From onion mixtures to hair transplants: a history of hair-loss cures

For thousands of years people have sought ways to prevent or reverse hair loss, producing a catalogue of remedies that ranged from ritual and topical concoctions to surgical solutions. Some historic methods were extreme enough to be dismissed by physicians of their day, while others anticipated modern understanding of hormones and scalp health. Today, clinicians generally rely on clinically tested medications and surgery, but the condition remains multifactorial and without a single universal cure.

Ancient civilizations developed some of the earliest recorded responses to hair loss. In Egypt, recorded remedies dating back about 4,000 years combined ritual with ingested and applied mixtures: one such formula called for reciting a spell to the sun god and swallowing a preparation of onions, iron, red lead, honey and alabaster. In Rome, a variety of topical treatments including animal fats were applied to the scalp; contemporaneous accounts also report cosmetic strategies, such as Julius Caesar wearing his hair long at the back and combing it forward to conceal recession.

Across other regions, remedies drew on local resources and beliefs. Indigenous groups in South America used heated banana extracts on the scalp, a treatment that may have offered conditioning benefits because bananas contain potassium, natural oils and vitamins. In 17th-century Britain, medical handbooks advised applications as unexpected as chicken dung and, for other purposes, cat dung; ashes of bird droppings with lye likewise appear in period texts. In Victorian-era America, vigorous brushing was widely recommended, and nightly topical mixtures combining cologne, spirit of camphor and cantharides were prescribed by some practitioners.

Ancient Greek physicians began to link hair loss with physiological causes. Hippocrates observed that males castrated before puberty did not typically develop pattern hair loss and experimented with various topical mixtures—reportedly including horseradish, cumin, pigeon droppings and nettles—although his treatments did not prove effective and contemporaneous accounts record that he himself lost hair. Modern endocrinology explains his observation: testosterone can be converted into dihydrotestosterone (DHT), a hormone associated with androgenetic alopecia, the most common form of pattern hair loss. Research summaries have noted that castration may prevent this process but, as one review from Duke University researchers put it in 1995, "while castration may be a cure, it is not commercially acceptable."

Medical understanding and therapeutic options expanded substantially in the 20th and 21st centuries. Clinically tested topical and oral drugs now target the biological mechanisms behind many cases of hair loss. Minoxidil, a topical vasodilator, and finasteride, an oral inhibitor of the enzyme that converts testosterone to DHT, are among treatments approved by regulatory authorities for certain types of hair loss. Dermatologists often prescribe combination regimens tailored to the patient’s diagnosis, pattern of loss, underlying health and treatment tolerance.

Surgical hair restoration is another established option. Hair transplantation redistributes follicular units from a ‘‘donor’’ area—typically the back and sides of the scalp, where hair is genetically more resistant to DHT—to thinning or bald regions. Modern techniques, including follicular unit transplantation and extraction, aim to create natural-looking density, but they require adequate donor hair and carry risks such as scarring, pain, swelling and the possibility of unsatisfactory cosmetic outcomes. Recovery times and the need for repeat procedures vary by technique and individual response.

Despite advances, hair loss remains a multifactorial condition influenced by genetics, hormones, age, immune factors, medication side effects, nutritional status and systemic disease. No single therapy guarantees restoration for all patients, and clinicians emphasize individualized assessment. Nonmedical approaches seen historically—ranging from animal fats to plant extracts and ritual—are largely regarded today as unproven, though some may improve scalp condition or cosmetic appearance.

Ongoing research continues to explore new pharmacologic agents, regenerative techniques such as platelet-rich plasma and stem-cell approaches, and improved surgical methods. For individuals concerned about hair loss, dermatologists and hair restoration specialists recommend medical evaluation to determine the probable cause and to weigh the benefits, limitations and risks of available treatments before beginning therapy.