be careful with nizoral

[brian]

So I wanted to update everybody.

I am back to my usual regimen of finasteride, minoxidil one every evening (twice on weekends) and Nizoral once every 4/5 days (using pea sized amount and leaving on for no longer than 3 minutes) and guess what...

since the nizoral related shed I have been seeing some definite results! Its like that shed really kick started some regrowth. Is it possible that temporarily abusing the nizoral got rid of the weaker hairs and got the ball rolling faster. I was also on the back end of a 3 month nizoral/minoxidil shed here too

 

[abcdefg]

I personally think nizoral is pretty over rated I mean the evidence it works for male pattern baldness is a lot less then the other 2 FDA treatments because its not approved for hair loss. I would never rely on nizoral to treat male pattern baldness by itself that is for sure. Most people just throw it in because its cheap and some evidence it MIGHT work so why not add it. I think there was some study showing nizoral got some results similar to rogain, but I question when used as a shampoo if that is really true or not. One small study alone does not always conclusively prove something

 

[Quadzilla99]

Here's a collection of all the Nizoral studies I could find. Figured this would be good to have in one place:


1%:


Reduces shedding and makes hair thicker:


Nudging hair shedding by antidandruff shamp... [Int J Cosmet Sci. 2002] - PubMed - NCBI


Effetti di uno shampoo al ketoconazolo sulla calvizie androgenetica


2%:


Almost as effective as 2% minoxidil:


Ketoconazole shampoo: effect of long-term use in... [Dermatology. 1998] - PubMed - NCBI


(nizoral + Propecia more effective than Propecia alone):


Comparative efficacy of various treatment regimen... [J Dermatol. 2002] - PubMed - NCBI


21 month study with graph (best results seen from months 6-15):


2% Nizoral Shampoo Increases Hair Growth in Men with Male Pattern Baldness


Small Japanese 2% cream study with before/after photos of two subjects:


http://www.hairsite.com/hair-loss/forum_entry-id-25116-page-0-category-0-order-last_answer.html


Scientists shaved mice repeatedly and applied either ketoconazole or a vehicle solution to their skin and the mice who received ketoconazole repeatedly demonstrated "a macroscopically significant stimulatory effect". In other words their hair grew like crazy.


Topical application of ketoconazole stimulates ha... [J Dermatol. 2005] - PubMed - NCBI


Others:


Ketocazole as an adjunct to finasteride in th... [Med Hypotheses. 2004] - PubMed - NCBI


Oral ketoconazole is such a potent anti-androgen its basically castration in a bottle:


Effect of ketoconazole and other imidazole fungicides on testosterone biosynthesis


Low-dose ketoconazole treatment in hirsu... [J Endocrinol Invest. 1990] - PubMed - NCBI


[Efficacy of low dose ketoconazole th... [Zhonghua Yi Xue Za Zhi. 2012] - PubMed - NCBI


[The effect of nizoral on the function of the hyp... [Lik Sprava. 1992] - PubMed - NCBI


It doesn't get absorbed enough from topical application to do any of that though:


Clinical pharmacokinetics of ketoconazole. [Clin Pharmacokinet. 1988] - PubMed - NCBI


and yet another early study on topical keto (det I can't find right now) showed that serum levels of ketoconazole were virtually undetectable even when they used large doses

 

[der29]

Personally, I have no idea why anyone on here uses it. I've consulted three different physicians, and they all laughed as they refused to write a prescription saying it's for ringworm

From what I've gathered, there is absolutely no evidence it works and people who say they are getting results with it are attributing their success to the finasteride/minoxidil combination.

it works...i ran out of finasteride for a year and only had nizoral and it maintained my hair no further loss that i expected. It's essential you include nizoral into your regimen!

 

[Georgie]

I've done research and it's turned up nothing, and the fact that physicians laugh at notion of Nizoral as a hair loss product makes me even more skeptical. I'd be interested, however, in some hard studies done that show Nizoral can effectively combat hair loss.

Just gonna throw in my two cents here and say that regular physicians and I would argue most regular dermatologists infanct know absolutely f**k all about hairloss, so....

 

[Beatlejim]

I used it twice leaving it on for 5 minutes which I read on here was the best way. I had dramatic hair fallout. I threw the damn bottle in the trash and from now on try to remember that everything you read is not true.

 

[countjulian]

I would guess it's because people assume that ketoconazole penetrates the scalp and prevents DHT from binding to the scalp AR's. The funny thing is, none of Nizorals active ingredients namely "Keto" get's absorbed through the scalp. With that in mind, I don't believe Keto anti androgenic effects block AR's, I may be wrong though. This shampoo does absolutely nothing for androgenic related hair loss. It can be helpful if hair loss is the result of other conditions such a SD and other inflammatory conditions.

How do you know this? The studies above show it as just as effective as minoxidil for AA.

 

[Georgie]

How do you know this? The studies above show it as just as effective as minoxidil for AA.

Sadly nizoral makes me also shed tons in the shower.

 

[Georgie]

As an antiandrogen, ketoconazole operates through at least two mechanisms of action. First, and most notably, high oral doses of ketoconazole (e.g. 400 mg three times per day) block both testicular and adrenal androgen biosynthesis, leading to a reduction in circulating testosterone levels.[16][31] It produces this effect through inhibition of 17α-hydroxylase and 17,20-lyase, which are involved in the synthesis and degradation of steroids, including the precursors of testosterone.[16] Due to its efficacy at reducing systemic androgen levels, ketoconazole has been used with some success as a treatment for androgen-dependent prostate cancer.[32] Second, ketoconazole is an androgen receptor antagonist, competing with androgens such as testosterone and dihydrotestosterone (DHT) for binding to the androgen receptor. This effect is thought to be quite weak however, even with high oral doses of ketoconazole.


Systemic Adverse Effects
Although hepatotoxicity, decreased testosterone concentrations, and decreased ACTH-induced corticosteroid concentrations have been reported with oral ketoconazole,32 105 110 these adverse effects have not been reported with topical ketoconazole105 110 and are unlikely since the drug does not appear to be appreciably absorbed following topical application to skin. This would mean that as an AR blocker, very little effect will come from the use of the Shampoo as practically no Ketoconazole is absorbing.

That said, even if the shampoo was an effective topical AR blocker you would need to use it daily to keep those receptors blocked at all times.

Great post. Do people actually take the oral stuff for hairloss..?

 

[countjulian]

As an antiandrogen, ketoconazole operates through at least two mechanisms of action. First, and most notably, high oral doses of ketoconazole (e.g. 400 mg three times per day) block both testicular and adrenal androgen biosynthesis, leading to a reduction in circulating testosterone levels.[16][31] It produces this effect through inhibition of 17α-hydroxylase and 17,20-lyase, which are involved in the synthesis and degradation of steroids, including the precursors of testosterone.[16] Due to its efficacy at reducing systemic androgen levels, ketoconazole has been used with some success as a treatment for androgen-dependent prostate cancer.[32] Second, ketoconazole is an androgen receptor antagonist, competing with androgens such as testosterone and dihydrotestosterone (DHT) for binding to the androgen receptor. This effect is thought to be quite weak however, even with high oral doses of ketoconazole.


Systemic Adverse Effects
Although hepatotoxicity, decreased testosterone concentrations, and decreased ACTH-induced corticosteroid concentrations have been reported with oral ketoconazole,32 105 110 these adverse effects have not been reported with topical ketoconazole105 110 and are unlikely since the drug does not appear to be appreciably absorbed following topical application to skin. This would mean that as an AR blocker, very little effect will come from the use of the Shampoo as practically no Ketoconazole is absorbing.

That said, even if the shampoo was an effective topical AR blocker you would need to use it daily to keep those receptors blocked at all times.

By this token we shouldn't be using minoxidil either since we don't really understand how or why it works. Ketacozonole has proven hair benefits though, it could be promoting hair growth and maintenance through means other than androgen receptor binding.

 

[HNMB]

As an antiandrogen, ketoconazole operates through at least two mechanisms of action. First, and most notably, high oral doses of ketoconazole (e.g. 400 mg three times per day) block both testicular and adrenal androgen biosynthesis, leading to a reduction in circulating testosterone levels.[16][31] It produces this effect through inhibition of 17α-hydroxylase and 17,20-lyase, which are involved in the synthesis and degradation of steroids, including the precursors of testosterone.[16] Due to its efficacy at reducing systemic androgen levels, ketoconazole has been used with some success as a treatment for androgen-dependent prostate cancer.[32] Second, ketoconazole is an androgen receptor antagonist, competing with androgens such as testosterone and dihydrotestosterone (DHT) for binding to the androgen receptor. This effect is thought to be quite weak however, even with high oral doses of ketoconazole.


Systemic Adverse Effects
Although hepatotoxicity, decreased testosterone concentrations, and decreased ACTH-induced corticosteroid concentrations have been reported with oral ketoconazole,32 105 110 these adverse effects have not been reported with topical ketoconazole105 110 and are unlikely since the drug does not appear to be appreciably absorbed following topical application to skin. This would mean that as an AR blocker, very little effect will come from the use of the Shampoo as practically no Ketoconazole is absorbing.

That said, even if the shampoo was an effective topical AR blocker you would need to use it daily to keep those receptors blocked at all times.

So as a shampoo Keto does nothing more than ensuring your scalp is fungal free? In terms of male pattern baldness that is.

 

[countjulian]

So as a shampoo Keto does nothing more than ensuring your scalp is fungal free? In terms of male pattern baldness that is.

METHOD:
The effect of 2% KCZ shampoo was compared to that of an unmedicated shampoo used in combination with or without 2% minoxidil therapy.

RESULTS:
Hair density and size and proportion of anagen follicles were improved almost similarly by both KCZ and minoxidil regimens. The sebum casual level appeared to be decreased by KCZ.

https://www.ncbi.nlm.nih.gov/pubmed/9669136

 

[HNMB]

METHOD:
The effect of 2% KCZ shampoo was compared to that of an unmedicated shampoo used in combination with or without 2% minoxidil therapy.

RESULTS:
Hair density and size and proportion of anagen follicles were improved almost similarly by both KCZ and minoxidil regimens. The sebum casual level appeared to be decreased by KCZ.

https://www.ncbi.nlm.nih.gov/pubmed/9669136

Interesting thank you! I've been on the fence about starting KCZ as my first "treatment" but with all the shedding posts and reviews saying it irritated their scalp/severely dried out their hair it makes me hesitant.

 

[countjulian]

Interesting thank you! I've been on the fence about starting KCZ as my first "treatment" but with all the shedding posts and reviews saying it irritated their scalp/severely dried out their hair it makes me hesitant.

@Quadzilla99 posted a bunch more right above in this very thread, check them out. We might not understand the mechanism 100% but KCZ's efficacy is well established.

 

[HNMB]

@Quadzilla99 posted a bunch more right above in this very thread, check them out. We might not understand the mechanism 100% but KCZ's efficacy is well established.

Even as a stand alone treatment?

 

[countjulian]

Even as a stand alone treatment?

That's what the studies indicate.

 

[countjulian]

Pretty much, like the information I posted above, at very high oral doses it's a weak androgen receptor blocker. As a shampoo with an extremely low percentage of Ketocanozole and no absorption is not going to have any effect on scalp AR's. Unless your hair loss is related to some type of inflammatory condition if will not be effective at all.

Then why have so many studies shown it to be effective?

 

[countjulian]

Minoxidil even though the mechanics are unknown, has shown positive results by itself and in combination with other treatments. Minoxidil unfortunately does not work for everyone nor does it prevent hair loss from further progressing. Nizoral as a shampoo has not shown anything as I can see on it's own as a positive treatment for androgenic hair loss nor does ketoconazole's pharmacokinetics.

KCZ has shown the same positive effects on its own and with other treatments, again androgens play a (huge) role but there's a lot going on with hair loss and AA that we don't understand.

 

[Georgie]

Perhaps there could be people who are super sensitive to the inflammatory effects hair loss can cause.

I think that’s a great point. There are studies which show an almost auto-immune like response in hair loss which causes an inflammatory process. Maybe it helps to quel that within the follicle in some minor way.

 

[HairCook]

I dont have the source but swiss also said not to take Ket when you are on the pg protocoll cause it fucks with the pge2 receptor.