According to a review published in the Journal of Holistic Integrative Pharmacy, the plant works through several mechanisms simultaneously. It inhibits 5-alpha-reductase — the enzyme that converts testosterone into dihydrotestosterone, the main cause of hair follicle miniaturization. In addition, He Shou Wu protects follicles from oxidative stress, improves scalp microcirculation, and activates the Wnt and Sonic Hedgehog signaling pathways responsible for hair growth.
In laboratory and small clinical studies, plant extracts have demonstrated increased hair density and reduced hair shedding. Particularly noteworthy are findings that its active components (stilbenes and anthraquinones) can prolong the anagen phase — the active growth period of hair.
However, the review authors emphasize an important point: the raw plant may be hepatotoxic. In traditional medicine, it is always specially processed, which significantly reduces the risk to the liver. Any use should occur only under specialist supervision.
He Shou Wu is one of the most promising natural candidates for combating androgenetic alopecia. Further large-scale clinical studies are needed to confirm its long-term efficacy and safety.