Traditional Chinese remedies for hair loss: what studies exist, and the safety questions

Traditional Chinese medicine (TCM, 中医) is part of everyday life for many Malaysians. When hair starts to thin, it is common to visit a TCM practitioner, pick up a herbal tonic from a Chinese medicine hall, or try a family recipe with he shou wu (何首乌) or black sesame. Some people combine these with modern treatment; others try TCM first. Both choices are understandable, and many people find the personal attention of a TCM consultation reassuring.

This guide explains how TCM views hair loss, what the research actually covers, where the evidence is weak, and the specific safety questions worth asking, especially about the liver, contaminants and interactions. It is general information, not personal medical advice. For the overall approach to treatment, see hair loss treatment in Malaysia.

Short answer

• TCM uses herbs, acupuncture and other methods based on its own theory of the body, in which hair is linked with the kidneys and blood ¹.
• The research on TCM for hair loss is small and mostly low quality. Some studies of acupuncture for alopecia areata and herbal compounds combined with minoxidil report benefit, but reviewers call for larger, better-designed trials ^{2 3 4}.
• Safety deserves real attention. Some herbs, most notably he shou wu, have been linked with liver injury, and some herbal products have been found contaminated with heavy metals or undeclared drugs ^{5 6 7}.
• For pattern hair loss, proven treatments remain the first choice ⁸. If you use TCM, tell your doctor, choose registered practitioners and products, and watch for warning signs.

How TCM views hair loss

In TCM theory, healthy hair reflects sufficient "kidney essence" (肾精) and "blood" (血). Hair loss may be described in terms of kidney deficiency, blood deficiency, "damp heat" or blood stasis, and treatment aims to correct these patterns ¹. A practitioner usually asks about sleep, stress, appetite and digestion, looks at the tongue and feels the pulse, then suggests herbs, acupuncture or dietary advice tailored to the pattern.

This framework is very different from the way doctors classify hair loss, which is by cause and pattern: androgenetic alopecia, alopecia areata, telogen effluvium, scarring alopecias and so on. The same TCM pattern might be applied to several medical diagnoses, and the same diagnosis might be given different TCM patterns. This can make it difficult to compare TCM research with standard medical research.

Common TCM approaches for hair

• Herbal formulas taken by mouth, often containing he shou wu, rehmannia (熟地黄), angelica (当归), goji (枸杞) or black sesame. See black sesame for hair.
• Topical herbal tonics applied to the scalp, sometimes containing ginger, ginseng or other herbs. See ginger for hair growth.
• Acupuncture, including scalp acupuncture and "plum blossom" needling (梅花针), which taps the skin with a cluster of fine needles.
• Moxibustion and other heat treatments.
• Diet and lifestyle advice, such as eating "black foods" and resting more.

What studies exist

Most published studies on TCM for hair loss come from China and are small. Some findings:

• Acupuncture for alopecia areata. A 2026 systematic review found that studies reported benefit, but the quality of evidence was low and sample sizes were small ².
• Compound glycyrrhizin with minoxidil for alopecia areata. A meta-analysis of randomised trials reported benefit when this licorice-derived compound was added to minoxidil, while noting that the included studies were of suboptimal quality ³. Compound glycyrrhizin is a prescription medicine in some countries rather than a home remedy.
• Acupoint treatments for pattern hair loss. Trials combining acupoint techniques with minoxidil are being planned or carried out; one published protocol describes such a trial but does not yet report results ⁹.
• Herbal remedies in general. Reviews of herbal treatments for hair loss describe the overall evidence as limited, with few large, well-controlled trials and inconsistent results ⁴.

Several problems recur in this research: small groups, short follow-up, lack of blinding, inconsistent ways of measuring hair, and many different formulas, which makes results difficult to apply to a specific product you might buy. Notably, several of the more positive results come from studies where TCM was added to minoxidil rather than used instead of it.

Why the condition matters

The value of any treatment depends on the type of hair loss:

• Androgenetic alopecia is progressive and driven by genetics and DHT. Evidence-based options such as minoxidil and finasteride are much better studied than any herbal approach ⁸. See male pattern baldness treatment.
• Alopecia areata often improves on its own, which makes it harder to judge whether a remedy helped. See alopecia areata.
• Telogen effluvium usually settles once the trigger, such as illness, childbirth or stress, has passed. See sudden heavy shedding.
• Scarring alopecias need prompt medical treatment, because delays can lead to lasting hair loss.

A proper diagnosis helps you decide whether TCM is a reasonable add-on or whether it risks delaying more effective care.

The safety questions

Liver injury

He shou wu (Polygonum multiflorum) is one of the herbs most often used for hair and greying, and it is also one of the herbs most clearly linked with liver injury. Cases range from mild changes in liver blood tests to serious hepatitis ⁵. Other herbs can also cause herb-induced liver injury, and the risk may be higher with long-term use, high doses or combined formulas ⁶. See he shou wu safety.

Warning signs include unusual tiredness, nausea, loss of appetite, dark urine, pale stools, itching, and yellowing of the skin or eyes. Anyone with these symptoms while taking herbal products should stop and see a doctor promptly.

Contaminants and undeclared ingredients

Studies around the world have found heavy metals such as lead, arsenic, mercury and cadmium in some herbal medicines, at levels that vary widely between products and sources ⁷. Some products sold as herbal have also been found to contain undeclared pharmaceutical drugs. Buying registered products from reputable sources reduces, but does not remove, this risk ¹.

Interactions and special situations

Herbs can interact with prescription medicines, such as blood thinners, diabetes medicines and some heart medicines. Herbs are also generally not recommended in pregnancy or breastfeeding unless a doctor agrees. People with liver or kidney disease should be especially cautious.

Acupuncture

Acupuncture is generally considered low risk when done by a trained practitioner using sterile, single-use needles. Possible problems include soreness, minor bleeding and, rarely, infection ¹⁰. Plum blossom needling on the scalp should be done with clean technique; avoid it over broken or infected skin.

Using TCM sensibly alongside medical care

If you want to include TCM in your plan, some practical steps:

1. Get a medical diagnosis first, so you know what type of hair loss you have.
2. Do not stop proven treatment such as minoxidil or finasteride in favour of herbs without discussing it with your doctor.
3. Tell both your doctor and your TCM practitioner about everything you are taking.
4. Ask exactly what is in a formula, including herb names and doses.
5. Consider liver blood tests if you take herbal formulas, particularly those with he shou wu, for more than a short time; your doctor can advise.
6. Set a review point, such as six months, and take standardised photos to judge whether anything has changed.

Choosing a practitioner and a product

If you decide to see a TCM practitioner, a few signs suggest a careful approach. A good practitioner asks about your medical history and current medicines, is willing to write down the herbs in a formula, encourages you to keep seeing your doctor, and does not insist on large prepaid packages or promise fast results. Be cautious with anyone who tells you to stop prescribed treatment, sells unlabelled powders, or claims that one formula suits every type of hair loss. For products, prefer those with a full ingredient list, a MAL registration number and a clear manufacturer address, and avoid buying loose herbs or capsules from unknown online sellers.

Life in Malaysia

TCM is widely available in Malaysia, from long-established medicine halls to clinics in shopping malls and some government hospitals that offer traditional and complementary medicine services. Traditional and complementary medicine practice in Malaysia is regulated under the Traditional and Complementary Medicine Act 2016, and practitioners in recognised fields are expected to register. Traditional products sold in Malaysia are required to be registered with the National Pharmaceutical Regulatory Agency, and registered products carry a MAL number on the label. Checking for registration is a simple first step, though registration does not mean a product has been shown to treat hair loss. See buying hair loss products at a pharmacy.

Common myths

• "Herbal means no side effects." Some herbs can harm the liver or interact with medicines.
• "TCM treats the root cause, so it works for all hair loss." The evidence does not support this for pattern hair loss.
• "If it worked for my neighbour, it will work for me." Different people have different causes of hair loss.
• "Stronger formulas work faster." Higher doses may raise the risk of side effects.
• "It is traditional, so it has been proven." Long use is not the same as tested benefit. See hair treatments with weak evidence.

Common mistakes

• Taking he shou wu for long periods without liver monitoring.
• Stopping minoxidil or finasteride to "give TCM a chance".
• Buying unlabelled herbs or products online without registration details.
• Combining several herbal products at once.
• Not telling the doctor about herbal use before surgery or new medicines.

Questions to ask your doctor or practitioner

1. What type of hair loss do I have?
2. What is in this formula, and in what doses?
3. Has this herb been linked with liver or kidney problems?
4. Could it interact with my other medicines?
5. Is this product registered in Malaysia?
6. Should I have blood tests while taking it?
7. How long should I try it before reviewing?
8. Can I continue my current treatment at the same time?

The bottom line

TCM is a respected tradition in Malaysia, and some people find its approach helpful. However, the research on TCM for hair loss is limited and mostly low quality, and the more encouraging studies often involve TCM used alongside minoxidil. Some herbs, especially he shou wu, carry a real risk of liver injury, and herbal products can be contaminated. If you choose TCM, get a medical diagnosis first, keep proven treatment in place where appropriate, use registered practitioners and products, and watch for warning signs.

Frequently asked questions

Does traditional Chinese medicine work for hair loss?

Some small studies report benefit, especially for acupuncture in alopecia areata and herbal compounds added to minoxidil, but the evidence is mostly low quality. For pattern hair loss, proven treatments remain the first choice.

Is he shou wu safe for hair?

He shou wu has been linked with liver injury, ranging from abnormal blood tests to serious hepatitis. Anyone considering it should talk to a doctor and watch for warning signs such as yellow eyes or dark urine.

Can I take TCM herbs with minoxidil or finasteride?

Many people do, but it is important to tell both your doctor and TCM practitioner about everything you take, so they can check for interactions and monitor safety.

Does acupuncture help hair loss?

A 2026 review of acupuncture for alopecia areata found reported benefits but low-quality evidence. There is little good evidence for acupuncture in pattern hair loss.

Can herbal products contain heavy metals?

Yes. Studies have found lead, arsenic, mercury and cadmium in some herbal medicines. Buying registered products from reputable sources reduces the risk.

How can I check whether a traditional product is registered in Malaysia?

Registered traditional products carry a MAL number on the label, and registration status can be checked with the National Pharmaceutical Regulatory Agency.

Is TCM safe during pregnancy?

Herbs are generally not recommended during pregnancy or breastfeeding unless a doctor agrees, because safety data are limited for many herbs.

How long should I try TCM before reviewing?

Set a review point, such as six months, take standardised photos, and if hair loss keeps progressing, discuss evidence-based options with a doctor.

Educational content. Not medical advice.