Alternative to Nizoral?

[litcII]

Are there any other shampoos that have the dht blocking effects of Nizoral out there? I've tried Nizoral, but it made my scalp irritated, and it seemed to make a lot more hair fall out....
Thanks

 

[pproctor]

Are there any other shampoos that have the dht blocking effects of Nizoral out there? I've tried Nizoral, but it made my scalp irritated, and it seemed to make a lot more hair fall out....
Thanks

This issue comes up regularly. Most likely, the in vitro antiandrogenic effects of ketoconazole ("nizoral") have little to do with its sometime efficacy in the treatment of pattern loss. Rather, it its efficacy against seborrheic dermatitis. Specifically, it kills the fungus which causes seb derm.

Other anti-seb derm agents with apparent efficacy in pattern loss include zinc pyrithione and "Tar", as in "T-gel". Again, the first century medical writer Galen mentions "Tar" as a potential treatment for pattern loss.

So this effect has been known for a long time, though only recently has it become generally-accepted among physicians. This is because, except for extreme cases of seborrheic dermatitis, it is generally not a big effect, though certainly a real one. E.g. , Merck used "T-gel" in both wings of the propecia trial to minimize seborrheic dermatitis as a variable.

Docs like to treat the primary disease and not the symptoms. So we generally use nizoral, though nobody can say if it works any better than the other antiseborrheic agents.

As for rate of loss--- do not, repeat, do not use this as a criteria for efficacy. Treatment works primarily by making hair grow, not by preventing it from falling out. In fact, treatment is much more likely to cause a temporary increase in shedding as it drives dormant follicles out of dormancy a little early.

Peter h. Proctor, PhD,MD

 

[helpmyhair]

Dr. Proctor, are you saying he should switch to T-gel? or stick with Nizoral as the increased shedding is normal in treatment?

I ask because I have the same problem, only I also get extreme scalp itch in addition.