Why no Nizoral in the Propecia Trials?
Some people wonder why the Propecia trial did not use Nizoral as the shampoo of choice. The main problem with this was that Nizoral shampoo was not readily available when the trial started. If the Propecia trial was taking place today when Nizoral is readily available it probably still would not be used. Although Nizoral is officially used for treating dermatitis and combating mild scalp fungal infections, the active ingredient (ketoconazole) has known anti androgen properties and this may have some positive effect on hair growth. The objective of arranging a trial to test Propecia was to examine the effects of the drug, not the effects of Nizoral.
In one small clinical study it was even suggested that the actions of Nizoral on hair growth were equivalent to the effects of 2% minoxidil (4).
Nizoral and Tgel are not made by Merck, the makers of Propecia, so they are not likely to promote the merits of combining Nizoral or Tgel with using Propecia even though there may be advantanges to the consumer in doing so. However, many dermatologists will recommend to their patients the use of Propecia, Nizoral and Tgel. You can use all three in a combined regimen. Nizoral should not be used more than twice a week. Other days you can use Tgel and normal shampoo in rotation. The only problem with Nizoral and Tgel is that they can be quite drying to the hair. You can remedy this with a separate conditioner.
Nizoral, the god of hair loss Shampoo's
Without exception, nizoral is the most successful shampoo on the market today at not only controlling the itch, but any underlying inflammation you may not be able to detect, while simulatneously helping stimulate minor hair growth. No other shampoo we know of can do this. Tgel is another good alternative, but no regimen should be without Nizoral. You can get Nizoral in the shampoo section of any grocery store, typically at the end, next to the Rogaine. We suggest all our users make use of it once every 3 days. Apply it immediately as you get in the shower, and let it soak for the duration of your shower. After a few weeks your itching should be gone, and we suggest continuing with it indefinitely. Its truly the only shampoo out there that can do what it does.
In the natural products isle at the local store you will also find aloe vera or tea tree lotions. These products can work well, but of course they only reduce the inflammation and do not treat the underlying cause of the inflammation. If you stop using them and the underlying promoter of the irritation is still present, then the inflammation will come back. One word of warning, anti-inflammatory products do seem to have the potential to promote folliculitis (let’s call it scalp acne) when they are used for a long time. It is ironic that an anti-inflammatory product should do this, but it does seem to occur in some people. If folliculitis develops just stop using the product and it should go away.
Inflammation and the Effectiveness of your Regimen
At this stage in our understanding of inflammatory cells and their influence on hair growth we don’t know which inflammatory signals are good and which are bad. However, it is reasonable to say that if your scalp is irritated/inflamed AND you see you are losing more hair, then the kind of skin irritation/inflammation you have is certainly not helping to grow hair and may even be exacerbating it. The best thing for you to do is make sure you are using Nizoral shampoo once every 3 days as part of your regimen. Its ability to reduce any noticeable (and unnoticeable) inflammation will only benefit your progress, and the effectiveness of your treatment regimen. Having antiandrogenic properties itself, it may also help stimulate hair growth, and it is literally the only shampoo on the store shelves today that can do this.
All the above applies more or less equally to men and women. The nature of inflammation in female Androgenetic Alopecia has not been investigated in any detail, but it is quite likely that at least some women have a big problem with scalp inflammation and this may be contributing to their hair loss. Skin biopsies from women with Androgenetic Alopecia can show much the same kind of cellular inflammation seen in biopsies from men. Women are also susceptible to dermatitis whether contact dermatitis or seborrheic dermatitis - just like men. If dermatitis seems to be a problem then medicated shampoos like Nizoral nad Tgel are just as valid for use by women as by men.
In Conclusion
Some say Androgenetic Alopecia and inflammation are inextricably linked and part of the same problem. Some say they are two separate conditions but often found together in the same person because they are so common. Some say inflammation is a primary cause of hair loss and others say the inflammation is just a secondary response to something else that is causing the hair loss. This is all very confusing and the scientific evidence to prove who is right and who is wrong is not likely to be produced for a long time. However, if you have hair loss and scalp irritation together it makes sense to look into reducing scalp inflammation. No one can say for sure if it will really help hair growth but it should do no harm. Is it possible that eliminating scalp irritation might stop hair loss completely for a while? – possibly!