Background
Amla, scientifically known as Phyllanthus emblica. Amla is predominantly grown in countries such as China, India, Southeast Asia, Sri Lanka, Malaysia, Pakistan, and Iran. Amla has many properties and health benefits, these properties include being antibacterial, antifungal, and antimicrobial . Amla is very significant in Ayurvedic medicine and is used for promoting hair growth, treating hair loss, and preserving hair color (1).
Hair growth occurs in a cycle that consists of four phases: anagen (growth), telogen (rest), catagen (regression), and exogen (shedding). To promote hair growth, it’s important to keep the hair in the anagen phase for as long as possible (2). Alopecia refers to temporary or permanent hair loss. Female androgenetic alopecia (FAGA) is a common cause of non-scarring hair loss in women. FAGA is characterized by diffuse hair thinning over the central scalp, while the hair on the edge of the scalp remains unaffected. During FAGA, the hair follicles shrink and the hair remains in the telogen phase for a longer time. Alopecia can be caused by abnormal changes in sex hormones, inflammation, and a decrease in growth factors in the dermal papilla cells (3) .
Female androgenetic alopecia study
In a 2024 study was conducted to test the effectiveness of amla syrup in treating Female Androgenetic Alopecia (FAGA). The experiment was conducted on a sample of 91 women with mild to severe FAGA. The participants were divided into two groups of 30. One group received a placebo, while the other received amla syrup. The syrup was made from 30 g of coarsely ground amla and the participants received 10 ml of syrup thrice a day. To measure the hair quality, a trichoscan was used at the beginning of the study and again after 12 weeks of treatment.
At the beginning of the study, it was established that there was no significant difference between the placebo and amla groups. After 12 weeks of treatment, the anagen percentage, telogen percentage, and the anagen-to-telogen ratio were measured for both groups. The amla group had an anagen-to-telogen ratio of 4, while the control group had a 2.7 anagen-to-telogen ratio, which was significantly lower than that of the amla group. The study concludes that oral supplementation of amla is effective in treating FAGA.
How does it work?
Amla is known to have several components that are beneficial for hair growth and preventing hair loss. Some of the compounds found in amla include gallic acid, ellagic acid, emblicanin A & B, phyllembein, quercetin, and ascorbic acid. These compounds are effective at nourishing hair and promoting its growth (3).
Moreover, amla is also effective against some of the hair loss-causing factors such as inflammation, hormone imbalances, and decreased growth factors in the dermal papilla cells (3).
Inflammation
According to a 2013 study, inflammation can cause temporary or permanent hair loss by increasing the anagen-to-telogen ratio and affecting the hair’s connective tissue. To test the anti-inflammatory properties of amla, it was compared to Diclofenac, an FDA-approved pain relief and inflammation drug, and a control group. The experiment involved 30 healthy mice, with five mice used in each of the three different tests. The mice were subjected to two types of tests – acute inflammation and chronic inflammation. In the acute inflammation test, Carrageenan was injected into the mouse paws to cause edema, while in the chronic inflammation test, four rexin pellets were placed in the dorsum skin of the mice. After three hours, the paw edema volume was measured with a plethysmograph, and the percentage inhibition of edema was calculated for the different groups. The mice were given 540mg/kg of amla powder, which is equivalent to a 6g/kg dose in humans. The results showed that amla reduced the edema and inflammatory infiltration by about 30-40%, while Diclofenac reduced it by around 50-60%.
Inflammation occurs when the immune system reacts to pathogens in the body. In a 2019 study, the anti-viral, anti-fungal, and anti-bacterial properties of amla extract were tested in an in vitro experiment. The study found that P. emblica extract had high antimicrobial effects against Gram-positive, Gram-negative, and resistant bacteria. Amla was also effective in reducing the bacteria count of S. aureus, E. coli, and oral bacteria like S. mutans and Porphyromonas gingivalis. In the anti-fungal in vitro experiment, amla extract was effective against Fusarium solani which causes dry potato tuber rot and candida, a type of yeast that can infect humans. The anti-viral properties of amla were shown to be effective against coxsackie virus, herpes simplex (HSV), human papillomavirus (HPV), human immunodeficiency viruses (HIV), and influenza A virus.
Hormones
During Androgenetic Alopecia, testosterone is converted into active dihydrotestosterone (DHT) by 5α-reductase enzymes. DHT binds to the androgen receptors of hair follicles, leading to hair loss by decreasing hair’s androgen phase (3).
In a 2012 study, the extract of 17 different Thai plants was tested for its ability to block DHT. It was found that Amla, among the plant extracts tested, was the second most potent DHT blocker. In the hair growth determination part of the experiment, the three plants with the highest DHT inhibitory activity were tested against two control groups. The positive control group was treated with 2% minoxidil, a medicine used in the treatment of male pattern baldness. The vehicle control group was treated with a solution composed of propylene glycol, water, and ethyl alcohol in a ratio of 5:3:2. Each treatment group had five mice, and the experiment lasted for 28 days. On the last day of the experiment, the hair follicles were counted using a Coscam® USB-22. The vehicle group had the lowest hair follicle count at 24.2 ± 2.8. The Minoxidil group was the second lowest, with a follicle count of 36.3 ± 4.1. The Amla group was the second highest, with a hair follicle count of 46.4 ± 3.0.
Growth Factors
Amla extract can enhance the mRNA expression of genes related to growth. It has been found that amla extract can increase the expression of Insulin-Like Growth Factor 1 (IGF-1) and Vascular Endothelial Growth Factor (VEGF). These factors accelerate the differentiation and growth of dermal papilla cells in a dose-dependent manner (3).