Does Viviscal® Work? Evidence-Based Findings Reveal the Truth

Article Summary

Viviscal™ is a hair loss supplement backed by numerous doctors and 12+ human studies. In this investigative article, we take a close look at Viviscal’s clinical trials, marketing efforts, and product ingredients. We even conducted a series of lab tests. Through these efforts, many issues came to light. Why, after 25 years, are there only a handful of photos demonstrating its efficacy? Why are the clinical studies published in low-ranking dermatology journals and filled with typos? By the end of this in-depth analysis, the fog will be lifted from around one of the world’s most popular hair loss supplements.

Full Article

Viviscal® is one of the most popular hair loss supplements in the world. What sets it apart from its competition? Clinical research. Viviscal has conducted 12+ human studies on its supplement line, all showing that its proprietary blend of marine extracts can improve hair growth in men and women, and with a variety of types of hair loss.

So, does this make Viviscal the go-to supplement for anyone interested in tackling hair loss naturally?

Maybe, maybe not. If there’s anything we’ve learned from other product reviews, it’s that clinical studies on a supplement rarely tell the full story.

More often than not, these studies can be designed to manufacture biased results; those results can create a false sense of hope; that hope can be transmitted to millions through advertising; that advertising won’t usually convey that the results from those clinical studies aren’t applicable to most of the people watching that ad.

That’s why it’s important to look beyond the marketing of a supplement to really see what that data says.

Before purchasing hair loss products, it’s important to examine the company’s products, marketing, and studies to find out whether this supplement is worth the investment. 

Here’s the Perfect Hair Health approach to product reviews:

1. Buy the product. Send the supplement to a third-party laboratory to test for impurities, heavy metals, and pathogenic microbes.
2. Examine the ingredients. Compare the company’s rationale for these ingredients versus what the totality of research says.
3. Read all published clinical studies. Evaluate their methodologies and results, identify areas of bias, and determine if these results align with the claims made in marketing.

The findings are surprising. The hope is that people fighting hair loss can make better decisions as to whether Viviscal is right for them.

Key takeaways

• Product: Supplement
• Effort: Low (once- or twice-daily supplement)
• Expectations: Clinical trials suggest improvement in as little as 3 months, however, Viviscal™ recommends at least 6 months of supplementation to see results.
• Response rate*: According to the clinical trials:
  • Male pattern hair loss: 85%
  • Women with temporary hair loss from stress, poor diet, or menstruation: 75-100%
  • Autoimmune hair loss: 30-90%
• Regrowth rate*: According to the clinical trials:
  • Male pattern hair loss: 0% (i.e., stabilization)
  • Women with temporary hair loss from stress, poor diet, or menstruation: 10% to 32%
  • Autoimmune hair loss: 5% to 85%. (Autoimmune hair loss is known to spontaneously fully reverse, so it’s hard to delineate how much of this is due to Viviscal versus the mysteries of biology.)
• Cost: $39.99/month
• Problems: Results contingent upon lifelong use; some biased methodologies in clinical research; hundreds of negative reviews online – with most seemingly complaining the product wasn’t effective after 3 months of use (despite one study showing a minimum 32% average increase in hair count after 3 months); for a product sold to millions of people, it’s nearly impossible to find clearcut before-and-after photos submitted by their customers.

*These response and regrowth rates likely do not reflect reality. Response rates and regrowth rates were calculated using Viviscal’s clinical studies. However, many of these studies came with biased methodologies. Normally, adjustments can be made for these biases in estimates. But the difference between clinical research versus customer reviews was so vast in this case, it’s hard finding a middle ground. The fact that so few before-after photos exist in Viviscal’s customer testimonials – after 25+ years of business – should be a telling sign to consumers. 

Ordering experience

• Checkout: 7/10: One-page checkout made the process relatively easy, but coupon popups and the absence of an autofill or PayPal option made form filling a bit more cumbersome than other checkout pages.
• Fulfillment: 9/10: An email receipt was generated instantly upon receipt of the order, and later to announce that the product had shipped.
• Arrival: 8/10: Arrived within 5 days and without issues.

Highlights

Compared to other hair loss supplements, Viviscal has its perks.

1. The company has conducted 12 clinical trials testing Viviscal™ in men and women with many types of hair loss. All of them show positive results.
2. Viviscal’s supplements don’t contain a lot of extraneous ingredients. This is a positive; many hair loss supplements are chock-full of dozens of vitamins and minerals – many of which are harmful if over-consumed.
3. The supplement contains ingredients that may address some underlying causes of hair loss.
4. The supplement passed our product purities testing for heavy metals, pollutants, and pathogenic microbes. In other words, what you see on the label is what you get.

Having said that, when looking more closely at Viviscal’s clinical trials, marketing efforts, and product ingredients, a lot of issues emerged. Here are just a few.

1. For a company that has conducted 12 clinical studies and been in business for 25+ years, there are almost no before-after photos from customers demonstrating clear, discernible improvements.
2. Most of Viviscal’s studies are either unpublished or poorly designed.
   1. At least 33% of their studies were never published in a scholarly journal.
   2. Of the studies that were published, there are glaring typos and selection biases that make the results less impressive than perceived at first glance. For example, many of Viviscal’s studies use participants who are losing their hair temporarily as a result of stress, bad diets, or menstruation-related nutrient deficiencies. These participants are most likely to see hair regrowth from a nutritional supplement and would’ve also likely seen just as impressive hair growth with better stress management and nutritional planning. Moreover, in the developed world, this hair loss from these causes is relatively less common – and it’s also avoidable with simple dietary and lifestyle adjustments. Therefore, it’s disingenuous (and perhaps deceptive) to market the results of these participants to the general population of hair loss sufferers.
3. Viviscal’s genesis story cannot be verified. Viviscal says that their product was developed after a Scandinavian professor observed that the Inuit peoples’ healthy, long-lasting hair was the result of their diets rich in marine foods. This professor allegedly was able to isolate the compounds responsible for the Inuit’s healthy hair, from which Viviscal was born. 

However, none of this is recorded in any of the clinical studies published by Viviscal. Moreover, Viviscal has not responded to our emails requesting the name of the professor. Rather, research actually points to Viviscal being developed from an earlier product targeting to improve aging skin in women.

A full analysis of Viviscal’s company (and supplements) can be found below.

What is Viviscal®?

Viviscal™ is a hair loss supplement endorsed by hundreds of doctors in the U.S. It’s supported by 12 clinical trials and 25 years of research. It goes without saying that Viviscal is the most heavily researched hair loss supplement out there.

Viviscal® Man

What makes Viviscal unique?

There’s one “ingredient” that makes Viviscal unique from all other hair loss supplements: its proprietary blend of shark cartilage and oyster extract powder, known as their AminoMar™ Marine Complex.

According to the company’s FAQ’s:

“The groundbreaking, clinically proven marine complex available exclusively in Viviscal supplements. Derived from key marine protein molecules combined with a blend of Horsetail (Stem) Extract and naturally occurring Silica, it provides essential nutrients needed to promote existing hair growth from within.”

In fact, this proprietary blend (AminoMar™) has been the focus of every clinical study on Viviscal. Its clinical effectiveness is what makes Viviscal so enticing to consumers looking for a natural solution to thinning hair.

Product Offerings

Viviscal™ offers two product lines based on gender.

For women, they offer a Viviscal™ supplement as well as a shampoo, conditioner, and topical. For men, they offer a Viviscal™ supplement (with slightly different ingredients) and a shampoo.

This review focuses exclusively on Viviscal’s supplements. After all, the supplements are the products that have been clinically studied.

Viviscal Hair Growth Supplement – Ingredients

Both Viviscal™ for Women and Viviscal™ for Men contain:

• Vitamin C
• Calcium
• Zinc
• Horsetail extract
• AminoMar™ (Viviscal™’s properietary blend of shark cartilage and oyster extract power).

However, Viviscal™ for Women also contains niacin, iron, biotin, and millet seed whereas Viviscal™ for Men contains flaxseed. Here’s the full list of ingredients.

Viviscal Woman vs. Viviscal Man: product ingredients

Viviscal™ for Women	Viviscal™ for Men
Vitamin C	Vitamin C
Calcium	Calcium
Zinc	Zinc
AminoMar™	AminoMar™
Niacin	Flaxseed
Iron
Biotin
Millet seed

There are also slight differences in the number of ingredients in each of the male and female supplements. Here are the labels.

Viviscal™ for Women

Viviscal™ for Men

How might these ingredients improve hair loss?

Viviscal’s clinical studies focus on their AminoMar™ proprietary blend. But their auxiliary ingredients – like flaxseed, biotin, and iron – may also help with hair growth for certain people, and in different ways.

Below is a list of Viviscal’s key ingredients and the company’s rationale for their inclusion. The team found some of Viviscal’s claims to be nondescript. These claims were compared against what the actual research says.

AminoMar™

What Viviscal® says

“The groundbreaking, clinically proven marine complex available exclusively in Viviscal supplements. Derived from key marine protein molecules combined with a blend of Horsetail (Stem) Extract and naturally occurring Silica, it provides essential nutrients needed to promote existing hair growth from within.”

What the research says

What’s Viviscal’s original rationale for how AminoMar™ might work? 

After all, their website just says that this marine extract, “promote[s] existing hair growth from within.” That’s a bit vague.

Viviscal’s first study (1993) referenced three earlier studies that tested a similar marine extract.^[1]https://pubmed.ncbi.nlm.nih.gov/1286738/ These studies focused on skin health, not hair health. But interestingly, they found that women using this marine extract also reported improvements to their brittle hair, at least in a survey that asked them about brittle hair.

But when we read these three studies, none of them explained or speculated about the ways in which the marine extract worked, either. To quote from the earliest study we could find:

“Although the mode of action of Imedeen® [the marine extract] is unclear, the results of the present study indicate that there are certain agents in the extract which seem to have a repairing effect on degenerated elastic and collagen tissue in the dermis.”^[2]https://www.ncbi.nlm.nih.gov/pubmed/1864451

Again, this is very vague, and very unusual – especially for a scientific journal. But it seems that more recent research papers (i.e., those after 2010) have tried to offer better explanations.

For instance, this 2019 review attributes Viviscal’s hair-promoting effects to the fatty acids, polysaccharides, and cartilage proteins inside the marine proprietary blend.^[3]https://www.karger.com/Article/FullText/492035

Specifically, the reviewers discuss a polysaccharide (i.e., sugar) called glycosaminoglycan. These sugars are found near the “powerhouse” of a hair follicle: the dermal papilla. This is near the hair follicle base, and it’s where a hair connects to its blood supply.

A hair follicle: note where the blood supply connects to its dermal papilla

When a hair follicle is growing, glycosaminoglycan levels surrounding the dermal papilla increase.^[4]https://www.ncbi.nlm.nih.gov/pubmed/1610689 And when a hair sheds, glycosaminoglycan levels in these regions decrease. Thus, one hypothesis is that AminoMar™ increases glycosaminoglycan levels surrounding our hair follicles, and in doing so, helps a hair grow longer and shed less frequently.

There might be some truth to this, too. In clinical studies on AminoMar™, the extract helps elongate our hair growth cycle – shifting more hairs into their growth stages, and fewer hairs into their shedding stages (more on this later).

Flaxseed (Viviscal® for Men)

What Viviscal® says

According to Viviscal, flaxseed extract is included in their male supplement because it contains vitamin E and omega 3 fatty acids, two substances that they say promote hair health.

“Vitamin E helps to nourish your roots and scalp and is found in Flaxseed. Flaxseed is one of the best foods to eat to combat hair loss, or to give your hair an extra boost of nutrients. Omega-3 fatty acid is in this amazing little, yet powerful, nutrient, helping to prevent your hair from drying out and losing its shine.”

What the research says

There is evidence that vitamin E supplementation might improve hair growth. And vitamin E is found inside flaxseed extract. According to NutritionData, one tablespoon of flaxseed oil (i.e., 14 grams) contains 2.4 milligrams of vitamin E, or 12% of our recommended daily intake.^[5]https://nutritiondata.self.com/facts/nut-and-seed-products/3163/2

Unfortunately, Viviscal supplements include just 0.05 grams of flaxseed extract. Adjusting for the size difference, this implies that Viviscal has only a fraction of 1% of our recommended vitamin E intake. Given that the studies on vitamin E for hair growth used supplements containing 667% our recommended daily intake, the amount in Viviscal is negligible, and likely has zero effect on our hair.^[6]https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3819075/

As far as omega 3 fatty acids are concerned, this 2015 study showed that omega 3 supplementation (alongside antioxidants like vitamin E) increased hair counts by ~ 5% in women with general thinning. But again, the amount of omega 3 + vitamin E in that study is dozens of times higher than the amount found in Viviscal, so results really cannot be compared.^[7]https://onlinelibrary.wiley.com/doi/abs/10.1111/jocd.12127

The bottom line: in some cases, vitamin E and omega 3 from flaxseed extract might improve hair loss, but probably not in the negligible amounts found in a Viviscal supplement.

Biotin (Viviscal® for Women)

What Viviscal® says

“Also known as Vitamin H, it is a water-soluble Vitamin B complex (Vitamin B7) that helps the body to metabolize carbohydrates, fats and amino acids, which are the building blocks of protein and thus essential in the formation of the hair structure.”

What the research says

Low-grade biotin deficiencies aren’t uncommon in the U.S. In fact, during pregnancy, about 50% of women will develop what’s known as a marginal biotin deficiency. This is when biotin levels drop slightly below what’s considered normal.

Having said that, marginal biotin deficiencies aren’t linked to hair loss. Rather, biotin-related hair loss is only seen in what’s known as a “profound deficiency”. These occur as a result of genetic mutations, chronic alcoholism, chronic antibiotic abuse, and/or a diet that is completely devoid of biotin for years.

So, just how common are partial or profound biotin deficiencies in the developed world?

Incredibly rare. According to worldwide neonatal screening surveys:

“…The incidence of profound biotin deficiency is one in 112271, and the incidence of partial deficiency is one in 129282.”^[8]https://www.ncbi.nlm.nih.gov/books/NBK547751/

In other words, severe biotin deficiencies occurs in less than .001% of people. And again, only severe biotin deficiencies are causally linked to hair loss.

This begs the question: how useful is it to supplement with biotin for hair?

According to some research groups, not very useful at all. In fact, one investigation team has recommended to “reject the practice of supplementing with high doses of biotin for treating hair loss” unless there is a lab-confirmed deficiency, and that the deficiency is severe enough to be of concern.^[9]https://perfecthairhealth.com/nutrient-deficiency-hair-loss/#biotin

Thus, biotin supplementation (even at the 400% recommended daily intake found in Viviscal®) probably won’t be that helpful, at least for the overwhelming majority of people taking the supplement.

Vitamin C and Iron (iron in Viviscal® for Women only)

What Viviscal® says

“[Vitamin C:] A powerful antioxidant that helps to absorb more Iron into the blood, which in turn promotes hair growth. Vitamin C in Viviscal supplements is sourced from the acerola cherry.”

“[Iron:] An essential mineral that has several important roles in the body, Iron helps to make red blood cells, which carry oxygen around to cells in the body, including hair follicles. Thinning hair can be one of the visible symptoms of anemia (Iron deficiency).”

What the research says

Viviscal’s rationale for including both vitamin C and iron center around an effort to enhance iron levels in their customers.

Vitamin C helps to increase iron absorption. This vitamin is included in both Viviscal® Man and Viviscal® Woman. However, supplemental iron is only found inside the female formulation of Viviscal. And this is because, unlike men, women are at a much higher risk of developing low iron (i.e., anemia) as a result of iron loss from menstruation.

There’s some evidence to support these positions. For instance, studies have linked mild-to-severe iron deficiencies in women to a variety of hair loss disorders – ranging from female pattern hair loss to telogen effluvium.^[10]https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3678013/ ^[11]https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6385517/ And while there’s still debate over how effective (and how high) iron levels need to raise in order to improve hair loss, it goes without saying that a lot of women have experienced great improvements to hair growth by restoring their iron to adequate levels.

Unfortunately, supplemental iron also harbors some risks. This is because iron is oxidative – meaning that in excess, its presence can create oxidative stress, also known as inflammation.

In fact, evidence indicates that vitamin C and iron salts (like the ferrous fumarate used in Viviscal™ for Women) may have a dangerous and synergistic interaction. Specifically, research suggests that vitamin C can “propel” the oxidative action of iron, meaning that vitamin C may enhance the inflammation that excess iron causes.^[12]https://www.ncbi.nlm.nih.gov/pmc/articles/PMC340385/ This suggests that in cases of longterm, excessive iron + vitamin C supplementation, we’re more likely to experience problems like ulcerations, inflammation, exacerbation of chronic disease, and, potentially even cancer.

Customer testimonials

It’s one thing to look at a supplement’s ingredients, then build a case for whether the research shows these ingredients will or won’t help with hair loss. It’s another thing to measure whether all of these ingredients – when taken together – actually improve hair growth in men and women with thinning hair.

To do this, one can analyze two pieces of evidence:

1. Customer testimonials. Viviscal has been in business for 25+ years. They claim to average one product sale every single minute of the day. That equates to millions of customers, and (hopefully) thousands of before-after photos.
2. Clinical research. Viviscal is the most heavily studied hair loss supplement in the world. If Viviscal’s clinical research proves as promising as claimed in their marketing, then customer testimonials should be validated in the data: increases to hair counts, hair diameters, etc.

This section focuses on that first lever: customer testimonials and before-after photos.

12 clinical studies and 25+ years of business. But where are the before-and-after photos?

When it comes to hair loss, before-and-after photosets are probably the most powerful tool used to validate the effectiveness of any approach. Yes, clinical trials are great (and often required). As will be discussed later, clinical research is only valid when a study is properly designed. Thus, if a product truly works, one can expect to see a combination of both clinical evidence + customer testimonials.

On review websites, customer reviews of Viviscal are mostly negative. However, these reviews were left out of this product review. Why? Because reviews can be written by anyone – including competitors or Viviscal employees. And given the inability for review websites to verify and rank the validity of any review, the focus remained on hard evidence: that of which is presented by Viviscal on their own website.

So, as one of the best-selling hair loss supplements on the planet, how does Viviscal do in the customer success department?

Puzzlingly, Viviscal has almost no customer before-and-after photos (at least on their website).

And of the ones that are featured, it’s as if they’re designed to be intentionally misleading. These can be segmented segment this by the photos featured on Viviscal’s (1) main website, (2) female site, and (3) male site.

The photos featured on Viviscal® appear to have had their backgrounds trimmed and/or recolored. This masks any lighting differences across photos; it makes fair photo comparisons impossible.

The success featured on Viviscal® Woman aren’t actually focused on hair; rather, they’re simply photos of women wearing different hairstyles before and after starting the supplement.

And the few customer photos featured on Viviscal® Man either face the same problems above or were taken from impossible-to-compare angles and lightings.

Why is this concerning?

Well, in their marketing, Viviscal claims that one packet of Viviscal is sold every single minute. This should equate to 10+ million customers over a 25-year period. And if the product were truly as effective as advertised, one would expect Viviscal to present significantly more before after-photos, and of significantly better quality.

For instance, let’s assume that Viviscal only has one million consistent customers (a fraction of what is suggested in their marketing). Now assume that just 0.1% of those customers (or one in 1,000) decide to take before-after photos, then share those photos with Viviscal. That leaves Viviscal with 1,000 before-after photos from which to share on their website.

For some reason, Viviscal seems to only have ~20 photosets total across men and women. And instead of high-quality photo comparisons, we’re left with misleading photosets.

What about before-after photos from Viviscal’s clinical studies?

It’s true that Viviscal’s clinical studies have higher-quality photosets, and that in some cases, these photosets demonstrate clear, discernible hair regrowth. But it’s also important to contextualize these photosets – because not all photos are from people with common hair loss types.

For men with androgenic alopecia (AGA) – the most common form of hair loss in adult men – the highest-quality before-after photoset available from a Viviscal study only showed stabilization after 180 days of use. In fact, this is the one advertised on their website.

For women, the highest-quality before-after photosets come from their website (here) and clinical studies ^[13]https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3509882/

But these women only had temporary forms of hair loss due to stress, poor diet, and nutrient deficiencies due to menstruation. In other words, these before-after photos don’t represent what the average Viviscal customer should expect, because hair loss from these causes are lesser common, and likely do not represent the average customer of Viviscal.

 Now for Viviscal’s clinical studies …

Clinical studies

When it comes to clinical studies on a hair loss supplement line, Viviscal® is the industry leader.

According to their marketing materials, Viviscal has conducted 12 clinical trials – more human studies on their product than any other hair loss supplement out there.

And even better, these clinical trials aren’t limited to just one population, or one type of hair loss. Of the 12 clinical trials, seven were conducted on women, two were done men with androgenic alopecia (AGA), and two were completed on men and women with autoimmune hair loss disorders like alopecia areata, alopecia totalis, and alopecia universalis.

In other words, they’ve not only got the most clinical studies, but they’ve also studied their supplement on the majority of types of hair loss out there. And amazingly, all of the studies have appeared to reap great results.

Viviscal’s clinical studies: summarized

Viviscal™’s Clinical Trials, Their Subjects, and the Results
Study #1 (2014)	Females with Self-Perceived Hair Thinning	“• 32% increase in terminal hairs after 3 months • 39% decrease in hair shedding • After 3 months there was significant self-perceived improvements in overall hair volume, scalp coverage and hair strength.”
Study #2 (2014)	Females with Self-Perceived Hair Thinning	• 57% increase in terminal hairs after 3 months • 80% increase in terminal hairs • 12% increase in hair diameter after 6 months • After 3 and 6 months there was a significant self-perceived improvement in overall hair volume, scalp coverage, hair and nail strength.
Study #3 (2014)	Females with Subclinical Hair Thinning	“• a 7.4% increase in hair diameter after 6 months • an 18% reduction in hair shedding after 3 months.”
Study #4 (2014)	Females with Self-Perceived Hair Thinning	• 94% in hair volume • 92% hair thickness • 91% in nail growth rate and • 92% in nail strength After 6 months.
Study #5 (2012)	Females with Self-Perceived Hair Thinning	• 111% increase in terminal hairs after 3 months versus no change amongst the placebo subjects. • 125% increase in terminal hairs after 6 months versus no change amongst the placebo subjects. • After 3 and 6 months there were significant self-perceived improvements in overall hair volume, thickness, and scalp coverage.
Study #6 (2011)	African American Females with Self-Perceived Hair Thinning	“Rapid changes in hair growth and appearance in as little as 2 months.”
Study #7 (2010)	Females with Self-Perceived Hair Thinning	“After a 10 week period, there was an average 46% reduction in hair loss reported. 75% saw an increased thickness in the body of their hair and 75% saw an increase in overall hair volume.”
Study #8 (1997)	Men with AGA	• 75.3% of patients observed a significant decrease in hair loss • 14.6% of patients showed partial regrowth
Study #9 (1996)	Males and Females with Alopecia Areata, Alopecia Totalis, or Alopecia Universalis	• 92% of areata group showed regrowth of permanent hair. After four months of treatment: • 83.3% of totalis group showed regrowth of permanent hair and • 31.8% of universalis group showed regrowth of permanent hair after five months. • Complete cure was observed in 14% of areata, 25% of totalis and 5% of universalis.
Study #10 (1994)	Men with AGA	“Hair loss stopped for 100% of subjects after two months treatment. 43% showed total regrowth, 23% showed three quarter regrowth, 13% showed half regrowth & 13% showed 30-50% regrowth.”
Study #11 (1992)	Men with AGA	“100% of treated subjects reported that hair loss had stopped after 2 months of treatment. Mean increase in non-vellus hair of 38% was recorded in patients after 6 months treatment. 95% of subjects showed both clinical and histological cure.”
Study #12 (1992)	Males and Females with Alopecia Areata, Alopecia Totalis, or Alopecia Universalis	“85% of subjects with Alopecia Areata were completely cured & 10% showed significant improvement. 25% of subjects with Alopecia Totalis were completely cured & 20% showed significant improvement.”

At a glance, this body of clinical research seems to position Viviscal as the go-to supplement for anyone with thinning hair. But as the Perfect Health team learned from its investigation into Nutrafol, clinical trial results can be misleading.

For instance, studies can pick participants who most likely have nutrient deficiency-related hair loss, and are thereby most likely to see hair regrowth from taking any nutritional supplement (not just the brand being investigated. Studies can also use biased hair counting methodologies to make it appear as though a supplement regrows a ton of hair, even when the results don’t translate to visual improvements to hair density.

So, do Viviscal’s studies have any of these biases?

In many cases, yes.

Whether or not these biases invalidate the body of research of Viviscal remains to be seen. It would be unproductive to go through each Viviscal study and dissect every little problem. Doing this would turn this already-long product review into a full-fledged novel.

In focusing more on the larger issues across these studies, hair loss sufferers can decide for themselves whether these concerns are worrying enough to influence purchasing decisions.

Problem #1: at least 33% of Viviscal’s clinical trials were never published

It’s one thing to conduct a clinical trial, analyze the data, write the results into a manuscript, submit that manuscript to a journal, get it reviewed by experts, receive feedback, make revisions, resubmit, and then finally have your study accepted for publication in a scholarly journal.

It’s another thing to conduct a clinical trial, analyze the data, write the results into a manuscript, and then bypass peer review and, instead, just publish the results as part of your marketing materials.

According to Perfect Hair Health research, 33% of Viviscal’s clinical trials fall under that secondary category. Of the 12 studies listed on Viviscal’s website, our investigation showed that four studies (#4, #6, #7, and #12) never made it into a scholarly journal. In fact, 3 of those 4 studies were never even submitted for publication.

Why not publish the results of a clinical trial in a scholarly journal, especially if the results are positive?

This is actually more commonplace than most people realize. In fact, conducting a clinical trial and not publishing the results in a scholarly journal happens all the time – especially for companies studying (and selling) natural health products.

Just take the companies selling low-level laser therapy devices. Companies in that hair loss sector have a history of registering clinical trials containing biased hair counting methods (e.g.., grouping vellus + terminal hair counts). These companies never intend to submit their results to a scholarly journal. Rather, they conduct these studies so that when their great (manufactured) results come in, they can legally claim their devices can “increase hair thickness by over 200%”.

In these cases, the goal isn’t to prove that the clinical research is legitimate; the goal is to avoid getting sued over false claims.

As such, it’s not a priority for these companies to submit their clinical data for peer review. If they did, reviewers would likely find the flaws in the study design, and then reject the study for publication.

Therefore, the most common reason why a company won’t publish clinical results in a journal – at least when those results are favorable – is that they know that the study is biased, and that the paper won’t survive peer review. So, instead, these companies will just write up their results to look like a paper, and then use it as part of their marketing.

(Note: this is different from burying unfavorable clinical trial results – or in other words, never publicizing the findings. This is what Nutrafol is suspected of doing for one of the clinical trials that they completed, but never published.)

For Viviscal, favorable unpublished clinical trial results make up 33% of the studies advertised on their website.

Now, this isn’t the end of the world… because that still leaves 8+ studies that have gone through peer review, and have been published in journals.

So, how do these published trials stack up?

Well, these published studies also have issues. This leads to another problem.

Problem #2: of Viviscal’s published studies, most of them were published in low-ranking journals

Low-ranking journals, and why they should be avoided

If the four studies Viviscal never published were ignored in favor of the eight studies that survived peer review, there would still be a great deal of noise that makes Viviscal’s emphasis on their clinical research problematic.

For starters, these eight clinical studies weren’t published in high-ranking dermatology journals. Rather, they were published in lower-ranking journals in dermatology and medicine. These are journals that rank below the top quartile, according to SciMago Journal Rankings.

Now, one might wonder, “Who cares about a journal’s ranking? Peer review means peer review!” But unfortunately, this isn’t true. This is because not all peer review is created equal.

Quality reviewers – those of reputable institutions and research centers – generally reject review requests from unknown or lesser-respected journals. Why? Because the papers submitted there are often of lower quality. This forces lower-quality journals to send mass emails of review requests –until they either find someone to accept the review or they decide to make a decision on the paper without any external review at all.

In the case of low-ranking journals, too often are their reviewers people with zero expertise regarding the manuscript in which they’re reviewing.

For example, Perfect Hair Health has published two papers about androgenic alopecia. A list of the last three review requests from low-ranking journals? Manuscripts about:

• Dapsone-loaded micro sponge gel for acne management
• Business management practices
• R&D teams: how innovation and performance varies between large American and Chinese firms

All three review requests were declined because the company only publishes research on hair.

So, just think of how far down a list someone has to get before they contact Perfect Hair Health: someone with zero experience, let alone expertise, in any of these fields.

What’s worse: a quick Google search just revealed that two of these three papers passed peer review, made it into a journal, and are now indexed in scholarly databases. That suggests they were reviewed by someone! If not me, then who? Someone with an equally absent level of expertise? Or nobody at all – given some journals’ incentives to collect authors’ payments in exchange for publications?

Now, back to Viviscal.

The company did, in fact, publish their clinical studies in lower-ranking journals. Knowing this, is there evidence that these studies weren’t properly reviewed?

Yes. In fact, one can identify – just by reading these papers – errors so big, they should’ve been flagged by literally anyone reading the paper.

Example 1: grammatical errors… in the first sentence of a paper

See the first of Viviscal’s 2015 study, published in International Journal of Trichology:

“Since skin and hair quality are potent vitality signals, and hair growth deficiency can cause significant psychological morbidity.”

That’s not even a complete sentence.

Example 2: hair count increases of 1,381%

In Viviscal’s first-ever study, investigators show the results of Viviscal supplementation on hair counts of men with androgenic alopecia (AGA) after six months. Their final hair count increase? A jump from 1,238 to 17,101 hairs per measured region… an increase of 1,381%.

Obviously, this is just a typo. The investigators clearly meant to write 1,710 and not 17,1010 (as indicated by the hair count differences listed in the final row). But a serious reviewer should’ve caught this.

This is the difference between publishing in reputable journals, and publishing just so you can tell people that your product has a peer-reviewed clinical study. The former actually matters; the latter is just for marketing.

Problem #3: Many of Viviscal’s studies have selection bias. Many were done on people with a type of hair loss that doesn’t represent the majority of Viviscal consumers.

It doesn’t just matter how people write up a clinical study; it also matters how that study was conducted. And in this regard, many of Viviscal’s published studies have serious problems. This is especially true in the way that they’ve selected participants for their study.

For reference, there are dozens of types of hair loss, and each type has a different set of causes. The most common types of hair loss are (1) androgenic alopecia (AGA) – also known as male and female pattern hair loss, and (2) telogen effluvium.

Current census is that AGA is caused by a combination of hormones and genetics. It’s chronic, progressive, and without treatment, it worsens. Conversely, telogen effluvium is a form of temporary hair loss. It’s got a wide set of causes – stress, medication use, hypothyroidism, etc. – and once the underlying cause of telogen effluvium is resolved, usually the hair will return in 3-6 months.

For women, one common cause of telogen effluvium is a nutrient deficiency. And one of the most common nutrient deficiencies in women of “childrearing age” is iron – because women lose iron each month during menstruation.

Therefore, this is a percentage of women losing their hair from telogen effluvium – a temporary form of hair loss. And a percentage of those women have telogen effluvium due to low iron stores. If these women correct their low iron stores, they’ll often regrow their hair.

So, let’s look at some of the best Viviscal studies: the ones published in journals that are lower-ranking, but still high enough to likely find reputable reviewers.

These studies were conducted in the U.S. That means they had to register the trials on clinicaltrials.gov. And whenever a trial registers on this site, they have to outline the selection criteria for participants. In other words, they have to tell you how the investigators selected people to include (or exclude) as part of their study.

So, when it comes to participant selection, what do all three of Viviscal’s US-based clinical trials have in common?

All of the studies selected women with temporary forms of hair thinning – mainly the result of poor diets, stress, or menstrual cycles – of which would’ve resolved without a nutritional supplement if the person had just taken measures to get more of those nutrients into their diets.

To quote directly from the trial setups:

 “Inclusion Criteria: Females with self-perceived thinning hair associated with poor diet, stress, hormone influences or abnormal menstrual cycle.”

All of these clinical trials showed statistically significant hair count increases to Viviscal after 3-6 months of use. Not surprisingly, at least two of these trials were conducted by the Ablon Group – the research institution that used nearly the same selection criteria for Nutrafol’s clinical study – which sufferers from the same problems will be illustrated.

Why is this such a problem?

For two reasons.

Firstly, this selection criteria is incredibly narrow. Women with telogen effluvium from a nutrient deficiency represent only a fraction of people with hair loss. While there’s no data on the incidence of nutrient deficiency-driven telogen effluvium, it probably responsible for less than 10% of hair loss cases in the U.S.

This means that if Viviscal advertises its “clinical results” to all U.S. hair loss sufferers – the results from their clinical trial won’t apply to 90% of them. But consumers don’t know this. They read the words “clinically proven”, and expect that this product applies to them and will reap positive results.

That’s the first problem.

The second problem is that if the women in this study had just reduced their stress levels, improved their diets, and/or made an effort to get more iron, they likely would’ve seen the same degree of hair regrowth… and without the aid of a supplement that costs $39.99 every month.

After all, studies on women with nutrient deficiency-related telogen effluvium have shown equivalent increases in hair counts – without Viviscal’s proprietary ingredients – and all with a basic nutritional supplement.^[14]https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6136400/

Are there any studies that fairly assess Viviscal?

Yes.

There is one clinical study on Viviscal that appears to meet this criteria. It was done on men with androgenic alopecia (AGA) – the most common cause of hair thinning for adult males.

It was a 1997 study conducted on 200 men with AGA, all of whom were instructed to take Viviscal® for Men twice daily for six months. The study wasn’t published in a high-ranking journal, but it also didn’t have the same selection criteria biases identified in Viviscal’s more recent studies.

Moreover, the study had clearly defined methodologies. The researchers used objective measurements for results – like hair count changes using a trichogram, or hairline changes by calculating the distance between the hairline and the eyebrows before and after treatment. In addition, the researchers also had participants complete a self-assessment survey to standardize their opinions of the supplement.

Over the six-month period, 32 men dropped out of the study. But of the 178 men who completed the trial, here were their results:

• Across all Viviscal users, hair counts increased by 4% (statistically insignificant)
• 75% of men reported a decrease in hair loss (i.e., the rate of hair loss slowed)
• 15% of men showed partial hair density improvements

These results aren’t that impressive. But, in our opinion, they’re the fairest results ever published on Viviscal. Why? Because they set realistic expectations of the supplement.

Males with AGA who are taking Viviscal should set their expectations that the supplement simply slows down the progression of hair loss; the supplement will not fix the problem. And for those who (1) are happy with that expectation, (2) understand the effects only last with continued use, and (3) don’t mind paying $39.99 per month indefinitely – then this supplement might be a good choice.

Viviscal’s clinical research: the bottom line

• Viviscal boasts over 12 clinical studies on their product line – more studies than any other hair loss supplement.
• However, of these 12 studies, four of them were never published in a scholarly journal.
• Of the studies that were published, these clinical trials were published in low-ranking journals that tend to have really easy peer-review procedures,
• Resultantly, these studies were published with problems that would’ve been flagged – and likely would’ve led to a rejection – in reputable journals: for example, typos in the opening sentences and selection biases for participants.
• This is most evident with three of Viviscal’s published studies: the ones that tested the supplement on women with temporary hair thinning as a result of stress, a poor diet, or menstruation-related iron loss. These types of hair loss sufferers are most likely to benefit from a basic nutritional supplement – particularly ones containing iron, zinc, and antioxidants.
• Moreover, hair loss due to a nutrient deficiency is relatively uncommon compared to all hair loss causes. This type of hair loss accounts for just a small fraction of hair loss cases in the U.S. – likely less than 10%. Therefore, it’s unethical to advertise these results as “clinically effective” to all people with hair loss, when the results only apply to a small portion of a people hearing the claim.
• There is one study on Viviscal that seems fairly conducted: a trial on 200 men with androgenic alopecia (AGA). This is the most common form of hair loss in adult men. The trial found that Viviscal did not statistically improve hair counts, but that the supplement did help decrease the rate of hair loss for these men.

As such, our takeaways on Viviscal’s clinical research are the following:

1. The product is great for females with hair loss due to a poor diet and/or nutrient loss from menstruation.
2. The product is great for males with AGA who want to take a natural approach to improving their hair and only want to slow down the rate of hair loss – and are comfortable spending $39.99 per month to do so.

Otherwise, we think that Viviscal by itself is not an effective solution for most people with hair loss, and that this money could be better invested elsewhere.

Product purity: heavy metals, microbes, and contaminants

While Viviscal’s clinical studies and testimonials aren’t as impressive as they look at first glance, there is good news. The company makes a high-quality supplement… at least in terms of product purity.

The Perfect Hair Health team bought Viviscal® For Men and sent it to a third-party lab testing facility to test for contaminants often found in consumer supplement products: heavy metals, pathogenic microbes, and impurities related to materials processing.

There were no red flags. By all means, this supplement appears to be made well. What you see on the ingredients list is what you get.

Viviscal® Man purity: heavy metals, microbes, and pesticide residues

This is a positive, as some products that the Perfect Hair Health team has reviewed (i.e., Hairguard Anti-Hair Loss Essentials Supplement) have demonstrated an absence of the ingredients they list on their product labels.

BONUS: How did Viviscal start?

This isn’t related to our analysis of the supplement, but it’s a part of our investigation worth sharing.

Viviscal says that the company all began with the discovery (and development) of AminoMar™ Marine Complex – a proprietary blend of shark cartilage and oyster extract power. According to their website:

“AminoMar is a proprietary marine complex available exclusively in Viviscal hair growth* supplements. In the 1980s, a professor from Scandinavia discovered that the Inuits’ great hair and skin was the result of their fish- and protein-rich diet. He isolated the key protein molecules in their diet and it was from these origins that AminoMar was created. Since then, Viviscal has been tried and tested by clinicians around the world.”

The story sounds almost too good to be true. An unnamed Scandinavian researcher… An observation made amongst the Inuits…. The identification of diet as responsible for the Inuit’s great hair… The isolation of key protein molecules from that diet… The packaging of these molecules into a clinically supported supplement.

Is there any validity to this story?  The Perfect Hair Health team attempted to identify this mysterious Scandinavian researcher, his early research on the Inuits, and how this research eventually culminated into the product Viviscal.

These efforts just led to more confusion.

Viviscal’s beginnings: fact or fiction?

Research began by combing through Viviscal’s earliest published studies from the 1990s. It was assumed that in these early papers, Viviscal would discuss their novel proprietary blend: how they came across it, how the blend’s suspected effects might improve hair growth, and why the company has decided to study the blend in a clinical setting.

Unfortunately, the team couldn’t find any references mentioning the story that Viviscal explains in their marketing.

The closest thing identified was a 2019 literature review on alternative hair loss treatments, “Complementary and Alternative Treatments for Alopecia: A Comprehensive Review.” According to that review:

“Marine proteins, including extracellular matrix components from sharks and mollusks, have been produced for over 15 years to enhance hair growth. A Scandinavian researcher first described the exceptionally healthy skin and hair of the Inuit peoples to be a result of their fish- and protein-rich diet [36, 37]”.^[15]https://www.karger.com/Article/FullText/492035

But when checking the review’s references (i.e., studies “[36, 37]”), it was found that those studies didn’t actually support the claims made in that quote.

For instance, that first reference is to Viviscal’s first-ever study.^[16]https://www.ncbi.nlm.nih.gov/pubmed/1286738 That study had already been read and there was no mention of Inuits or a Scandinavian researcher. The second reference (i.e., “37”) couldn’t be found either. Why? Because according to Viviscal, that reference is to a clinical trial that was never even published.

So, the digging continued. The only thing to do next: read all of the studies mentioned in Viviscal’s first study from 1992. In other words, read the papers within a paper.

Still no references to a Scandinavian researcher or the Inuit… or anything about how this marine extract was developed or its purported mechanisms of action.

A how-to guide on passing peer review

The closest thing the team could find were studies on a product called Imedeen® – a marine extract supplement that was shown to improve skin health in females. These studies were done from 1991-1992 – one year before Viviscal’s first study – but these studies also don’t mention what prompted anyone to start studying these marine extracts.

What is Viviscal’s true genesis story?

This remains unknown. Perfect Hair Health reached to Viviscal® in a good faith effort to obtain the name of this Scandinavian professor, so that the team could verify the story they tell in their marketing. No reply has been recieved.

Interestingly, a 2001 clinical study on HairGain® – the earlier brand name of Viviscal® – was found.^[17]https://www.researchgate.net/publication/12056799 This study showed that the supplement led to impressive hair regrowth in men with androgenic alopecia. The study was done by a man named Erling Thom – a Scandinavian researcher who was later accused of falsifying data in the studies he conducted on alternative health products.

The team couldn’t find any evidence tying Erlin Thom to Viviscal’s earlier clinical research. But there also wasn’t any evidence that he wasn’t involved. After all, Viviscal’s elusive genesis story seems to have no paper trail – which is odd for a product involved in so much clinical research.

It appears as though Viviscal was created from Imedeen® – an earlier product that contained a similar marine extract, but was positioned for improving aging skin rather than hair loss. Survey portions of Imedeen® studies in the early 1990’s showed that women also reported improvements to their brittle hair. So, our guess is that marketers of Imedeen® saw an opportunity to retarget the product, and either sold off or repositioned the marine extract into a hair supplement and later started testing it on hair loss sufferers.

But as far as this Scandinavian professor, his observations on the Inuits, and the actual identification of why these marine extracts might prove helpful to skin or hair… this part of the story seems to remain lost in time (and clinical research).

Viviscal®: who are the best candidates?

Viviscal® might be right for …

• Females with hair loss due to a poor diet and/or nutrient loss from menstruation.
• Males with AGA who want to take a natural approach to improving their hair and only want to slow down the rate at which they’re losing hair – and are comfortable spending $39.99 per month to do so.

Viviscal® might not be a good fit for …

• Male with AGA with expectations any higher than the above.
• Females with hair loss related to thyroid dysfunction, PCOS, childbirth, stress, vitamin D deficiency… or virtually anything else outside of the nutrient deficiencies that Viviscal® Woman helps to address (i.e., fatty acids, iron, and zinc).

The bottom line

Viviscal is the most clinically studied hair loss supplement on the planet. But that doesn’t mean it’s the best hair loss supplement available. This is obvious at the outset with Viviscal’s relatively low number of customer before-after photos featured on their website – which, for a company with millions of customers over 25+ years, is a little unusual.

Moreover, Viviscal’s clinical research isn’t as impressive as conveyed in its marketing. For starters, at least 33% of their clinical studies were never published in a scholarly journal. Of the ones that were published, all of them were published in low-ranking dermatology journals – with many of those studies containing glaring typos and selection biases that would’ve led to their rejection from reputable journals.

In addition, the Viviscal studies producing the clearest before-after photos were done on women with temporary hair loss due to stress, a poor diet, and/or nutrient deficiencies as a result of menstruation. This specific type of hair loss is the one that is best positioned to respond to a nutritional supplement, and it’s also a type of hair loss that is (1) relatively uncommon among hair loss sufferers in the developed world, and (2) one that can be improved without a $39.99 supplement – and just through lifestyle and dietary changes.

Lastly, Viviscal®’s genesis story of a Scandinavian professor – his observations on Inuits, their hair-healthy diets, and the isolation of marine compounds responsible for the Inuit’s great hair – is either exaggerated or fabricated. After review, it can be assumed that this product was developed from an earlier skincare product (with a similar marine extract) after survey research found that women thought that product also improved their brittle hair.

On the positives – Viviscal® Man did pass Perfect Hair Health’s third-party laboratory testing for heavy metals, pollutants, and pathogenic microorganisms. In other words, what you see on the label is what you get. But unfortunately, this isn’t enough to earn a recommendation – especially given its price point and the discrepancies in Viviscal’s real-world results versus their clinical research.

Questions? Comments? Please reach out in the dedicated forum thread below