Response to: Rethinking Biotin Therapy for Hair, Nail, and Skin Disorders

The authors of the letter concurred with Dr. Lipner's concerns about the routine use of biotin for hair and nail improvement, recognizing the lack of supporting evidence and potential risks as per FDA warnings. They conducted a literature review of 31 articles, primarily case reports, which suggested that biotin supplementation at doses of 2.5 to 20 mg/day might benefit certain dermatologic conditions like alopecia and telogen effluvium in infants and children. However, they acknowledged the challenge in determining whether these conditions would have improved without biotin. The authors concluded that while biotin could be helpful for specific hair disorders, there is no evidence for its use in promoting hair growth in healthy individuals. They emphasized the need for future large-scale, randomized clinical trials to confirm biotin's efficacy and safety and agreed with Dr. Lipner that biotin should only be recommended in evidence-based clinical scenarios with a thorough risk-benefit analysis.