Does Ketoconazole Block Dht Systemically Or Only In The Follicles?

[otann]

I haven't done any more research, but I do have a question: if the mechanism of action of kcz is to act as an AA (and somehow affect local DHT levels) how come it is effective as a shampoo? That is, being applied only 5-10 mins and then washed away, every 2-3 days?

Short contact therapy is effective because topically applied ketoconazole persists in hair for an average of 3 days and in the epidermis for an average of 7 days. The full texts of the aforementioned research articles investigating ketoconazole's anti-androgenic effect can be accessed through Library Genesis. In short, ketoconazole impacts hair through both androgen-dependent (inhibition of AR activity and upregulation of genes involved in follicular differentiation) and androgen-independent (suppression of microbial-induced inflammation) mechanisms.

 

[dale2]

source?

 

[otann]

Following a single application of ketoconazole shampoo, ketoconazole persists at therapeutic concentrations for 7 days in the epidermal layers. In addition, substantial pityrosporal inhibitory doses of ketoconazole were detected on the hair for several days after use of the shampoo, the mean level at 72 h was 11.6 μg/mg.

 

[dale2]

Thanks, so it should be enough to use the 2% shampoo only 1 time per week, which is really good news because all 2% formulations (Nizoral and generic versions) are harsh on the scalp and hair. I guess that the 1% formulations (like RegenePure, no sulphates) should be used 2-3 times per week instead? I wish the study gave more details (e.g. quantity and especially how long to keep it before to wash it away) but maybe we can assume that it was applied following the package insert...

 

[Dimitri001]

@otann do you know of any research, other than what we've mentioned so far, into whether the AA effect is systemic or, generally, whether k goes systemic?