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Benefits and risks of hair, skin, and nail supplements in older adults

Summary

This article reviews popular supplements that older adults, especially women, take to improve their hair, skin, and nails. While some supplements like nicotinamide show promise for sun-damaged skin, most lack strong evidence of benefit in healthy people. Important risks include biotin interfering with heart and thyroid tests, too much zinc causing copper deficiency, and excess vitamins A and E building up to toxic levels. Doctors should talk to older patients about these supplements and help them make informed decisions based on scientific evidence rather than marketing claims.

Background

Many older adults, particularly women, use over-the-counter supplements for antiaging benefits. The supplement industry is largely unregulated by the FDA, and interactions between supplements and medications are often overlooked. Nearly 80% of geriatric patients have at least one skin disease, and supplement use for hair, skin, and nail health has nearly doubled from 2011 to 2020.

Objective

This narrative review evaluates the evidence for commonly used supplements for hair, skin, and nails in older adults, including their proposed mechanisms of action, benefits, and potential risks. The review aims to provide clinicians with evidence-based information to guide patient counseling about supplement use and potential harms.

Results

The review identifies that while some supplements may have limited benefits, particularly nicotinamide and active forms of vitamin A for photoaging, most lack strong evidence of efficacy. Biotin may interfere with laboratory tests including troponin and thyroid testing. Zinc supplementation is commonly excessive and can cause copper deficiency. Fat-soluble vitamins A and E can accumulate to toxic levels. Many clinical trials supporting collagen and hyaluronic acid are industry-funded.

Conclusion

Evidence supporting most supplements for hair, skin, and nails is limited, particularly in healthy individuals without deficiencies. Clinicians should counsel older patients about the lack of strong evidence and potential harms, including drug-supplement interactions, laboratory test interference, and over-supplementation risks. Awareness of polypharmacy concerns is essential when caring for older patients’ skin and nails.
  • Published in:International Journal of Women's Dermatology,
  • Study Type:Narrative Review,
  • Source: PMID: 41278416, DOI: 10.1097/JW9.0000000000000236
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