Skin, hair and nail beauty
Cosmetic request to strengthen hair, nails and improve skin. Supplement marketing aggressively promotes biotin, pantothenic acid, collagen, silicon and «hair» complexes. In patients without diagnosed deficiency (biotinidase, malabsorption) clinical trials show no benefit over placebo.
9 drugs
Also known as: Beauty supplements, Hair and nails vitamins, Cosmetic nutraceuticals
Drugs used for this condition
Marketing claims without evidence base
The drug is promoted for these uses outside international guidelines. Each entry below is analyzed against AEMPS, FDA, EMA, Cochrane and major RCTs.
- DBiotinNot recommended · Vitamin B7 (H). Water-soluble vitamin, cofactor of four carboxylases. AEMPS registers biotin as a medicine for treating confirmed deficiency; in multivitamins and mono-supplements – dietary supplementBiotin is widely sold «for hair growth and nail beauty». EFSA approved the claim «contributes to normal hair and skin» at adequate intake – this is a MAINTENANCE-of-normal-state claim, not a TREATMENT claim for hair loss in non-deficient individuals. Patel 2017 systematic review (18 cases) showed clinical improvement in hair loss ONLY in patients with confirmed biotin deficiency or rare congenital syndromes. In healthy adults without deficiency, RCTs with clinical endpoints for biotin 1–10 mg/day did not show meaningful effect on hair or nails. AAD 2022 does not include biotin in hair loss recommendations. Doses in commercial supplements reach 5000-10000 mcg (100–300 times the adequate intake of 30 mcg/day) – such doses do not benefit healthy individuals but create a serious analytical risk (see below). Hair loss workup matters: ferritin, TSH, scalp examination, ruling out androgenetic alopecia. If biotin was recommended without blood work and examination, consider seeking a second opinion from a dermatologist.
- DHorsetailNot recommended · Botanical supplement, aerial parts of Equisetum arvense (field horsetail), source of silica and flavonoids; in the EU registered as a traditional-use herbal medicinal product (EMA HMPC) for mild diuretic effect; sold on iHerb as silica for «skin, hair and nails»Field horsetail is an over-the-counter silica supplement. On iHerb it is sold as «silica for skin, hair and nails», promising collagen reinforcement, hair growth and strong nails. EFSA in 2009 rejected all silicon health claims – applications for «healthy connective tissue», «bones», «hair and nails» were not supported by quality evidence. Silicon bioavailability from horsetail is lower than from orthosilicic acid, and whether it reaches collagen fibres of skin and nails in meaningful amounts is unknown. RCTs with hard endpoints (objective hair-thickness, nail-growth rate, skin elasticity) do not exist. The 2016 EMA HMPC monograph recognises horsetail only as a traditional-use diuretic, not as a hair or nail product. AESAN classifies horsetail as a complemento alimenticio without therapeutic indication. If horsetail was bought for «hair and nails» in the setting of hair loss, discuss with a doctor – real causes (iron deficiency, hypothyroidism, telogen effluvium, androgenetic alopecia) need blood tests and targeted treatment with minoxidil, finasteride, iron or levothyroxine, not a plant supplement.
- DHyaluronic Acid (oral)Not recommended · Dietary supplement. Glycosaminoglycan produced by bacterial fermentation of Streptococcus zooepidemicus. AEMPS does not register oral hyaluronic acid as a medicine; intra-articular and topical forms (M09AX01, S01KA01) are registered medicinesOral hyaluronic acid is sold in beauty complexes «for skin, hair and nails». Evidence base concerns only stratum corneum hydration in small Japanese RCTs; no RCTs with clinical hair or nail endpoints are published. EFSA has not approved any health claim for hyaluronic acid under Reg 432/2012. AAD 2022 for hair loss recommends cause workup (ferritin, TSH, scalp examination), topical minoxidil and finasteride for male androgenetic alopecia; oral hyaluronic acid is not in recommendations. If oral hyaluronic acid was recommended for hair loss without minimal workup, consider seeking a second opinion from a dermatologist.
- DHydrolysed Collagen Peptides (type I and III)Not recommended · Dietary supplement, hydrolysate of animal or marine connective tissue. In Russia and Spain sold as dietary supplement. AEMPS does not register oral collagen as a medicineMarketing attributes hair and nail strengthening to collagen. Evidence base is absent: no systematic reviews with clinical hair and nail endpoints published; EFSA has not approved any collagen health claim under Reg 432/2012 or subsequent assessments. For hair loss, AAD 2022 recommends diagnosing the cause (androgenetic alopecia, telogen effluvium, iron deficiency), topical 5% minoxidil and finasteride in male androgenetic alopecia. For nail brittleness without iron or zinc deficiency, oral supplements do not work – blood work is needed to exclude thyroid disease and anaemia. If collagen was recommended for hair loss without ferritin, TSH and scalp examination, consider seeking a second opinion.
- DL-lysineNot recommended · Essential amino acidOn iHerb and Instagram L-lysine is promoted as a collagen building block for skin beauty, hair strength and nail growth. EFSA (2011, opinion 2063) authorised no health claim for L-lysine; there is no approved claim on skin, hair or nails. There are no controlled studies for aesthetic indications. In a patient without nutritional deficiency (balanced diet with animal or plant protein) the supplement will not produce a visible effect on skin or hair. If hair loss or brittle nails bother the patient, discuss iron, zinc, vitamin D and thyroid function with the doctor.
- DMethylsulfonylmethane (MSM)Not recommended · Dietary supplement. Organic sulphur compound, dimethyl sulfone. AEMPS does not register as a medicine; in Russia and Spain – dietary supplementMethylsulfonylmethane (MSM) is a sulfur source that supplement makers market for skin radiance and stronger hair and nails. No convincing benefit for this use has been shown: there are no good-quality studies on skin, hair, or nails specifically, and the claims rest on marketing rather than an evidence base. Taken for this purpose the compound is well tolerated and carries no notable risk. What actually helps skin, hair, and nails is balanced nutrition and correcting a confirmed deficiency (iron, protein, zinc), which is worth discussing with a doctor.
- DPantothenic acidNot recommended · Water-soluble vitamin B5Pantothenic acid (vitamin B5) is a water-soluble vitamin involved in metabolism. Supplements market it for glowing skin, hair growth, and stronger nails. No convincing benefit has been shown for this use: deficiency is rare on a normal diet, and extra intake does not improve skin, hair, or nails. Skin appearance responds to good skincare and sun protection; for hair loss or brittle nails, a dermatologist can find the cause – such as iron deficiency, a thyroid problem, or a skin condition – and treat it. The vitamin is harmless in this role, but do not take it instead of treatment with proven benefit, since that can mean missing the care you actually need.
- DSilicon (organic silicon, silica from horsetail or bamboo)Not recommended · Mineral in supplement form. Not registered as medicine in EU or AEMPSSilicon is mass-marketed as a «product for hair, nails and skin» promising «collagen synthesis stimulation». EFSA 2009 reviewed manufacturer health claim applications for silicon on collagen synthesis and skin, hair and nail status: none approved. Several small RCTs (Wickett 2007, Barel 2005) showed moderate improvements in skin elasticity and nail strength with ch-OSA (choline-stabilised orthosilicic acid) 10 mg/day × 5–9 months; sample sizes around 50, not reproduced in independent groups. For diffuse hair loss AAD 2024 lists workup (ferritin, TSH, testosterone, zinc) and treating the underlying cause; silicon supplements are not in the guideline. If silicon was recommended for marked hair loss or nail brittleness without workup, consider seeking a second opinion.
How to read tiers A–F
Evidence tiers belong to the drug-indication pair, not to the drug as a whole: the same substance can be A for one condition and F for another.
- AStrong evidence – first or second line in international guidelines
- BRecommended in selected cases
- CStudy data contradict each other
- DBenefit not proven, no documented harm
- FDocumented harm, or risk without benefit