lets talk bout Nizoral's anti DHT properties

[maddoc23]

Bruce and Bryan,

Nizoral treats Seborrheic Dermatitis, which is characterized by an excessive amount of sebum production. Is it surprising that nizoral would then shrink the sebaceous gland. After all it is an anti-inflammatory.

Maddoc, that answer sounds a little too pat and opportunistic to me, because I'm not aware that anti-inflammatory agents per se shrink sebaceous glands. If you can find any evidence that they do, I'll certainly accept it; but for now, I think the simplest and best explanation (let's use Occam's Razor! ) is that Nizoral shrinks sebaceous glands by virtue of its mild antiandrogenic properties.

Bryan

Bryan,

First, I have included the link that corroborates there is excessive sebum production caused by s. dermatitis. Sebum is produced by a gland, and like any gland that is producing excessive amounts of product, it is going to become enlarged/inflammed. Compare that to your logic that it is the anti-androgenic properties that reduce DHT production and thus reduces the size of the sebaceous gland. The sebaceous gland is not going to have a 20% reduction in size because a hormone (which is made of considerably small proteins) is inhibited. The sebaceous gland produces and secretes sebum and is going to increase/decrease in size based on the amount of sebum production. This answer seems pat, because it is that simple. When people believe it has anti-androgenic properties some people think they can just use nizoral shampoo to treat male pattern baldness, and this is why it is important to dispel this myth.

D

The link: http://www.hairless.net/dandruff.html

Feel free to crosscheck it with other sources.

D

 

[Bryan]

Bryan,

First, I have included the link that corroborates there is excessive sebum production caused by s. dermatitis.

You're twisting it around a little. Excessive sebum production is ASSOCIATED with s. dermatitis. In fact, you might even put it the other way around: excessive sebum production CAUSES (not is caused by) s. dermatitis. Probably.

Sebum is produced by a gland, and like any gland that is producing excessive amounts of product, it is going to become enlarged/inflammed.

No, not necessarily.

Compare that to your logic that it is the anti-androgenic properties that reduce DHT production and thus reduces the size of the sebaceous gland.

Ok, I just did, and the second one makes a lot more sense than the first one. I think William of Occam would agree.

The sebaceous gland is not going to have a 20% reduction in size because a hormone (which is made of considerably small proteins) is inhibited.

HUH?? Maddoc, I _hope_ you're joking, because the activity of sebaceous glands is strongly under androgenic control. That's COMMON KNOWLEDGE. I guarantee you that you can reduce sebaceous gland size and decrease sebum output by that same amount with the use of antiandrogens and/or 5a-reductase inhibitors.

The sebaceous gland produces and secretes sebum and is going to increase/decrease in size based on the amount of sebum production.

It's the other way around: sebaceous glands produce sebum based on their size. And both of those are STRONGLY influenced by androgens.

This answer seems pat, because it is that simple. When people believe it has anti-androgenic properties some people think they can just use nizoral shampoo to treat male pattern baldness, and this is why it is important to dispel this myth.

Have you even READ the Nizoral study? It seems to support the idea that Nizoral _can_ be used to treat male pattern baldness.

Bryan

 

[maddoc23]

Bryan,

Obviously we are just going to disagree on this. There are just 3 things you should think about:

1) Applying any DHT inhibitor for 5 minutes before rinsing it off will NOT have any affect on internal DHT levels.

2) The study does "suggest" it has anti-androgenic properties. Now, doesn't it sound better to "suggest " something has anti-androgenic properties rather than anti-fungal properties in relation to male pattern baldness.
Basically if someone says the word anti-androgenic there is a lot more press on it.

3) Ketoconazole (to the best of my knowledge) inhibits testosterone synthesis not DHT synthesis.....something to think about.

If we choose to take the most simple explanation to be true then mine is it. Yours assumes in 5 minutes enough ketoconazole penetrates all the dermal layers to inhibit a very small amount of DHT and that is responsible for the 20% decrease in sebaceous glandular size rather than the treatment of s. dermatitis being responsible for the same decrease(which is known to be marked by excessive sebum production). Keeping in mind that ketoconazole is a very mild anti-androgenic at best when taking orally (~100% absorption). This seems painfully obvious to me.

I have actually considered your arguments, consider mine.

D

 

[Bryan]

Bryan,

Obviously we are just going to disagree on this. There are just 3 things you should think about:

1) Applying any DHT inhibitor for 5 minutes before rinsing it off will NOT have any affect on internal DHT levels.

I'm not sure what you mean by "DHT inhibitor". Do you mean a androgen receptor blocker, or do you mean a 5a-reductase inhibitor, or do you mean something which interferes with the synthesis of androgens, or do you mean ANY or ALL of things? I wish people would avoid the use of that vague and ambiguous term. Also, I'm not sure what you mean by "internal DHT levels". Are you talking about serum DHT, or DHT inside hair follicle cells?

It's not out of the question that applying an antiandrogen for only 5 minutes could work. After all, the screamingly obvious fact that Nizoral DOES have an effect on sebaceous glands (even though you and I may disagree on the exact mechanism) proves that it does have some kind of medicinal effect on them. Therefore, I think we can dismiss your claim out of hand.

2) The study does "suggest" it has anti-androgenic properties. Now, doesn't it sound better to "suggest " something has anti-androgenic properties rather than anti-fungal properties in relation to male pattern baldness. Basically if someone says the word anti-androgenic there is a lot more press on it.

I don't understand your point.

3) Ketoconazole (to the best of my knowledge) inhibits testosterone synthesis not DHT synthesis.....something to think about.

I was referring to its androgen receptor blocking abilities (citation available upon request), although the effect you mention above is probably helpful for hair follicles, too.

If we choose to take the most simple explanation to be true then mine is it. Yours assumes in 5 minutes enough ketoconazole penetrates all the dermal layers to inhibit a very small amount of DHT and that is responsible for the 20% decrease in sebaceous glandular size rather than the treatment of s. dermatitis being responsible for the same decrease(which is known to be marked by excessive sebum production). Keeping in mind that ketoconazole is a very mild anti-androgenic at best when taking orally (~100% absorption). This seems painfully obvious to me.

First of all, keto doesn't have to "penetrate all the dermal layers" just to get to the sebaceous glands. The stratum corneum can be a formidable barrier, but the seb glands and hair follicles are more directly accessible.

Second of all, I don't understand your point about the "very small amount of DHT". Are you STILL contesting the common knowledge that sebaceous glands are strongly influenced by androgens?

Third of all, you still haven't provided any evidence to me that reducing fungal organisms has any effect on the size of sebaceous glands or their sebum output. I'm trying to keep an open mind about that because I don't recall reading anything about that, one way or the other. But until you CAN provide such evidence, I think any reasonable person (including William of Occam) would prefer the simple and elegant explanation that it's Nizoral's antiandrogenic properties which account for its effects on sebaceous glands.

Fourth of all, I think there's a big difference between taking a relatively small amount of keto orally and having it spread out and get diluted systemically all over the body, compared to applying it in a 2% vehicle directly to a problem area of the body for several minutes.

Bryan

 

[Guest]

To shift the discussion just a bit, I have been wondering about the impact of sweating (specifically scalp sweating) on hair loss. Since the Seb glands are involved in hair loss (as I understand it) and since they are involved in sweating (scalp sweating) the simple question to me is, does it make any difference (all other things being held constant) in male pattern baldness if we address this. (seems we already agree that swollen seb glands are not a good thing, then how about "overactive" sweat glands)?

In other words, would inordinate amounts of sweating (prof. athletes, laborers in the sun, etc) impact male pattern baldness either way? Similarly, if someone is working out say several times a day, would it make sense to shampoo after these workouts or not?(from a male pattern baldness perspective).

I hope this is not too simplistic an issue or has already been dealt with, but your dialog sparked the question.

Personally, I always felt it was better to clean my scalp after a big workout but never tied that to male pattern baldness, just basic hygiene.

Thanks guys.

 

[Loopydude]

What ketoconazole does and doesn't

Ketoconazole is an inhibitor of a class of enzymes called "cytochrome P450" enzymes, or CYP450 for short. So, in addition to doing all kinds of other stuff, keto inhibits steroidogenesis. Technically, it does not directly inhibit DHT production; it inhibits testosterone production, and hence DHT production, since DHT is a metabolite of testosterone. Ketoconazole may also inhibit enzymes responsible for converting arachadonic acid into inflammatory metabolites, like prostaglandins. At any rate, it's known to have anti-inflammatory effects.

My guess is, since topical ketoconazole is not well absorbed beyond the dermis, and thus has little systemic effect, Nizoral or other keto shampoos should have about zero anti-androgenic value. The primary site of steroidogenesis is not the skin, after all, so I can't see how having keto in the skin should make any difference one way or the other. It is known, however, that at the cellular level male pattern baldness looks like an immunological response, sort of like organ rejection, so it is possible that an anti-inflammatory drug could have some protective effects. I kind of wonder about that too: I mean, there are plenty of oral NSAIDS on the market, people take them quite a bit, and nobody seems to have correlated popping Advil with stemming hair loss. In fact, I've seen some reports that naproxin (Aleve) may cause hair loss. Simple reduction of arachadonic acid metabolites seems unlikely to be the entire story. Whatever keto does (if it does anything), I think it's still a bit mysterious.

FWIW, I really don't understand why Dr. Lee promotes his 2%keto/salicylic acid shampoo as an "anti-DHT" shampoo. Seems like bunk to me. Sal. acid is a keratolytic, and who knows what keto does. Why not just say "Hair Restoration" shampoo or whatever? There are a couple reports out there suggesting 2% keto shampoo might be as good as 2% minoxidil (which we should all understand is rather unimpressive). That should be good enough without the flights of fancy. The suggestion that topical keto inhibits DHT is, as far as I can see, without any good scientific basis.

 

[VoRteX]

sorry but.............yawn.


now that the brain-duel is over I'd just like to say that several studies show that nizoral is beneficial in a male pattern baldness regimen. Is it beneficial because it actually "inhibits" DHT? I dont know, but I'll continue to use it because I've had good results with it.

peace.

 

[Loopydude]

If it works for you

I think that's a good, pragmatic attitude, vortex.

However, there is some value, I think, to looking at the fine print, and trying to be rational about hair-restoration products, both effective and ineffective. If, for instance, a doctor goes around saying a product is an anti-androgen, when, in fact, there's no good basis for such a claim, one might reasonably wonder about the ethics and/or intellect of that doctor.

At the end of the day, there are only two proven treatments for male pattern baldness: finasteride and minoxidil. Nothing else has been subjected to enough scrutiny to justify assertions of its efficacy in treating male pattern baldness. Most of the studies about Nizoral are uncontrolled, and all of them are too small to have real statistical power. I work in the pharm industry, and let me tell you, there are plenty of drugs that make it all the way to PhaseIII and nonetheless prove under rigorous study to lack sufficient efficacy to warrant approval. That means in PhaseII they looked good enough to spend the tens to hundreds of millions it take to carry out PhaseIII trials. Nothing published about Nizoral and male pattern baldness even comes close to passing PhaseII muster as far as numbers and study design goes, so there's little reason to trust the science that is extant. That's not to say it's wrong, just that it's not good enough to be confident about yet.

So, yeah, if you think it works for you, great. However, you've got two of the proven treatments in your regimen. How do you know what part of the coctail is responsible for what?

It's everybody's dollar to spend as they choose, but why not be educated and skeptical before forking over your hard-earned cash? In the case of keto shampoos, they're proven safe, and aren't all that expensive, so there's little harm in throwing it in. But there may be no harm in leaving it out, for all anyone really knows. It's important to understand that. Caveat emptor, as they say.

 

[Guest]

Re: If it works for you

I think that's a good, pragmatic attitude, vortex.

However, there is some value, I think, to looking at the fine print, and trying to be rational about hair-restoration products, both effective and ineffective. If, for instance, a doctor goes around saying a product is an anti-androgen, when, in fact, there's no good basis for such a claim, one might reasonably wonder about the ethics and/or intellect of that doctor.

At the end of the day, there are only two proven treatments for male pattern baldness: finasteride and minoxidil. Nothing else has been subjected to enough scrutiny to justify assertions of its efficacy in treating male pattern baldness. Most of the studies about Nizoral are uncontrolled, and all of them are too small to have real statistical power. I work in the pharm industry, and let me tell you, there are plenty of drugs that make it all the way to PhaseIII and nonetheless prove under rigorous study to lack sufficient efficacy to warrant approval. That means in PhaseII they looked good enough to spend the tens to hundreds of millions it take to carry out PhaseIII trials. Nothing published about Nizoral and male pattern baldness even comes close to passing PhaseII muster as far as numbers and study design goes, so there's little reason to trust the science that is extant. That's not to say it's wrong, just that it's not good enough to be confident about yet.

So, yeah, if you think it works for you, great. However, you've got two of the proven treatments in your regimen. How do you know what part of the coctail is responsible for what?

It's everybody's dollar to spend as they choose, but why not be educated and skeptical before forking over your hard-earned cash? In the case of keto shampoos, they're proven safe, and aren't all that expensive, so there's little harm in throwing it in. But there may be no harm in leaving it out, for all anyone really knows. It's important to understand that. Caveat emptor, as they say.

Hard to argue with your logic, BUT--If dandruff and inflammation are part of the male pattern baldness cycle (which I believe is now accepted as "fact") and if Nizoral acts to reduce both (which I believe is accepted in fact) then it is a reasonable jump to add this to the routine for male pattern baldness without claiming that it has the same efficacy as minoxidil for example.

The other way to look at this is---if I have male pattern baldness and dandruff, irritation and inflammation, would you suggest that I let it alone and not treat it? I think you would not do so, but would treat that condition.

So, given the $3 per month cost and the absence of downside (to my knowledge) and the potential for upside, would you leave it out of your program?

Just food for though! :rockon:

 

[Loopydude]

Well...

Hey Bruce,

Simple question: Are there people with itchy, flakey scalp and dandruff who don't go bald, and never will?

You are right, though: The downside to using Nizoral is about zero, so what the hell. I just think folks should approach it that way. You know, can't hurt, so why not. When people go around saying it's this or it's that with no real basis for such claims, that's when I get concerned.

FWIW, I use Nizoral 1% on a regular basis, and I don't have dandruff . That's just what I do. I'll never go and tell somebody that's what THEY should do. It's my choice to waste my money on, and, of course, it's not much of a loss.

So what the hell!

 

[Guest]

Re: Well...

Hey Bruce,

Simple question: Are there people with itchy, flakey scalp and dandruff who don't go bald, and never will?

You are right, though: The downside to using Nizoral is about zero, so what the hell. I just think folks should approach it that way. You know, can't hurt, so why not. When people go around saying it's this or it's that with no real basis for such claims, that's when I get concerned.

FWIW, I use Nizoral 1% on a regular basis, and I don't have dandruff . That's just what I do. I'll never go and tell somebody that's what THEY should do. It's my choice to waste my money on, and, of course, it's not much of a loss.

So what the hell!

I am kind of in your camp. I also assume that it is possible to have some level of inflammation that does not result in dandruff so that is another reason to use Nizoral.

And it is a nice shampoo too!

Thanks

 

[descending_again]

sorry but.............yawn.


now that the brain-duel is over I'd just like to say that several studies show that nizoral is beneficial in a male pattern baldness regimen. Is it beneficial because it actually "inhibits" DHT? I dont know, but I'll continue to use it because I've had good results with it.

peace.

Vortex....NICE! :lol: I was getting tired of reading all of the crap that has no interest to me, as well. (No offense guys.)

The sh*t either works or it doesn't. Nizoral works in my case. Turn the Page.

 

[descending_again]

Re: If it works for you

I think that's a good, pragmatic attitude, vortex.

However, there is some value, I think, to looking at the fine print, and trying to be rational about hair-restoration products, both effective and ineffective. If, for instance, a doctor goes around saying a product is an anti-androgen, when, in fact, there's no good basis for such a claim, one might reasonably wonder about the ethics and/or intellect of that doctor.

At the end of the day, there are only two proven treatments for male pattern baldness: finasteride and minoxidil. Nothing else has been subjected to enough scrutiny to justify assertions of its efficacy in treating male pattern baldness. Most of the studies about Nizoral are uncontrolled, and all of them are too small to have real statistical power. I work in the pharm industry, and let me tell you, there are plenty of drugs that make it all the way to PhaseIII and nonetheless prove under rigorous study to lack sufficient efficacy to warrant approval. That means in PhaseII they looked good enough to spend the tens to hundreds of millions it take to carry out PhaseIII trials. Nothing published about Nizoral and male pattern baldness even comes close to passing PhaseII muster as far as numbers and study design goes, so there's little reason to trust the science that is extant. That's not to say it's wrong, just that it's not good enough to be confident about yet.

So, yeah, if you think it works for you, great. However, you've got two of the proven treatments in your regimen. How do you know what part of the coctail is responsible for what?

It's everybody's dollar to spend as they choose, but why not be educated and skeptical before forking over your hard-earned cash? In the case of keto shampoos, they're proven safe, and aren't all that expensive, so there's little harm in throwing it in. But there may be no harm in leaving it out, for all anyone really knows. It's important to understand that. Caveat emptor, as they say.

Tooshay Loopy! Good point. Advantage.....Loopy!

 

[descending_again]

The reason that Nizoral works for me, or that I feel it does, is because it IS an anti-flammatory...so it keeps my scalp healthy with the irritation of the PPG from the minoxidil.

 

[maddoc23]

Bruce,

In regards to overactive sweating exacerbating hairloss.....I don't know. I have not found any material that links the two, but I can't say for sure.

D

 

[Bryan]

Re: What ketoconazole does and doesn't

My guess is, since topical ketoconazole is not well absorbed beyond the dermis, and thus has little systemic effect, Nizoral or other keto shampoos should have about zero anti-androgenic value. The primary site of steroidogenesis is not the skin, after all, so I can't see how having keto in the skin should make any difference one way or the other.

I'm very puzzled by that statement. Are you claiming that topical antiandrogens cannot have any beneficial effect on hair follicles? That's certainly what you _appear_ to be saying. If so, I profoundly disagree with you.

Bryan

 

[Bryan]

[quote="vortex72-->":fd46c]sorry but.............yawn.

Vortex....NICE! :lol: I was getting tired of reading all of the crap that has no interest to me, as well. (No offense guys.)[/quote:fd46c]

Why on earth were you even READING this thread if you weren't interested in the subject matter which was clearly and unequivocally spelled-out in its subject? "lets talk bout Nizoral's anti DHT properties" It couldn't have been stated any more explicitly than that! If you're not interested in it, don't read it! :twisted:

Bryan

 

[Loopydude]

Answer to Bryan

Hiya, Bryain,

I think you misunderstood me a bit.

Let's focus on testosterone (T). T is produced primarily in the testes and adrenals (in order of importance), with a tiny smattering coming from other tissues. T then circulates throughout the body where it can be transformed by 5AR into dihydroxytestosterone (DHT), the really potent male adrogen. Ketoconazole is not a 5AR inhibitor. It is an inhibitor of one or more of the enzymes responsible for converting precursor molecules into T.

It is widely understood that ketoconazole, topically applied, has little or no systemic effects. So, topical keto will have an insignificant effect on steroidogenesis. Therefore, it has no impact on the amount of T that gets to your scalp from other parts of your body. It also has no impact (so far as we know) on the conversion of T to DHT in your scalp or any other part of your body.

So, I'm not saying topical antiandrogens can't work, if they work the right way. I'm saying that keto doesn't seem like it would be an effective topical antiandrogen, since, delivered topically, it has very little impact on the body's production of T. Given this line of reasoning, how does Dr. Lee support his assertion that keto shampoo is an "anti-DHT" shampoo? I just don't see it. I'm not going to say that keto shampoo can't help with hair loss. Some of the preliminary research out there suggests it might be helpful. All I'm saying is it's not clear to me what mechanism keto uses to exert this beneficial effect. It's an interesting question to answer rigorously, IMO, as it might lead to better treatments for hair loss. I highly doubt inhibition of steroidogenesis is the reason, though. You mentioned in an earlier post that keto may be an androgen receptor antagonist. If that proves to be true, that could be the mechanism, who knows. Could you provide a link to that reference?

Sorry for the confusion.

 

[VoRteX]

Why on earth were you even READING this thread if you weren't interested in the subject matter which was clearly and unequivocally spelled-out in its subject? "lets talk bout Nizoral's anti DHT properties" It couldn't have been stated any more explicitly than that! If you're not interested in it, don't read it!

Bryan

No offense meant to you Bryan. I DID read every word of the thread but near the end it seemed to turn more into a "whose brain is bigger" thread rather than meaningful discussion. I value your input to this site and encourage you to further debate any subject you wish! I have learned quite a bit from you thus far :love:

 

[Axon]

Gotta agree with Vortex. Egos here frighteningly enormous. Never ending pissing contests mind-bending.