Coenzyme Q10 (CoQ10) is a naturally occurring compound essential for cellular energy production and antioxidant defence. As hair follicles are among the most metabolically active tissues in the body, requiring substantial energy for growth, there is growing interest in whether CoQ10 supplementation might support hair health or address hair loss. Whilst the biological rationale is plausible—given CoQ10's role in mitochondrial function and protection against oxidative stress—the clinical evidence linking CoQ10 to hair regrowth remains limited. This article examines the science behind CoQ10, its theoretical mechanisms in hair growth, current evidence, and practical considerations for those considering supplementation.

What Is CoQ10 and How Does It Work in the Body?

Coenzyme Q10 (CoQ10), also known as ubiquinone, is a naturally occurring, vitamin-like compound found in virtually every cell of the human body. It plays a crucial role in cellular energy production within the mitochondria—the powerhouses of cells—where it facilitates the conversion of nutrients into adenosine triphosphate (ATP), the primary energy currency used by cells to perform their functions.

Beyond its role in energy metabolism, CoQ10 functions as a potent antioxidant , protecting cells from oxidative damage caused by free radicals. This dual function is particularly important in tissues with high metabolic demands, such as the heart, liver, kidneys, and muscles. The body naturally produces CoQ10, with levels generally declining with age. Certain factors—including the use of statin medications, chronic diseases, and nutritional deficiencies—may also affect CoQ10 levels.

CoQ10 exists in two main forms: ubiquinone (the oxidised form) and ubiquinol (the reduced, active antioxidant form). Once absorbed, the body can convert between these forms as needed. Dietary sources of CoQ10 include oily fish (such as mackerel and sardines), organ meats (particularly heart and liver), whole grains, and certain vegetables, though the amounts obtained through diet alone are relatively modest.

In the UK, CoQ10 is sold as a food supplement, not as a licensed medicine. While CoQ10 supplementation has been investigated for various conditions, including heart failure, migraine prophylaxis, and mitochondrial disorders, it is important to note that NICE does not routinely recommend CoQ10 for these conditions, and evidence for its effectiveness varies. Interest in its potential effects on hair follicle health stems from its role in cellular energy production and antioxidant defence, as hair growth is an energy-intensive process requiring robust cellular metabolism.

The Link Between CoQ10 and Hair Growth

The theoretical basis for CoQ10's potential role in hair health stems from the high metabolic activity of hair follicles. Hair follicles are among the most rapidly dividing cell populations in the human body, with the anagen (growth) phase requiring substantial energy production to support keratinocyte proliferation and protein synthesis. Any compromise in cellular energy metabolism or increase in oxidative stress could theoretically impair this process, potentially contributing to hair thinning or loss.

Oxidative stress has been implicated in various forms of hair loss, including androgenetic alopecia (pattern hair loss) and telogen effluvium (stress-related shedding). Free radicals can damage hair follicle cells, disrupt the hair growth cycle, and potentially contribute to follicular changes. As an antioxidant, CoQ10 may theoretically help neutralise these damaging free radicals and protect follicular cells from oxidative injury.

Furthermore, adequate mitochondrial function is essential for maintaining the anagen phase of the hair cycle. Impaired energy production could potentially shorten this growth phase, leading to premature entry into the catagen (transitional) and telogen (resting) phases, ultimately resulting in increased hair shedding and reduced hair density.

It is important to note, however, that whilst these mechanisms are biologically plausible, there is no official link definitively established between CoQ10 supplementation and hair regrowth in humans. The hair follicle is a complex mini-organ influenced by numerous factors including genetics, hormones (particularly androgens), immune function, nutritional status, and local growth factors. In androgenetic alopecia, dihydrotestosterone (DHT) plays a central role in follicular miniaturisation, and antioxidants alone are unlikely to reverse this process. Whether addressing CoQ10 levels can meaningfully impact hair growth remains an area requiring further investigation.

Evidence for CoQ10 in Treating Hair Loss

The scientific evidence supporting CoQ10 as a treatment for hair loss in humans remains limited and preliminary. Most research has been conducted in laboratory settings or animal models, with very few well-designed clinical trials in human subjects specifically examining CoQ10's effects on hair growth.

In vitro and animal studies have shown some promising results. Laboratory research has demonstrated that CoQ10 can protect hair follicle cells from oxidative damage and may help maintain cellular energy production. Some animal studies have suggested that topical application of CoQ10 might stimulate hair growth and reduce age-related changes in hair follicles. However, these findings cannot be directly extrapolated to human hair loss conditions, as the biology of hair growth differs significantly between species.

A small number of human studies have investigated CoQ10 in combination with other ingredients in topical formulations for hair loss, making it difficult to isolate CoQ10's specific contribution. Some cosmetic studies have reported improvements in hair thickness or density with products containing CoQ10 alongside other active ingredients, but these studies often lack rigorous methodology, appropriate control groups, or independent verification.

Currently, NICE guidance does not include CoQ10 as a recommended treatment for any form of hair loss. Established, evidence-based treatments for androgenetic alopecia include topical minoxidil and oral finasteride (in men only), as outlined in the British National Formulary and NICE Clinical Knowledge Summaries. Other conditions such as alopecia areata may require different approaches including topical or intralesional corticosteroids.

Patients experiencing hair loss should be appropriately investigated to identify the underlying cause. UK clinical practice typically includes thyroid function tests, full blood count, ferritin levels, and assessment for nutritional deficiencies. Women with signs of hyperandrogenism may require androgen profile testing. Treatment should be directed at the specific diagnosis rather than empirical supplementation with unproven therapies. Whilst CoQ10 supplementation is generally considered safe, individuals should discuss any concerns about hair loss with their GP to ensure proper evaluation and evidence-based management. Referral to a dermatologist should be considered for suspected scarring alopecia, rapidly progressive loss, or diagnostic uncertainty.

How to Use CoQ10 for Hair Health

For individuals considering CoQ10 supplementation for hair health, it is important to understand that there is no established dosing regimen specifically for this indication, as robust clinical evidence is lacking. However, CoQ10 supplements are widely available and have been studied for other conditions, providing some general guidance on usage.

Oral supplementation is the most common route of administration. Typical doses used in clinical studies for various conditions range from 90 to 200 mg daily, though some studies have used higher doses for specific medical conditions under medical supervision. It is advisable not to exceed the dose recommended on the product label without healthcare professional guidance. CoQ10 is a fat-soluble compound, meaning absorption is enhanced when taken with meals containing dietary fat. Some research suggests the ubiquinol form may have better bioavailability compared to ubiquinone, though both forms are converted within the body.

Topical products containing CoQ10 are also marketed for hair and scalp health, often in combination with other ingredients such as caffeine, biotin, or various plant extracts. The penetration of CoQ10 through the scalp to reach hair follicles when applied topically has not been well characterised, and there is insufficient evidence to recommend specific topical formulations.

Before starting CoQ10 supplementation, individuals should:

• Consult their GP or pharmacist, particularly if taking other medications, as CoQ10 may interact with anticoagulants such as warfarin, potentially reducing their effectiveness

• Consider whether investigation of the underlying cause of hair loss is needed, as supplementation should not delay appropriate medical evaluation or proven treatments

• Set realistic expectations, understanding that evidence for CoQ10's efficacy in hair loss is limited

• Choose reputable products from established manufacturers, as dietary supplements in the UK are regulated as foods rather than medicines, with less stringent quality controls

It is worth noting that optimal hair health depends on multiple factors including adequate nutrition (particularly protein, iron, zinc, and B vitamins), management of underlying medical conditions, stress reduction, and gentle hair care practices. A holistic approach addressing these factors is more likely to be beneficial than relying on any single supplement.

Potential Side Effects and Safety Considerations

CoQ10 supplementation is generally well tolerated by most individuals, with a favourable safety profile established through numerous clinical studies. However, as with any supplement, potential side effects and interactions should be considered before use.

Common side effects, when they occur, are typically mild and may include:

• Gastrointestinal symptoms such as nausea, diarrhoea, or stomach upset

• Headache

• Dizziness

• Sleep disturbances (uncommon; if affected, morning dosing may be preferable)

• Skin rash (rare)

These effects are generally dose-dependent and often resolve with dose reduction or taking the supplement with food. Serious adverse effects are uncommon at standard supplemental doses.

Drug interactions represent an important consideration. CoQ10 may reduce the anticoagulant effect of warfarin, potentially requiring dose adjustments and more frequent INR monitoring. Patients taking warfarin should not start CoQ10 without consulting their GP or anticoagulation clinic. Additionally, since statin medications can reduce circulating CoQ10 levels, some patients on statins take CoQ10 supplements, though evidence for this practice preventing statin-related muscle symptoms remains mixed.

Special populations require particular consideration:

• Pregnant and breastfeeding women: There is insufficient safety data, so CoQ10 supplementation is not generally recommended unless specifically advised by a healthcare professional

• Children: Safety and appropriate dosing have not been well established

• Individuals with diabetes: CoQ10 may have modest effects on blood glucose levels; monitoring is advisable

• Those with low blood pressure: CoQ10 may have mild blood pressure-lowering effects

When to seek medical advice: Individuals should contact their GP if they notice sudden or severe hair shedding, patchy hair loss, scalp symptoms (such as redness, scaling, or pain), or hair loss accompanied by other symptoms suggesting systemic illness. Children with scaly patches and lymphadenopathy should be assessed promptly as this may suggest tinea capitis (scalp ringworm). These features may indicate conditions requiring specific medical treatment rather than supplementation.

Any suspected adverse reactions to CoQ10 supplements should be reported through the MHRA Yellow Card Scheme, which monitors the safety of medicines and supplements in the UK.

Frequently Asked Questions