Comparative evaluation of two Unani formulation combinations in the treatment of telogen effluvium: A randomized, single-blind clinical trial

• Hair loss impacts physical, psychological, and social well-being. • Conventional drugs such as Minoxidil have side effects and limited use in diffuse hair shedding. • Unani medicine offers holistic, time-tested treatments for hair loss. • Trial compared Itrifal Kishneezi with Roghan Amla vs. Baiza Murgh . • Itrifal Kishneezi with Roghan Amla was more effective in reducing hair loss. : Telogen Effluvium is a diffuse, non-scarring alopecia characterized by excessive hair shedding and is associated with considerable psychological distress and impaired quality of life. Although Unani medicine describes several oral and topical interventions for hair disorders, robust clinical evidence supporting their efficacy remains limited. : To evaluate and compare the efficacy of two Unani formulation combinations-Itrifal Kishneezi with Roghan Amla Khas and with Roghan Baiza Murgh in the management of Telogen Effluvium. : A randomized, single-blind, comparative clinical trial was conducted among 40 patients aged 18-60 years diagnosed with Telogen Effluvium. Participants were randomly allocated into two groups. Group A received oral Itrifal Kishneezi (10 g twice daily) along with topical Roghan Amla Khas (10 mL), while Group B received the same oral formulation with topical Roghan Baiza Murgh (10 mL). The intervention was administered for 45 days, with fortnightly follow-up assessments. Treatment efficacy was evaluated using a hair shedding visual analogue scale, hair pull test, and trichoscopic parameters. Ethical approval was obtained from the Institutional Ethics Committee, National Institute of Unani Medicine, Bengaluru (NIUM/IEC/2021-22/030/JT/02), and the trial was registered with the Clinical Trials Registry of India (CTRI/2023/06/053580, dated 05-06-2023). Trial commenced on 26 July 2023. : Both groups demonstrated statistically significant improvements from baseline in all outcome measures ( P < 0.001). Group A showed comparatively greater reductions in hair shedding scores (2.90 vs. 2.50), hair pull test positivity, and in trichoscopic parameters, including hair density, shaft thickness, and reduction in empty follicles. However, the intergroup differences were not statistically significant ( P > 0.05). : Both Unani formulation combinations were effective in the management of Telogen Effluvium, resulting in significant reductions in hair shedding and improvements in clinical and trichoscopic outcomes. Although Itrifal Kishneezi with Roghan Amla Khas demonstrated a relatively faster early response, the overall therapeutic efficacy of both regimens was comparable.