Ketoconazole 2% Does More Harm Than Good?

[Timii]

Hello, I'm 18 years old and unfortunately I have androgenetic alopecia. I'm currently a Norwood 1.5, maybe even lower, so this gives me some time to act before it's too late. As some people point out, sooner or later I will have to start with Finasteride and I accept this, but my goal is gaining at least 2 years so I don't mess up with my growth which should end at age 20. So I bought Regaine and a ketoconazole Shampoo (Ketozolin 2%). Unfortunately as I read the package of Regaine, it says you shouldn't use it if you have blood pressure problems. Recently, I ' ve had the suspect of high blood pressure (yeah, it' s strange considering my age, I guess anxiety because of my hair contributed to it), so I temporary have to put Regaine aside. My doctor measured normal blood pressure, but at the pharmacy I got a clear high value. I can't explain myself how that's possible, anyway next Samsday I'm going to the hospital to be completely sure. So, I read some studies who confirmed that Ketoconazole is helpful against male baldness, so I applied some of it today for the first time. I was scarried when I saw that I was shedding a remarkable number of hair (given the fact that I massaged my scalp, it's not so worrying but still I shedded many more hairs than with a normal shampoo) and that my hair looked slightly thinner, it's not that bad but I can see my scalp more clearly than usual. Is this normal? I feel as if nobody can help me because this shampoo is not made to stop hair loss. I don't have dandruff, I have an oily scalp though.

 

[Boatie]

I used 2 % Ketoconazole for a few months and noticed some serious thinning. Maybe it was just a cosmetic effect but I stopped keto after that. Lots of folk seem to use it though, without any problems.

 

[Oknow]

Same as poster above, hair thinned after using keto, I dropped it. There was no shedding, the thinning hair shed and never returned.

 

[ripple-effect]

I'm a big advocate of Nizoral based on personal experience but that is only for the 1% shampoo. I tried the 2% shampoo expecting better results but I had the same experience as you guys did b/c it completely dried out my hair. I would highly suggest giving the 1% a try - the studies also prove it's more effective than 2%.

 

[Tosh]

Can anyone provide a link to the article? All I've managed to find is the Ketoconazole 1% and 2% are both effective. I can't find anywhere that states 1% is better than 2%.

 

[Oknow]

I'm a big advocate of Nizoral based on personal experience but that is only for the 1% shampoo. I tried the 2% shampoo expecting better results but I had the same experience as you guys did b/c it completely dried out my hair. I would highly suggest giving the 1% a try - the studies also prove it's more effective than 2%.

it was 1 percent i used

 

[Tosh]

I could only find the 1% vs. 2% Ketoconazole (KCZ) here: http://www.hairlosshelp.com/html/nizoral1study.cfm, which admits to comparing two different studies. The problem in comparing the two studies is that they may have unknown variables that contribute differently. I was unable to find the source and the comparison was based on hair shaft diameter.

However, I did manage to find two separate articles for 2% and 1% KCZ:
https://www.karger.com/Article/Abstract/17954
(https://www.haargroeispecialist.nl/...t-of-Long-Term-Use-in-Androgenic-Alopecia.pdf)
2% KCZ improved hair density by +18% and shaft diameter by +7%, using an application of 2-4x a week

http://onlinelibrary.wiley.com/doi/10.1046/j.1467-2494.2002.00145.x/full
1% KCZ the hair density was unchanged, but the anagen hair percent increased by +4.9% and +5.49% for hair shaft diameter, , using an application of 2-3x a week

From these two comparisons, it looks like 2% is better, but it's also possible the differences relate to statistical noise.

It is also worth mentioning that the bottom article zinc pyrithione had a minor negative effect on hair shaft diameter.

 

[Timii]

Update: After I dried my hair, it looked slightly less thin, I was relieved. Also my hair looks darker but I guess it's a cosmetic effect. For some reason the base of my hair is thinner so that I can see my scalp if I look closer on the mirror. In the meantime I didn't shed any hair, this morning I found no hair on the pillow . I don't know if this is good news but I will stick to this and apply it 2x a week. I will update every now and then to help you guys judge if it's worth it

 

[Timii]

Just a question: Assuming that I respond well to ketoconazole, is this enough to MAINTAIN my hair? This is my issue. I'm planning to start a huge travel as a backpacker that will last 3 months next year. If I start Minoxidil I will have to stop it and I will undergo a massive shed and I will get close to becoming bald before I even hit my 20s, or in any case I would become a Norwood 3 or something like that, which I really want to avoid. Currently, I don't know how aggressive my Androgenetic Alopecia is but it surely isn't a mild one. So this is my situation , my hands are basically tied at the moment. I can't start finasteride because I would mess up with my biological growth, if I start Minoxidil ( I don't expect regrowth, but at least maintenance) I would have to stop the treatment one and half year from now, assuming I don't get side effects which is unlikely. My only hope is that Ketoconazole stops hair loss for 2 years, I'm not pretending to save my hair with Keto alone for 10 years or my entire life, only 2 years. I also read something about this "zix" which apparently works if your goal is to maintain your hair. So the question is now how can I recognize if Keto is working for me? What are some good signs that it's stopping my Androgenetic Alopecia? Or am I just too optimistic? I I'm open to suggestions, thank you

 

[ripple-effect]

Just a question: Assuming that I respond well to ketoconazole, is this enough to MAINTAIN my hair? This is my issue. I'm planning to start a huge travel as a backpacker that will last 3 months next year. If I start Minoxidil I will have to stop it and I will undergo a massive shed and I will get close to becoming bald before I even hit my 20s, or in any case I would become a Norwood 3 or something like that, which I really want to avoid. Currently, I don't know how aggressive my Androgenetic Alopecia is but it surely isn't a mild one. So this is my situation , my hands are basically tied at the moment. I can't start finasteride because I would mess up with my biological growth, if I start Minoxidil ( I don't expect regrowth, but at least maintenance) I would have to stop the treatment one and half year from now, assuming I don't get side effects which is unlikely. My only hope is that Ketoconazole stops hair loss for 2 years, I'm not pretending to save my hair with Keto alone for 10 years or my entire life, only 2 years. I also read something about this "zix" which apparently works if your goal is to maintain your hair. So the question is now how can I recognize if Keto is working for me? What are some good signs that it's stopping my Androgenetic Alopecia? Or am I just too optimistic? I I'm open to suggestions, thank you

It's hard to notice at first - I personally noticed a difference when experimenting with different shampoos. It won't be enough to stop hair loss, but it will definitely slow it down. I would recommend a DHT blocker like the Zix formula to maintain what you have.

 

[Timii]

ripple-effect , thank you for your answer. So going back to the question: is it a bad sign if I shed under the shower?

 

[ripple-effect]

ripple-effect , thank you for your answer. So going back to the question: is it a bad sign if I shed under the shower?

If you're not applying/taking a DHT blocker then yes - but if you are it can be a good sign.

 

[otis]

Hello, I'm 18 years old and unfortunately I have androgenetic alopecia. I'm currently a Norwood 1.5, maybe even lower, so this gives me some time to act before it's too late. As some people point out, sooner or later I will have to start with Finasteride and I accept this, but my goal is gaining at least 2 years so I don't mess up with my growth which should end at age 20. So I bought Regaine and a ketoconazole Shampoo (Ketozolin 2%). Unfortunately as I read the package of Regaine, it says you shouldn't use it if you have blood pressure problems. Recently, I ' ve had the suspect of high blood pressure (yeah, it' s strange considering my age, I guess anxiety because of my hair contributed to it), so I temporary have to put Regaine aside. My doctor measured normal blood pressure, but at the pharmacy I got a clear high value. I can't explain myself how that's possible, anyway next Samsday I'm going to the hospital to be completely sure. So, I read some studies who confirmed that Ketoconazole is helpful against male baldness, so I applied some of it today for the first time. I was scarried when I saw that I was shedding a remarkable number of hair (given the fact that I massaged my scalp, it's not so worrying but still I shedded many more hairs than with a normal shampoo) and that my hair looked slightly thinner, it's not that bad but I can see my scalp more clearly than usual. Is this normal? I feel as if nobody can help me because this shampoo is not made to stop hair loss. I don't have dandruff, I have an oily scalp though.

A side effect of the shampoo is hair loss.

 

[Timii]

Today I tried a h&s shampoo and I still shed more than usual. Not as much as with keto, but close. What is going on?

 

[DavidsDome]

Keto can inhibit endogenous PGE2 synthesis.
PGE2 is good for our hair.
So its not really the best treatment.
I understand that you dont want to jump on Finasteride.
But I sure as hell wished I started using it earlier in life.
I started with RU, maybe you can try this.
Its topical so not too much going systemic.
Works well for some in slowing down the process.
On the other hand, finasteride did more for me than RU ever did.
My advice is to decide what you want for yourself.
If you really want to maintain your hair, you'd better go all the way from the first moment.
Its nearly impossible to regrow hair so you better try to keep em from day one...
You can give keto, minoxidil and RU a try.
If it works for you, great!
If it doesnt, better to jump to the real deal (like finasteride, dutasteride, or maybe some other strong topical anti-androgens)
Read about the possible side-effects, make out if its worth the risk to you.
Its up to you!

 

[Timii]

Keto can inhibit endogenous PGE2 synthesis.
PGE2 is good for our hair.
So its not really the best treatment.
I understand that you dont want to jump on Finasteride.
But I sure as hell wished I started using it earlier in life.
I started with RU, maybe you can try this.
Its topical so not too much going systemic.
Works well for some in slowing down the process.
On the other hand, finasteride did more for me than RU ever did.
My advice is to decide what you want for yourself.
If you really want to maintain your hair, you'd better go all the way from the first moment.
Its nearly impossible to regrow hair so you better try to keep em from day one...
You can give keto, minoxidil and RU a try.
If it works for you, great!
If it doesnt, better to jump to the real deal (like finasteride, dutasteride, or maybe some other strong topical anti-androgens)
Read about the possible side-effects, make out if its worth the risk to you.
Its up to you!

Thank you for your advice, but I really want to avoid finasteride for the next 2 or one and a half years. I started minoxidil, I will try the Zix formula and experiment with some pre-conditioner to stop shedding with ketoconazole.

 

[ffar1989]

I am using Nizoral 2% for while... I did not notice any shedding. I don't see much difference on head, but i definitely have more hair on my chest. And I am pretty sure that shampoo is responsible for that.

 

[Rocknroutlaw]

My regime consists of Big 3 minus the shampoo, plus microneedling and supplements.
The reason I have not included keto shampoo is mostly due to what many of you reported as above, and because I do so much already and I'd suspect keto to add little more value...
However, I've now considering the benefits of protein binding that keto provides...
what do you guys think about adding a few drops of essential oil to counteract the harsh drying properties?

 

[DavidsDome]

I used to have issues with dry scalp as well. flakes n stuff. really annoying.
I apply eth-based lotions 4 times a day.
That sh*t will dry your scalp. Add a shampoo that dries even more to that and you're fucked.
What I did to fix it:
Mix some Castor oil in ethanol.
Castor oil has at least a partly PGE2 effect.
And it completely fixed my dry scalp problem.
I apply straight after washing my hair in the morning and when i come home after work at 18h00.
I know its still ethanol-based but you need a penetration enhancer for it to work as a PGF2.
The castor oil is sticky enough to still nourish my skin.
Dont use too much or your hair will be too sticky.

 

[Timii]

Update: Thank you for your answer. I started rubbing it off less intensely and now I shed much less. However it seems that my hair looks incredibly thin (you can really see my scalp, even when it's dry). I ' ve always had very thin hair (I remember myself thinking "is it normal too see my scalp through the hair?") but now it looks horrible. Here are some pics, sorry if my hair looks greasy and unkempt. Has anyone some experience? Should I drop it? These pics don't show the reality. You can literally see my scalp. Even though studies show that it increases the density, it isn't normal to have such a thinning cosmetic effect