Nizoral seems like a nice shampoo thus far. I can't really say what's it's full effectiveness is, but I'll explain my short experience with it.. I've been using it 2x per week for a few weeks now. 5/6 total uses so far.. On days that I use it I'll prewash myhair with a PH balanced baby shampoo. Just a simple lather and rinse.. I think this is important to get your hair and scalp prepped better for the active ingredient in Nizoral and similar shampoos, ketoconazole. I may use a different shampoo between Nizoral uses, but as of late I've been using a PH balanced baby shampoo as my everyday shampoo. I always use cold water when shampooing my hair. It's just something I believe in for whatever that's worth. I use the 2% version of Nizoral.
Something I've noticed in my short experience with it, is that it seems to thicken my hair shafts, which a lot of people have seen. I like the way it makes my hair look and my scalp feel. If anything, it's a solid shampoo. Not sure what it'll do for me as far as hair growth/loss, but the scientific studies speak for themselves. I've also noticed that I see it's benefit more on the days between it's uses after I've washed with my other shampoo.
My guess is that for guys with aggressive male pattern baldness, Nizoral may not do much and they will discredit it and give up on it before it's had a chance to make any difference. Even if it would be slight for them.. As of now, I have mild hair loss. I'm an NW2 at 27 and have been an NW2 since 20.. I think I'm going to stick with Nizoral and then research and add on to my regimen from here in hopes of maintaining my hair or slightly improving it.