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for dihydrotestosterone (DHT) as an androgen that is natural compounds such as tannins, alkaloids, flavonoids and
produced by peripheral conversion of testosterone by 5-alpha saponins. The rhizomes have long been used against
43
reductase enzyme resulting hair follicles to become arthritis, rheumatism, bronchial catarrh, bad breath, ulcers,
progressively smaller and finer. The size of the follicles is whooping cough in children and throat infections to control
5,9
increased in the beard, chest and limbs and decreased in the incontinence. Also anti-inflammatory, anti-psychiatric,
bitemporal region by androgens at puberty, which causes the anti-phlogistic, analgesic, anti-emetic, carminative and
hairline shapes in men and many women. The young people anti-spasmodic effects have been reported. According to an
44
1
with androgenic alopecia have more androgen receptors, in vito study, the acetone extract of the rhizomes of
higher levels of 5-alpha reductase and lower levels of A. officinarum showed considerable 5-alpha reductase
cytochrome P450 aromatase, which last enzyme causing to inhibitory activity and analyzing the responsible fraction
convert testosterone to estradiol in hair follicles in the frontal represented four active constituents with Diarylheptanoid
region of the scalp than in the occipital section. 1 structures. 19
There are numerous available treatment options that
currently is used by people with androgenic alopecia. Drug Artocarpus altilis
therapies such as minoxidil (vasodilation, angiogenesis, Breadfruit or Artocarpus altilis (Parkinson) Fosberg
enhanced proliferation of cell, mediation via potassium (synonym: Artocarpus incises), (family: Moraceae) is a
channel opening and a small stimulatory activity on 5-alpha moderate size tree, which indigenous to Southeast Asia and
reductase), finasteride (a synthetic inhibitor of type II 5-alpha is widely distributed in tropical and subtropical areas. It is a
reductase), dutasteride (a type I and II 5-alpha reductase rich source of prenylated flavonoids and other various
inhibitor), prostaglandin analogues (latanoprost and flavonoid and triterpenoid structures have been reported in
bimatoprost), ketoconazole (as an anti-androgen), previous studies. The leaves of the plant have been used in
anti-androgen compounds as inhibitors of 5α reductase folk medicine as liver cirrhosis, hypertension and diabetes
(Cyproterone acetate and spironolactone), Laser-light remedies and the pulp of fruits is believed to be a tonic for
treatment, surgical treatment, cell mediated treatment and the liver. Other biological activities that were shown from the
alternative treatments (vitamin, mineral and herbal flavonoids of A. altilis including anti-bacterial, anti-malarial,
components) are common therapeutic methods prescribed anti-tubercular and cytotoxic effects. Some of the in vitro
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for androgenic alopecia. 9-15 hair loss studies showed potent 5-alpha reductase inhibitory
Herbal medicine as an alternative treatment method is activity of the leaf extract of A. altilis and 2-geranyl-2’,3,4,4’-
used as primeval as human civilization and for a very long tetrahydroxydihydrochalcone was the most potent identified
time, it is one of effective sources of drugs and is considered compound of the extract. 4,20
as a part of a healthy lifestyle. 16-18 The aim of this review is
evaluating of useful natural sources for treatment of Camellia sinensis
androgenic alopecia. Camellia sinensis or green tea (family: Theaceae) is a
famous herb that has been used every day as a beverage.
MATERIALS AND METHODS Unfermented extract of C. sinensis contains high amounts of
In this review, most of the natural sources that used in catechin, epicatechin and epigallocatechin gallate with
the treatment of androgenic alopecia were collected from oligomeric catechin tanning agents, flavonoids, purine
electronic databases including Web of Science, PubMed, alkaloids and caffic acid derivative. 4,21 Pharmacological
Scopus and Google Scholar were searched for these plants. properties of C. sinensis have been considered by folk
All articles were assessed to find out any in vitro, in vivo and medicine recently. Previous studies suggested this plant for
also clinical evidence of their therapeutic effects and reduction of cardiovascular disease risk and cancer. It has
pharmacological mechanisms. Data were gathered from 1970 been used as an anti-hypertensive, anti-bacterial, anti-viral,
to 2016. Only published articles were reviewed in this article weight losing, neuroprotective, bone mineral density
and also only English language articles were contained. increasing and anti-fibrotic agent. Moreover, C. sinensis
46
have a significant anti-androgenic effect. The active principle,
RESULTS AND DISCUSSION epigallocatechin as a polyphenol, was reported to inhibit the
Medicinal fungi or plants with their possible mechanisms 5-alpha reductase and conversion of testosterone to DHT
and active phytoconstituents were used in androgenic and then significantly increasing hair growth. 4,22
alopecia are described and the summarized information is
presented in Table 1. Carthamus tinctorius L.
Safflower or Carthamus tinctorius L. (family: Compositae)
Alpinia officinarum is an annual or biennial plant with a widely traditional use in
Lesser galangal or Alpinia officinarum Hance (family: Chinese medicine. Quinochalones, flavonoids, alkaloids,
Zingiberaceae) is an annual plant, which is distributed in polyacetylene, aromatic glucosides and organic acids have

south of China. Phytochemical studies on the rhizomes of been identified from C. tinctorius. It has a wide spectrum of
A. officinarum showed the presence of different groups of pharmacological effects and is used in the treatment of

28 ALTERNATIVE THERAPIES, JUL/AUG 2020 VOL. 26 NO. 4 Asnaashari—Herbal medicines for Androgenic Alopecia