One of the top concerns in every dermatology practice is hair loss. While the concern of losing one’s hair is very common, it can manifest in different forms from true disorders to subtler findings like more hair shedding or breakage over time. In my experience, many patients have tried to their own remedies before they even see me for hair loss, and biotin supplements are by far the most common strategy my patients have used. A new study found that roughly a third of all patients seen at a dermatology practice had used biotin supplements, and about a third of those patients had been recommended the supplement by a doctor. While the use of biotin supplements is hugely popular, I’ve started recommending against it for my own patients because there is no convincing evidence that it helps to grow hair and it can actually be dangerous.
What is biotin?
Biotin is a water-soluble B-vitamin necessary for metabolism of carbohydrates, fatty acids and amino acids. In layman’s terms: it’s a vitamin needed to process nutrients within the body. It’s found in many foods including nuts, vegetables, fish and meat. Since biotin is water soluble, any excess intake that the body doesn’t need is excreted in the urine.
What do we know about biotin and hair growth?
Biotin is necessary for many normal functions of the skin including hair and nail growth. Because of this, hair loss can be seen in people with biotin deficiency. That said, anyone eating a typical diet should not be biotin deficient and taking in more biotin than you need will not increase hair growth. There are no clinical trials in the literature showing that biotin supplementation increases hair growth or stops hair loss in normal people without any other symptoms. There have been some reports in the medical literature showing hair growth as a result of biotin supplementation, but nearly all of these reports were in children with a metabolic disorder, meaning they likely couldn’t process biotin normally.
Why could it be dangerous?
While excess biotin is excreted in the urine, studies have shown that it can build up in the blood before being expelled from the body, and this can cause medical complications. The reason for this is that biotin is used in many lab tests and having excess biotin in the blood can skew important test results. The US FDA actually released a warning about biotin supplements based on report that a patient on biotin died from a heart attack after a blood test used to detect damage to the heart (cardiac troponins) came back normal. There have also been studies showing that taking biotin supplements can obscure other lab tests, including some used to measure thyroid function.
What should I do about hair loss then?
If you think that you’re experiencing hair loss, talk to your primary doctor and seek a consultation with a dermatologist before you start taking any supplements. While the general attitude towards vitamin supplements is that they’re harmless, they can have a serious impact on your health. I also tell anyone that will listen: time is hair! If you do think that you’re losing hair, you might have a treatable condition. The sooner you are evaluated, the easier it will be to conserve the hair that you have and maybe even grow new hair!