Many of our patients ask about supplements or medications for hair loss during and after treatment. Some have anectdotally reported good results with either biotin or a hair/skin/nail vitamin. What are your thoughts and recommendations? —Jennifer Grap, MSN, CRNP

Can vitamins or supplements grow hair? The hair thinning or loss from cancer therapy differs from generalized loss, so this is a question that oncology nurses are frequently asked. Given the vast number of vitamins, supplements, and plant extracts claiming to grow hair, you would think that this would no longer be an issue.

While there are a handful of studies showing that some exotic plant extracts, such as Asiasari radix extract, Citrullus colocynthis schrad extract, Polygonum multiflorum extract, Thuja orientalis extract, Eclipta alba extract, and Cuscuta reflexa Roxb extract, may assist in hair growth, most of those studies were done on specially bred mice—none of them were performed on people in an appropriate, independent study. So, while the results may be good for the mice, it is unclear if it is an answer.

When it comes to vitamins and supplements for hair growth, if your patients are not seriously vitamin deficient (and most are not), there are no studies showing any vitamin or mix of vitamins and supplements can change a single thinning hair.

If they are truly vitamin deficient, it is important to find out which vitamin or vitamins are lacking, because hair loss would probably be the least of their problems. For example, biotin, a form of B vitamin, is often present in hair-growth supplements. But, if patients were truly biotin deficient, they would be too sick to get to the store.

Blood tests can show if patients are low in vitamin D, zinc, or iron, all of which are related to hair growth as well as to other important fundamental bodily functions related to overall health. Getting these nutrients back within the normal range definitely can make a difference in well-being, and possibly can help increase the density of hair.

Other vitamins and supplements that show up in claimed hair-growing products include vitamin C, omega-3 and omega-6 fatty acids, amino acids, B vitamins, vitamin A, and vitamin E. All of these are basic ingredients in most vitamin supplements (including prenatal vitamins, which many swear by to help their hair grow). So a general vitamin may be the answer.

Can diet affect hair growth? As is true for every part of a person’s body, a healthy diet can go a long way toward making hair, nails, and skin look beautiful. That said, there is no research showing a specific diet or group of foods will help grow hair. You’ll read about lentils, walnuts, salmon, and even poultry as being a few of the dietary answers for hair growth, but it is really about a healthy diet.

One interesting aspect of diet: Because hair is mostly protein (in this case, a protein known as keratin), it is a good, though unproven, assumption that there is a need for protein in the diet to grow hair. A protein deficiency can cause hair loss, as can malnutrition from excessive dieting or the eating disorder anorexia, but these are related to serious protein deficiency, and affect only a small percentage of the population. However, patients with cancer do sometimes decrease protein intake during treatment secondary to taste changes and/or the treatments themselves.