Ketoconazole and hair loss

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Ketoconazole is an antifungal agent that is available by prescription and is typically applied topically to treat fungal infections. However, it also possesses anti-androgenic effects that reduce the secretion of various androgens-including testosterone-via the adrenal glands and female and male reproductive organs. As a result, ketoconazole has been used to reduce hair loss in men and women. For instance, Nizoral shampoo contains a 2% concentration of Ketoconazole in every bottle, and has been commonly prescribed to not only treat numerous scalp conditions but has also been prescribed to help treat androgenetic alopecia (AGA). Interestingly, a 1% ketoconazole variant is also available over-the-counter, and while its effectiveness in reducing hair loss may not be as effective as its 2% counterpart, neither version has been shown to cause any significant side effects.

Furthermore, numerous studies have been conducted to study the effects of Nizoral shampoo on hair loss in men vis-a-vis conventional shampoos. For instance, Pierard-Franchimont et al conducted a study involving 39 men between the ages of 21 and 33, who suffered from AGA. All of the men in the experiment had suffered from AGA for 2 to 6 years, albeit none of the men had problems involving seborrheic dermatitis or dandruff in the six months leading to the study, indicating that the men’s hair loss was solely caused by male pattern baldness.

The study was broken down into 4 different groups; namely a normal shampoo & control group, a ketoconazole and AGA group, a ketoconazole and control group, and a normal shampoo and AGA group. Essentially, the control groups consisted of subjects who had a full volume of hair, while the other groups of respondents suffered from hair loss to varying degrees. In addition, the ketoconazole groups were asked to lather and rinse with Nizoral shampoo 2 to 4 times per week for a duration of 21 months.

After the results were analyzed the researchers found that men who suffered from AGA and used regular shampoo continued to steadily lose their hair over the course of the 21 month experiment. Those suffering from AGA who used ketoconazole, however, noticed increases in both their hair thickness, as well as anagen/growth percentage.

Interestingly, the noticeable improvement in hair growth was demonstrated after only 6 months, with peak growth being achieved at the 15 month mark. As an added benefit, the ketoconazole in the shampoo also reduced sebum levels in the AGA group by 18%. Increased sebum has been linked to oily skin and acne formation. In sum, ketoconazole has been clinically proven to reduce hair loss and promote hair growth in men who suffer from male pattern baldness/androgenetic alopecia.


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