Acupuncture and herbs outperform a popular hair loss drug for patients with seborrheic alopecia. Heilongjiang University of Traditional Chinese Medicine Second Affiliated Hospital researchers compared results in a clinical trial. Drug therapy produced an 82.5% total effective rate. Acupuncture and Chinese herbal medicine produced an 87.5% total effective rate. The researchers conclude that the application of acupuncture and herbs “is an effective method in treating seborrheic alopecia.” 
This type of hair loss is due to a skin condition (seborrheic dermatitis) wherein there is an excess production of sebum on the scalp, typically accompanied by itching, pain, and flaking dandruff. The protocolized investigation by Kong et al. compared patients receiving finasteride with patients receiving acupuncture and herbal medicine.
Finasteride is a 5-alpha reductase inhibitor that is used for the treatment of hair loss. The drug blocks the action of 5-alpha-reductase, an enzyme responsible for converting testosterone into dihydrotestosterone. The two commonly available 5-alpha-reductase inhibitor medications available, finasteride and dutasteride, increase testosterone levels while simultaneously reducing levels of dihydrotestosterone.
This is significant because men with increased levels of dihydrotestosterone may suffer from androgenetic alopecia, a condition commonly referred to as male pattern baldness. Approved uses of 5-alpha reductase inhibitors include the treatment of androgenic alopecia and benign prostatic hyperplasia. Patients receiving only finasteride tablets had an 82.5% total effective rate. Patients receiving standard acupuncture and Chinese herbal medicine had an 87.5% total effective rate.
Inclusion criteria consisted of the Traditional Chinese Medicinal (TCM) differential diagnostic pattern of damp-heat steaming the upper body. In TCM, damp-heat may lead to instability of skin interstices, obstruction of meridians, and inhibited generation of essence and blood. For this reason, seborrheic alopecia patients with this diagnostic pattern typically have hair loss due to loose hair roots and inhibited growth of new hair.
TCM signs include loose hair with an oily and peeling scalp, profuse sweating, bitter taste in the mouth, and dry stools. The tongue is red with a yellow and greasy coating. The pulse string-like (wiry) and rapid or is thin and rapid. The zang-fu organ related to this type of alopecia is the spleen. The treatment in TCM focuses on strengthening the spleen, clearing damp-heat, and improving regrowth of hair.
Multiple subjective and objective instruments were used to measure patient outcomes. The degree of hair loss and growth was measured. Symptom scores were recorded (scalp itchiness, greasiness, peeling, etc.). Serum levels of testosterone (T) and estradiol (E2) were observed. The researchers note that acupuncture and herbal medicine significantly stimulated hair growth, relieved symptoms, and improved serum T and E2 levels.
The acupuncture plus herbs group received standard acupuncture and a version of a traditional Chinese herbal medicine formula called Yin Chen Wu Ling powder. The drug group received oral administration of finasteride tablets (1 mg per day), for a total of 12 weeks. For standard acupuncture, the primary acupoints were the following:
- ST36 (Zusanli)
- SP6 (Sanyinjiao)
- SP9 (Yinlingquan)
- ST44 (Neiting)
- ST40 (Fenglong)
Treatment commenced with patients in a supine position. After disinfection of the acupoint sites, a 0.35 mm x 40 mm disposable filiform needle was inserted into each acupoint, reaching a depth of 1–1.5 cm. Manual acupuncture stimulation techniques for achieving a deqi sensation included lifting, thrusting, and rotating. Once a deqi sensation was obtained, the needles were retained for 30 minutes. The treatment was conducted once daily, 7 times per week, for a total of 12 weeks. The traditional herbal decoction included the following ingredients:
- Yin Chen Hao 20 g
- Fu Ling 30 g
- Bai Zhu 15 g
- Ze Xie 6 g
- Zhu Ling 10 g
- Dan Shen 15 g
- Shan Zha 20 g
- Hu Zhang 10 g
- Ce Bai Ye 15 g
- Jue Ming Zi 10 g
- Xian He Cao 15 g
- He Ye 10 g
- Shi Chang Pu 10 g
- Xi Lian Cao 10 g
The prescribed dosage was one decoction daily. The above ingredients were brewed with water to obtain a 300 ml decoction, which was split into 2 servings, taken after breakfast and dinner respectively. The treatment was administered every day for 12 weeks. Throughout the treatment period, patients were advised to have a good mood and adequate sleep and to avoid spicy and other exacerbating foods. Treatment efficacy was evaluated and categorized into 1 of 4 tiers:
- Recovery: Hair loss stopped. Absence of itchy, greasy, and peeling scalp. ≥90% hair regrowth in lesion areas.
- Significantly Effective: Hair loss stopped. Significant improvement of itchy, greasy, and peeling scalp. ≥60% hair regrowth in lesion areas.
- Effective: Hair loss stopped. Significant improvement of itchy, greasy, and peeling scalp. ≥30% hair regrowth in lesion areas.
- Ineffective: Hair loss not stopped. No improvement of itchy, greasy, and peeling scalp. No hair regrowth in lesion areas.
The research of Kong et al. indicates that acupuncture and herbal medicine treatments produce significant positive patient outcomes for patients with seborrheic alopecia due to damp-heat steaming the upper body. Acupuncture and herbs produced an 87.5% total effective rate. Finasteride produced an 82.5% total effective rate.