Shampoos & Scalp Conditioin Vs Propecia

[Oliver510]

This website claims in its men's hair loss guide and review of propecia that a shampoo with ketoconazole like Nizoral must be used with any hair loss treatment and no other treatment will work without it. I know the study where ketoconazole 2% increased hair shaft diameter, but their is nothing I can find to back the claim that it is necessary for any treatment.

For one, the propecia FDA trials used a tar-based shampoo and two, not for the purpose of ensuring efficacy of propecia. The clinical studies information for the drug listed on rxlist states:

"In order to prevent seborrheic dermatitis which might confound the assessment of hair growth in these studies, all men, whether treated with finasteride or placebo, were instructed to use a specified, medicated, tar-based shampoo (Neutrogena T/Gel® Shampoo) during the first 2 years of the studies."

Meaning in order to precisely measure hair count, shaft diameter, etc, they prevented a separate condition which may only prevent those assessments from being taken as well as they need to be in a scientific study. This does not mean seborrheic dermatitis will effect hair growth or the efficacy of propecia. As of course, there are men with this condition or other scalp conditons who don't bald, and men who do bald without scalp conditions. And they didn't even use ketoconazole in the study so I don't know why it's stated on this site that they did, let alone why it's necessary. Wouldn't Merck, medical literature, and doctors state if it's necessary to use a shampoo and/or treat scalp conditions completely if it was in fact necessary or even beneficial while using propecia?

I'm all for keeping a healthy scalp and attacking from all angles, but I can't see the necessity and how not using certain shampoos and preventing common scalp conditions would prevent the efficacy of a treatment like propecia. Is there anyone here with dandruff or more who has had results from Propecia?

 

[Johnmpb]

I think you may be looking into this too much. Or your interpretation is off.

You probably won't find many studies linking male pattern baldness with scalp conditions. But you will found countless accounts (mine included) where scalp issues such as seborrheic dermatitis and dandruff develop when male pattern baldness is ravaging ones scalp.

One theory is the same hormones that affect male pattern baldness will affect sebaceous glands which create excess oil/sebum and can create the perfect environment for scalp microflora to thrive and issues to develop (which ends up in massive inflammation). Another possibility is that the hormones that cause male pattern baldness also induce a hormonal response within your body that causes your immune system to attack hair follicles which results in inflammation.

There is a study on this site (at least there used to be) where Kevin Mcelwee was interviewed and they talked about how in scalps with male pattern baldness there is microinflammation present in the scalp (in many cases you will not even feel it but it is still present) and this negatively affects the hair follicles.

Also look at it this way...so many of the couple thousand men in the Propecia studies had scalp issues that the scientists at Merck REQUIRED all wings of the study to use T/gel shampoo- shouldn't that tell you something? I believe at that time nizoral was not OTC so they used T/gel coal tar.

The author of the article you read on this site is the admin and I think in part he was talking from his own experience too. I read his story a long time ago and he claimed he went on Propecia but never saw a cessation of his loss for months until he controlled the scalp inflammation through nizoral use.

Nizoral is proven in studies to help hair and you have to shampoo anyway? The logical choice is to go ahead and use it a few times a week. Personally I use keto 2% and generic t/gel because my scalp condition is so severe.

Hope this helps

 

[Oliver510]

I think you may be looking into this too much. Or your interpretation is off.

You probably won't find many studies linking male pattern baldness with scalp conditions. But you will found countless accounts (mine included) where scalp issues such as seborrheic dermatitis and dandruff develop when male pattern baldness is ravaging ones scalp.

One theory is the same hormones that affect male pattern baldness will affect sebaceous glands which create excess oil/sebum and can create the perfect environment for scalp microflora to thrive and issues to develop (which ends up in massive inflammation). Another possibility is that the hormones that cause male pattern baldness also induce a hormonal response within your body that causes your immune system to attack hair follicles which results in inflammation.

There is a study on this site (at least there used to be) where Kevin Mcelwee was interviewed and they talked about how in scalps with male pattern baldness there is microinflammation present in the scalp (in many cases you will not even feel it but it is still present) and this negatively affects the hair follicles.

Also look at it this way...so many of the couple thousand men in the Propecia studies had scalp issues that the scientists at Merck REQUIRED all wings of the study to use T/gel shampoo- shouldn't that tell you something? I believe at that time nizoral was not OTC so they used T/gel coal tar.

The author of the article you read on this site is the admin and I think in part he was talking from his own experience too. I read his story a long time ago and he claimed he went on Propecia but never saw a cessation of his loss for months until he controlled the scalp inflammation through nizoral use.

Nizoral is proven in studies to help hair and you have to shampoo anyway? The logical choice is to go ahead and use it a few times a week. Personally I use keto 2% and generic t/gel because my scalp condition is so severe.

Hope this helps

I hear ya. I'm just a little paranoid to be honest since I have a scaly, flaky scalp and I've been using Nizoral and plan to continue using it but I think Neutrogena's T/GEL shampoo with coal-tar would be best because coal-tar breaks down and loosens dead skin/flakes, and also prevents the excessive shedding of skin. T/SAL's salicylic acid also breaks down flakes. I'm not sure if I have full blown seborrheic dermatitis, and nothing more than just plain old dandruff. Any thoughts or advice?

 

[Johnmpb]

I actually use all the shampoos you listed. Each day I first lather up with with salicylic acid (3%) shampoo. Then the next round of lathering I use either generic coal tar shampoo from walmart or generic 2% nizoral I have a script for.

My dandruff/seb derm/possibly psoriasis gets pretty bad though and I have a fairly greasy scalp so this may not be the best regimen for you. You could possibly just try rotating between the three and see how that does. Conditioner might be required to keep your hair in good condition as these shampoos generally dry hair out.

Sometimes I'll also use a tea tree shampoo called Giovanni tea tree triple treat. I just picked some more up from walmart. It has tea tree oil, aloe, and a bunch of other topical oils that can potentially act as anti inflammatory. That might be worth a shot.

Good luck I know how frustrating scalp issues can be

 

[Oliver510]

I actually use all the shampoos you listed. Each day I first lather up with with salicylic acid (3%) shampoo. Then the next round of lathering I use either generic coal tar shampoo from walmart or generic 2% nizoral I have a script for.

My dandruff/seb derm/possibly psoriasis gets pretty bad though and I have a fairly greasy scalp so this may not be the best regimen for you. You could possibly just try rotating between the three and see how that does. Conditioner might be required to keep your hair in good condition as these shampoos generally dry hair out.

Sometimes I'll also use a tea tree shampoo called Giovanni tea tree triple treat. I just picked some more up from walmart. It has tea tree oil, aloe, and a bunch of other topical oils that can potentially act as anti inflammatory. That might be worth a shot.

Good luck I know how frustrating scalp issues can be

Yea I was thinking about something like Monday TSAL, Thursday TGEL, Sunday Nizoral, Wednesday TSAL, and so on. Sounds like your using daily. I don't wanna dry my scalp out since that's not good either and forces your glands to produce more oil to counteract. How did hair loss improve after doing what you said, did it help your propecia if your using it?