them are:

• sensitivity of hair follicles to androgenic hormones⁴
• inadequate oxygen supply to hair follicles¹¹
• inflammation in the hair follicles.^7,8,9

The intensity of the effects of these three factors on hair growth depends upon one's genetic make-up.

The first factor — sensitivity to androgens (such as testosterone and its derivatives) — is the basis for several hair-loss treatments. Finasteride (Propecia®), for example, is a drug that blocks the conversion of testosterone into a derivative called DHT which is a powerful inhibitor of hair growth on the scalp. Unfortunately only a small percentage of users see major benefits from finasteride and similar treatments.

The second factor — inadequate oxygen supply to hair follicles — is the basis for another type of treatment in which vasodilating drugs are applied to the scalp to increase blood flow in the skin. For example, the hair-restoring drug minoxidil (Rogaine®) is believed to operate on this principle.

The third factor — inflammation in the hair follicles — has not, to my knowledge, been exploited as a basis for hair restoration. But it certainly should be, since it has been shown to be highly correlated with male pattern hair loss.^7,8 In fact, researchers in 1982 reported that users of the anti-inflammatory drug benoxaprofen experienced a reversal of their scalp hair loss!⁹ (Unfortunately, this drug was withdrawn from the market that same year for safety reasons.¹⁰)

LifeLink’s niacinamide gel

LifeLink carries a product called ‘Metazene’, used mainly to treat acne. It has three active ingredients: niacinamide, ‘witch hazel’ (extract of Hamamelis), and aloe vera. I would not expect Metazene to have any significant effect on androgenic hormones, but all three of its ingredients are anti-inflammatories, and niacinamide is also a vasodilator. This product therefore deals with two of the three principal known causes of male pattern hair loss.

Niacinamide is one of several forms of vitamin B3 — a vitamin that plays an essential role in the metabolism of carbohydrates, lipids and proteins.^1,6 The two most widely used forms of vitamin B3 are niacinamide itself, and niacin.² Niacin has been studied as a cholesterol regulator, but is seldom used for this purpose because of its side effects: At the oral dosages required for cholesterol benefits niacin causes the capillaries in the skin to dilate, causing a “flushing” reaction — the skin becomes very red, and sometimes itchy.³ Niacinamide lacks these side effects.⁵

Niacinamide has a good track record as a cosmetic ingredient, so one needn’t have any safety concerns. As stated in a 2004 review article,

“In ageing skin, topical application of niacinamide improves the surface structure, smoothes out wrinkles and inhibits photocarcinogenesis. It is possible to demonstrate anti-inflammatory effects in acne, rosacea and nitrogen mustard-induced irritation. Because of its verifiable beneficial effects, niacinamide would be a suitable component in cosmetic products for use in disorders of epidermal barrier function, for ageing skin, for improving pigmentary disorders and for use on skin prone to acne.”²

The theory looks good, but does it work?

Your query has actually prompted me try the idea on my own hair to counteract the general thinning I've been seeing during the past 15 years or so. I am rubbing some Metazene gel into the upper part of my scalp every other night — about 6 presses of the Metazene dispenser. I don't expect to see significant results for several months.

This mini clinical trial would, of course, be immediately rejected by medical researchers as statistically worthless, since it involves only one subject, no controls, and no quantitative measurements. Indeed, this experiment would be unable to distinguish between a small effect and no effect. On the other hand, if the treatment turned out to be spectacularly successful, its low statistical power would be happily ignored by me and by nearly everyone who wants a thicker head of hair.

For more information on niacinamide cream see LifeLink’s monograph for Metazene.

— Dr. Alexis Zarkov, Ph.D.

You can contact Dr. Zarkov at AskDrZarkov@yahoo.com.

Last modified 2011.Mar.16

References

[1]  What’s Niacin/Niacinamide Lonza website

[2]  Nicotinic acid/niacinamide and the skin. J Cosmet Dermatol. 2004 Apr; 3(2):88-93 Gehring W

[3]  Seeing red: flushing out instigators of niacin-associated skin toxicity. J Clin Invest. 2010 Aug 2; 120(8):2651-5 Dunbar RL, Gelfand JM

[4]  Finasteride in the treatment of alopecia. Expert Opin Pharmacother. 2004 Apr; 5(4):933-40 Libecco JF, Bergfeld WF

[5]  Niacin versus niacinamide. CMAJ. 1992 Oct 1; 147(7):990 Jaconello P

[6]  Niacin Wikipedia website

[7]  Quantitative and ultrastructural analysis of inflammatory infiltrates in male pattern alopecia. Acta Derm Venereol. 1999 Sep; 79(5):347-50 Sueki H, Stoudemayer T, Kligman AM, Murphy GF

[8]  Cutaneous immunopathology of androgenetic alopecia. J Am Osteopath Assoc. 1991 Aug; 91(8):765-71 Young JW, Conte ET, Leavitt ML, Nafz MA, Schroeter AL

[9]  Reversal of male-pattern baldness, hypertrichosis, and accelerated hair and nail growth in patients receiving benoxaprofen. Br Med J (Clin Res Ed). 1982 Apr 24; 284(6324):1228-9 Fenton DA, English JS, Wilkinson JD

[10]  Benoxaprofen. Wikipedia website

[11]  Transcutaneous PO2 of the scalp in male pattern baldness: a new piece to the puzzle. Plast Reconstr Surg. 1996 May; 97(6):1109-16; discussion 1117 Goldman BE, Fisher DM, Ringler SL

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Disclaimer: The information provided in this “Ask Dr. Zarkov” article contains no medical advice whatsoever — it contains biological information. Nothing in the article constitutes an effort to persuade readers to use, or not to use, this biological information as a basis for action.