Wednesday, March 11, 2009

2% Nizoral Shampoo Increases Hair Growth in Men with Male Pattern Baldness

2% Nizoral Shampoo Increases Hair Growth in Men with Male Pattern Baldness
Not all shampoos are created equal. (Photo by specialkrb)

I wrote in an earlier post about a study suggesting that topical ketoconazole increases hair growth in mice through an unknown mechanism. As interesting as rodent studies can be, the truth is that nothing beats experiments done on humans. That's especially true of hair growth studies.

Luckily, I found an old paper by Piérard-Franchimont et al. who compared the effects of topical ketoconazole to ordinary shampoos and minoxidil on people suffering from hair loss. Ketoconazole is the active ingredient in Nizoral, which is available as 1% and 2% strength. The latter was the one used in the study. Since the study included two separate experiments, I'm going to concentrate on the first one in this post and discuss the second one later.

Nizoral vs. normal shampoo in people with hair loss

In the first experiment, 39 men between 21 and 33 years with androgenic alopecia (AGA) on the crown of the head. The duration of hair loss ranged from 2 to 6 years. However, none of them reported having had dandruff or seborrheic dermatitis in the last six months, which means that they probably just had good old male pattern baldness.

The study included four groups: AGA + ketoconazole group, AGA + normal shampoo group, control + ketoconazole group, and control + normal shampoo group. Participants in the first two groups were the ones suffering from hair loss, while everyone in the two control groups had full heads of hair. The ketoconazole groups washed their hair with Nizoral shampoo 2-4 times per week for 21 months.

The authors had their own somewhat novel method of measuring the results. First, the proportion of vertex hairs in anagen (growth) phase was measured. Then the average diameter of hairs 1.5 cm from the bulb was measured. Finally, to give an overall score, the anagen percentage was multiplied by the average diameter. This score, titled Pilary Index (PI) by the authors, was measured every three months.

Results

The graph below shows the PI of the two AGA groups. The black squares represent the participants with hair loss using Nizoral, and the white squares represent participants with hair loss using normal shampoo. The N and the arrow next to it refers to the PI values of the participants with no hair loss.


Ketoconazole (Nizoral) and hair growth
The PI score of the AGA + normal shampoo group declined steadily throughout the study. In other words, they kept losing their hair. On the other hand, the AGA + ketoconazole group increased their PI score, meaning that their anagen percentage and/or hair thickness improved. The effect was evident after 6 months and seemed to plateau after 15 months. Ketoconazole also seemed to decrease sebum levels in the AGA group, with a median reduction of 18% at the end of the study.

Compared to the AGA + normal shampoo group, the AGA + ketoconazole did considerably better. Even though the most drastic improvement was seen between months 6-15, the trendline was still up at the end of the study. And in fact, since a slight decrease was also seen between months 3-6, after which things picked up again, it may well be that Nizoral would have increased hair growth even further after the 21st month.

As good as the results were, the PI scores of the AGA + ketoconazole group were still far behind those of the control group. Unfortunately, the paper doesn't say whether ketoconazole affected hair growth in participants without hair loss.

Conclusion

In men with hair loss, using 2% Nizoral shampoo 2-4 per week significantly improved measures of vertex hairs in anagen phase and hair diameter during the course of a 21-month study. At 15 months, the increase in the hair growth score was close to 50%. A slight decrease in hair growth scores was seen in those using normal shampoo.

For more information on hair growth, see these posts:

Topical Ketoconazole (Nizoral) Increases Hair Growth in Mice
Emu Oil and Hair Growth: A Critical Look at the Evidence
Lygodium japonicum Promotes Hair Growth by Inhibiting Testosterone to DHT Conversion
Hyaluronic Acid for Skin & Hair – Experiment Begins



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46 kommenttia:

Howard December 8, 2009 at 6:32 PM  

I don't have baldness per se, but my hair is getting thin. I've been using 2% Nizoral for years, perhaps several months at a time, 3 days a week, and not only did I NOT get hair growth, but it DID NOT solve my dandruff problem, either.

Anonymous January 2, 2010 at 3:11 AM  

According to the Environmental Working Group Cosmetic Database, this shampoo is rated a 6 / 10 in terms of toxicity (10 being the worst).

So my question is, is this article some sort of paid advertising?

Natural haircare January 11, 2010 at 8:27 AM  

In most people with alopecia areata, hair usually grows back within a year without any treatment. herbal natural remedies that have been explored for alopecia areata are the best way to treat baldness

Anonymous January 17, 2010 at 1:27 PM  

I THINK these might have been the studies funded by McNeil (the people who make Nizoral). I'm not knocking the researchers; they may have been influenced (even subconciously) into having some skewedness.
I'm just sayin'...

Jyn January 17, 2010 at 1:40 PM  

Hey 2nd Anon...that's a sweet site!

I gotta wonder about the scoring method tho...they seem to look at the ingredients, grab some studies, and say they're right bad (or not bad). I mean, ethanol as a 5, citric acid as a 4? Seems kinda excessive (I could be misunderstanding it tho).

My haircare treatment January 19, 2010 at 2:20 PM  

Chinese herbalists as well as Indian herbalists from centuries ago found some of the most effective natural herbs like Lemongrass, Heena and Acacia concinna and these herbs preferred from herb specialists all over the world as a good and effective baldness cure.

Anonymous February 14, 2010 at 11:52 PM  

New studies show that the DHT theory of both male baldness and BHP is wrong and that the real cause is imbalance between the levels of estrogens and DHT, which also is the most potent/active form of testosterone, and therefore very useful for men in many ways

JLL February 15, 2010 at 9:34 AM  

@Anonymous,

What studies are those?

Anonymous March 5, 2010 at 6:58 PM  

Hey all, Just thought I'd leave my experience on this issue. I've been using a combo approach that has been working really well for the past 5 months. I started using Nizoral AD 2% (every other day), Rogaine foam (twice a day), and ,on other days, I make sure to use a sulfate-free shampoo and conditioner. The thinning spot on top is greatly improved. I believe that even the thinning at the hairline has ceased. I realize that there's no way to find out which of these three has had the greatest effect but they're all relatively cheap and easy to work into my routine. That's really the biggest thing. Just find a way to work these into you regular week and hopefully, you'll see some results. I tried that HairMax Laser and it was way too time consuming. Good Luck guys and keep fighting the good fight. Also, like most of your women, my wife has promised to stick with me through "thick or thin."

Anonymous June 28, 2010 at 9:41 AM  

This class of drug is an endocrine disruptor. And there is no reason that a topical application wouldn't have some systemic effects. Better to lose the hair and still be potent rather than to have hair and not.

I'll offer the following as proof of my concern:

PMID: 18067565

Int J Androl. 2008 Apr;31(2):170-7.
Epub 2007 Dec 6.

Endocrine-disrupting properties
in vivo of widely used azole fungicides.
========================================

PMID: 15516735

Biol Pharm Bull. 2004 Nov;27(11):1844-9.

Studies on the interactions between drugs and estrogen. III. Inhibitory effects of 29 drugs reported to induce gynecomastia on the glucuronidation of estradiol.

The full article is available without charge by way of a link at the
pubmed.gov site.

Trig

Anonymous September 1, 2010 at 6:18 PM  

Your study was for: "50, 100 and 150 mg/kg body weight/day".

For an adult of 65 kg like me, that translates to 3.25 g/day (at the lowest bound of 50 mg/kg).

OK ? Now in a bottle of 100 ml of nizoral 2% there are 2 g of keta, and I use it in 45 days, so i'm receiving 0.044 g per day, i.e. 100x less than in the study...

Anonymous September 21, 2010 at 5:05 PM  

Also check out

http://rosacea-support.org/sebazole-topical-ketoconazole-gel-2.html

Jourdan October 2, 2010 at 6:26 PM  

Would applying and subsequently washing off 2% Nizoral cream have the same effectiveness as using 2% Nizoral shamploo?

Anonymous November 9, 2010 at 5:22 AM  

I'd read for years that ketoconozole controls sun fungus. The sun fungus supposedly kills hair follicles with long term exposure.

I can't say for sure this is true. The whole topic of hair loss is so loaded with adverts for this or that miracle cure.

Francis March 11, 2011 at 1:15 PM  

Nizoral has Ketoconazole but it also has harmful sulfates.
Regenepure hair loss shampoo has ketoconazole but a bunch of other fantastic ingredients. Go to www.Regenepure.com. They list all ingredients plus benefits.

PAWAN June 2, 2011 at 5:16 AM  

Hi, Hi, Three weeks back i started using Nizoral 2% Shampoee. I used it four times in two weeks and i lost 50% of my hair on Vertex/Crown also on the Front just in three weeks. I got lot of rashes and bumps on my head..It was severyly irritating on my head..Also i had rapid heart bead. Dizzines and breathing problems. I realized that all this is because of Nizoral usage lately and i stopped using it. I am worried if i am i will be able to regrow my hair back or not. This is realy bothering me. By the way my age is 25 Years.

JLL June 2, 2011 at 1:54 PM  

@PAWAN,

If the cause really was ketoconazole then yes it should grow back with the next hair cycle. Ketoconazole can be irritating on the scalp -- some people tolerate the 1% version better than the 2% version. The rashes and bumps are not a good sign; however, shedding hairs *is* normal with any hair growth remedy. You could also try zinc pyrithione or piroctone olamine (search the blog for a post on that) if you find ketoconazole too drying.

- JLL

Matt July 22, 2011 at 1:27 AM  

@Pawan

That's because you are supposed to wash your hair with it, not drink it..



.. .. that was a joke!! >=_=<

henna October 13, 2011 at 3:23 PM  

nice posting.Hair Loss Shampoo

Anonymous November 9, 2011 at 3:00 PM  

Also stuff (natural stuff) that can help prevent hair falling out in the first place and promote growth

http://www.livestrong.com/article/250822-essential-oils-that-prevent-hair-fallout/

I also found (for some reason) Flax Seed / Linseed Oil (in concentrated form) is extremely bad and made my hair shed BADLY, if using these stop immediately and I bet you notice less shedding (use it in whole foods as originally intended only)and will even do the opposite and promote hair growth.

I use Nizoral (some people are to sensitive for this) and Flaxseed Lignans, started seeing results after about 6 - 8 weeks (taking 1 morning and 1 night, some people need up to 3 a day though) hair thicker / more of it on my head. Please note I only had a receding hairline not balding from the rear. Which would otherwise prompt me to use something like Minoxidil / Rogaine.

Hair Growth December 4, 2011 at 6:00 AM  

Very informative post! Thanks!

Anonymous April 30, 2012 at 4:40 AM  

I have been using % 2 ketoconazole for 9 months straight(since the beginning of the nizoral shortage in the US). I have seen significant improvement - around % 15-20. I use it every day.

Melissa Locks July 6, 2012 at 4:47 AM  

My wife uses the Shielo Volume Shampoo to give her volume, and when I started using it and it has really thickened my hair and made it stronger. It has biotin in it which makes each follicle stronger so the hairs have really stopped falling out. It works much nicer than regular shampoo and doubles as a great face wash.

Anonymous August 8, 2012 at 2:30 PM  

I was experiencing a receding hairline and decided to search online for non prescription remedies. I came across a few blogs stating that nizoral shampoo with 2% Ketoconazole should help. I used the product for 4 weeks and saw no results. After which I spoke with my doctor because I had alopecia areata occurring to the back of my head. My doctor suggested I use
Dermatrophin PMG (made by standard process you can’t buy online from their website, but you can get it online. I suggest you get from a local doctor if possible to avoid counterfeit products). I used this whole vitamin along with a shampoo and conditioner made by Eden Body Works, peppermint tea tree shampoo and peppermint tea tree conditioner.

The peppermint shampoo and conditioner gives a nice warm tingling sensation when used, you might want to look at using their jojoba mononi hair oil which is used to stimulate hair growth (can’t hurt to try). Now this site caters to African American hair but I don’t see why it won’t work for all races being their products are made with natural oils and ingredients.

I am happy to say this combination worked, I can feel and see the portion of my receding hairline returning. Now I don’t have any studies to back up my claims all I have are my personal results. Give it a try and spread the word if it works for you.

amrk 7 September 14, 2012 at 2:12 AM  

You need a shampoo with biotin and Saw Palmetto!!. I am sure these ingredients help!

I have been using the perfect hair shampoo for more than 4 months now and I am on my 3rd one. Its the Shielo VOLUME Shampoo - its thick and lather really well on my hair.

It also has a very nice fresh mint smell. I have a thinning hair condition, so called male pattern hair loss. I did see an improvement over all.

Alfred September 29, 2012 at 4:57 PM  

Regenepure DR is the best hair loss shampoo with Ketoconazole and all other beneficial ingredients. Check
Out http://www.regenepure.com

simon December 13, 2012 at 7:53 PM  

yeah, but nizoral is kinda hard to get now, it is better to get regenepure which people could get it on www.regenepure.com

nizoral stop doing the 2%.

better to get regenepure as the hair loss treatment.

Salon December 31, 2012 at 11:28 AM  

Yes it really does! I am using it since last 5 years and now I hardly have any dandruff and my hair is voluminous!

Anonymous January 27, 2013 at 1:49 PM  

Pretty much all of the comments here are "hey, it works for me, it's going to work for you". OR "hey, it does not work for you, so I can guarantee it is not going to work for you either". Dumb. And on top of that sheer ignorance: "hey, it's been proven that herbal natural remedies are the best way to treat alopecia areata". False, the only proven treatments are corticosteroids and immunodepressant drugs. Dumber.

Trent March 26, 2013 at 12:51 PM  

Regenepure DR is a major upgrade to Nizoral and is sulfate free. Look online at the reviews. Plus they have some many other ingredients geared for hair growth. I also use Regenepures Monoxidil Spray.

aleena Mclean June 4, 2013 at 8:46 AM  

Great Blog!! That was amazing. Your thought processing is wonderful. The way you tell the thing is awesome. You are really a master. Thanks for sharing such a beautiful information about Nizoral Shampoo.

porno izle July 7, 2013 at 1:51 PM  

According to the Environmental Working Group Cosmetic Database, this shampoo is rated a 6 / 10 in terms of toxicity (10 being the worst).

Ryan July 12, 2013 at 6:44 AM  

Not Regenepure. I looked up all of their ingredients. All safe. Actually all good for the hair. You must be referring to Nizoral. Plus Nizoral had sulfates. Regenepure doesn't

Anonymous July 16, 2013 at 7:30 AM  

I use to have a bald spot on the back of my head. Exact same spot my dad has his at. I figured it was genetic and let it go. Then I ran out of my normal shampoo(head and shoulderS) so I used a bottle of nizoral(1%) i had sitting around for a year or 2.

By the time that bottle was gone my bald spot was nearly completely gone.

I stopped using nizoral because it was hard to get. About 6~ months later my bald spot came back.

I went to my doctor got them to prescribe me 2% since I couldn't get it in stores.

Cleared up the bald spot in about a month.

Now I just use it every 3~ days and haven't had any problems since.

It's definitely worth a try if you're having hair loss issues.

Anonymous July 16, 2013 at 7:32 AM  

I use to have a bald spot on the back of my head. Exact same spot my dad has his at. I figured it was genetic and let it go. Then I ran out of my normal shampoo(head and shoulderS) so I used a bottle of nizoral(1%) i had sitting around for a year or 2.

By the time that bottle was gone my bald spot was nearly completely gone.

I stopped using nizoral because it was hard to get. About 6~ months later my bald spot came back.

I went to my doctor got them to prescribe me 2% since I couldn't get it in stores.

Cleared up the bald spot in about a month.

Now I just use it every 3~ days and haven't had any problems since.

It's definitely worth a try if you're having hair loss issues.

Anonymous September 20, 2013 at 5:45 PM  

I got 2% nizoral shampoo from the doctor after a fungal infection left me with two large bald patches on my already thin and fine crown hair.

After using it 3 time a week for about six weeks it was noticeable that my hair was thickening on my crown and the bald patches were growing again after many months.

Now after three months I have just a slight thinning on my crown which I am confident will thicken up over the next few months.

I put about 1 gram of shampoo directly on my scalp and leave it for half an hour before washing with water.

lily December 20, 2013 at 8:28 AM  

We very much hope that your research can bring people to change! Many times people need to use other methods to change the status, such as using hair replacement system.

hair system January 3, 2014 at 9:17 AM  

2% Nizoral Shampoo make people's hair growth....

Haar February 18, 2014 at 4:21 PM  

Im using 2% Nizoral Shampoo 2 Times a week.
+ 2% ketoconazole cream 5 times a week.

Doing this since 1,5 Month.
I did not see any impovement yet. But I will stick to it for at least 2 more month.

Anonymous March 17, 2014 at 10:57 AM  

I used to have hair patch loss problem every time I used regular shampoo...I used 2% Nizoral Shampoo for about 6 months and it went away and have not had any patch hair loss any more and I did notice that my hair does get thicker ( perhaps some ingredient in it interact with ketoconazole....but the patch spot does grow white hair out ever since...now I am using 1% over the counter nizoral shampoo and it resolves my itchy scalp problems and it works.

hair systems September 27, 2014 at 7:00 AM  

I realized that all this is because of Nizoral usage lately and i stopped using it. I am worried if i am i will be able to regrow my hair back or not.

DILIP SINGH October 1, 2014 at 11:54 AM  

For me Dualgen-15 helped me in Re-Growth of my Hair. I tried it from dualgen15express.com. You should also try this.

Alex Lewis February 3, 2015 at 9:29 AM  

Try Anti fungal shampoo it worked well for me

Mak K February 9, 2015 at 6:57 PM  

Thanks for this nice and helpful article i read and i really like your shit article thanks for share and keep it up..i like to share one more nice about Regrowing your Loss Hairs..

http://trendsfuel.blogspot.com/2015/02/how-to-stop-hair-loss-and-regrow-hair.html

Dexter Benson April 3, 2015 at 5:34 AM  

Hair loss runs in my family. I'm 26 years old and I started to lose my hair right after high school. My hairline started to recede and was becoming thin around the temple area. I've been using the Shielo Volume Shampoo now for 4-5 months now and I love it!
Once I started using this shampoo with the conditioner as well, I've noticed a HUGE difference! My hair stopped falling out. My hair grows faster and its thicker....Don't expect this to grow hair where you lost it. It's not going to happen. But to stop and prevent hair from falling out, this is the stuff for you

Mimz Lipz March 17, 2016 at 3:05 AM  

My hair was falling out like crazy! Biotin does help - I am taking biotin 1000 for over a year now, but i still had hair falling out. I did a full physical at my doctor and dermatologist. He recommended I change my shampoo & conditioner because i was using stuff from the store that was full of chemicals. I now use the Somaluxe Paradise Shampoo which is all natural and I have noticed my hair stopped falling out. Chemicals are so dangerous, and I wish I knew this before! Use the Somaluxe Shampoo - Take Biotin, and that should work. Im hoping it will not grow the rest of my hair back that I lost to harmful shampoos!

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