Ketoconazole as an adjunct to finasteride

[helpmefindmyhair]

http://www.ncbi.nlm.nih.gov/entrez/quer ... s=14729013


It can reasonably be concluded that the clinical efficacy of ketoconazole shampoo in the treatment of Androgenetic Alopecia is primarily a function of DHT pathway disruption rather than an anti-inflammatory effect. In rat studies ketoconazole caused 5-R inhibition [28]. Furthermore, in humans ketoconazole has also been shown to inhibit the binding of 5-R to sex hormone globulins [29]. These clinical studies suggest that ketoconazole like finasteride may inhibit the production of DHT. Unlike finasteride ketoconazole has been shown to bind to human AR [30]. Thus, the effect of ketoconazole on the DHT pathway may be two-fold: inhibition of DHT and/or inhibition of DHT binding to AR. Either or both of these properties would result in reduced incidence of DHT binding to AR and inhibiting the pathway that leads to the miniaturizing of hair follicles.

 

[too bald too furious]

I am changing my regimen from Nizoral 1% to 2%.
Thanks for the article

 

[avri]

I don't think there's even one study showing that Ketoconazole 1% shampoo does anything with respect to hair loss. Until then, stick to 2%.


avri

 

[Deaner]

Been usin' 2% since the beginning over here!

 

[Guest]

Good article.

 

[wheyface33]

Need to replace my nizoral this weekend...looks like I'll be using 2% from now on. Thanks a lot for the article man!

 

[Hotlegs]

I've been using 1% nizoral shampoo for the last 2 months and from the very moment (as in: weeks) my shedding has been reduced dramatically... this article (and other ones which use ketoconazol for Androgenetic Alopecia) indeed use 2% versions, but this doesn't necessarily mean 1% is inferior.... I wouldn't use more than needed (I mean, if it works it works, right?) :wink:

 

[Deaner]

Stop trying to convince yourself that 1% is just as strong, get the 2% and try to forgive yourself for the error of your ways.

 

[douggie]

March 04, 2001 - American Academy of Dermatology Meeting - Washington DC - Scientists working for McNeil, makers of Nizoral anti-dandruff shampoo, presented the findings of a study done on 1% Nizoral shampoo which has good news for hair loss sufferers. It has long been known that 2% prescription Nizoral has beneficial effects on Androgenic Alopecia (male pattern baldness). It however has been unclear whether the same benefits can be obtained by using the non-prescription 1% version.
In the study presented (see below), one hundred male volunteers with mild to moderate dandruff and somewhat oily scalp, were using, in a double-blind fashion, either a 1% Nizoral shampoo or a 1% zinc pyrithione shampoo, 2-3 times a week for 6 months.
Analysis of the different parameters set up in the study shows that the hair diameter gradually increased with Nizoral use (+8.46%) over a 6 month period, whereas the diameter showed a trend to decrease with zinc pyrithione use over the same period (-2.28%). The sebum excretion rate was reduced with Nizoral (-6.54%) while it increased with zinc pyrithione (+8.2%) over the same period of time. The number of hair shed over a 24-hour period was reduced by 16.46% with Nizoral and 6.02% with zinc pyrithione after 6 months. Finally, the percentage hairs in anagen phase increased by 6.4% and 8.4% respectively during the study time.

The results are similar to a previous study done on 2% prescription strength Nizoral where it was shown that use of 2% Nizoral yielded a 7% average increase in hair shaft diameter similar to what was achieved by the control group using 2% Minoxidil and a non-medicated shampoo.

So for any hair loss sufferer, this research clearly indicates that using 1% or 2% Nizoral 2-3 times per week, will have positive effects on hair growth as well as controlling dandruff. It is still unclear at this time whether it's the anti-fungal properties or the anti-androgenic properties of Ketokonazole (active ingredient in Nizoral) thats responsible for the hair thickening effects, however because of the decrease in sebum rates as well, it is the authors opinion that the results are due to the anti-androgenic properties of Ketokonazole.

 

[klaus]

I've been using 1% nizoral shampoo for the last 2 months and from the very moment (as in: weeks) my shedding has been reduced dramatically... this article (and other ones which use ketoconazol for Androgenetic Alopecia) indeed use 2% versions, but this doesn't necessarily mean 1% is inferior.... I wouldn't use more than needed (I mean, if it works it works, right?) :wink:

it is good speaking that nizoral 1% has the half ketoconazole of nizoral 2%.

 

[Guest]

it is good speaking that nizoral 1% has the half ketoconazole of nizoral 2%.

yes!

 

[asolof]

douggie & helpmefindmyhair,

Thanks for posting this info on 1% nizoral shampoo. I hadn't seen it.

Well the next step is to do a study directly comparing 1% to 2% nizoral shampoo in the treatment of male pattern baldness, so that if any clinical superiority exists in the 2% formulation, it can be measured. Although both work, the clinical superiority of 2% nizoral over 1% nizoral in treating fungal infections has been previously documented.

 

[Hotlegs]

it is good speaking that nizoral 1% has the half ketoconazole of nizoral 2%.

Uhh, yeah... this cannot be denied, but as has been mentioned by 'asolof' only a decent study in which a 1% and 2% ketoconazole shampoo in a treatment for Androgenetic Alopecia is compared one could draw a conclusion that a higher concentration leads to better results... since ketoconazole probably isn't very healthy for your hair itself I wouldnt use more than needed... this was the point I was trying to make :wink:

Anyway, I'll try the 2% for a couple of months from now on and see for myself... not a very good scientific approach, but I can get a 2% version for free... so why not.

regards

 

[avri]

only a decent study in which a 1% and 2% ketoconazole shampoo in a treatment for Androgenetic Alopecia is compared one could draw a conclusion that a higher concentration leads to better results

The only "study" that shows 1% does anything for hair loss is a dependent one conducted by Nizoral's own maker, trying to protect their OTC version, with specific comparison to ZPT, which happens to be the active ingredient of their main OTC dandruff-treating competitor, Head & Shoulders. Again, there is not one half-credible study that shows 1% does anything for hair loss.


avri

 

[Hotlegs]

Alrighty... I was sort-o thinking of a future study in which a 1% and 2% (and why not 5%? :wink: ) ketoconazole shampoo, a 2% minoxidil (with and without finasteride), placebo (and other control-groups) and perhaps other anti-drandruff/fugal treatments (by the way: Head and Shoulders sux big time, but that's of course my opinion) are compared over a period of lets say 6 months, in which hair diameters/counts are measured (or whatever method is common in this area)... and you're right... there are no studies in which a 1% keto has been shown to be effective... (but if, and only if, 1% shows to be as effective as a 2% solution, why use more... I know... I'm repeating myself here)

By the way... are you planning to do a study yourself? (with my background in biochemistry a interesting study ion this area perhaps lies on my path... on the other hand... there are more urging matters to attend to, although alot-o-people here would disagree)

 

[douggie]

Uhh, you do realize that both the 1% and 2% studies were done by the exact same people, right? So if you are gonna call one credible and one not you are incredibly flawed in your thinking.

Also, it would make no sense to say the 1% is more effective than the 2% considering the profits of the 2% are much greater.

 

[avri]

Not all 2% studies were done by Nizoral maker. Check your facts. And the 1% study is especially unreliable because it was designed to address their main competitor.


avri

 

[silkeysmooth]

ive only been using nizoral 1% for a few days, and although my scalp feels less flakey, im not sure its helped with the inflammatory aspect, which people said it was supposed to do. Is it not suppoed to have any anti-inflammatory properties then?

 

[douggie]

Not all 2% studies were done by Nizoral maker. Check your facts. And the 1% study is especially unreliable because it was designed to address their main competitor.


avri

They were not performed by the exact same people, there were different researchers performing the study, but both studies measuring hair diameter were funded by the maker, Janssen Pharmaceutica. If Janssen Pharmaceutica was caught doing pharmaceutical research that did not follow the FDAs GCPs, regardless of their intent to publish such data, they would no longer be in business. You have no idea the amount of compliance audits and institutional review bullshit researchers need to go through to perform research on a drug. I don't know how much you know about clinical research, but I am a coordinator in a CRO so I am fairly well versed on the guidelines one would have to follow in research, and publishing just one noncompliant study will sink a company.

 

[avri]

This was not research toward any kind of FDA approval, and again, several 2% hair loss-related studies have been made by researchers who don't get their paycheck from Janssen, which cannot be said about the 1%.


avri