When can a person start using Nizoral post-op and be safe?

[Lion]

Hi, I remember reading that nizoral post HT wasn't recommmended, so I would like to know when can a person start using Nizoral again post-op and be safe? Thanks

[Bill - Seemiller]

Lion,

 

In my opinion, it's best to wait a solid month after a hair transplant to start using Nizoral. Even so, it's best only to use Nizoral 2 or 3 times a week since it has a tendency to cause dry hair and skin.

 

All the Best,

 

Bill

[Lion]

Hey Bill, Thanks for answering my question. I'm planning to add nizoral to my hair loss regimen(finasteride)since if I'm not mistaken in a study they found that Nizoral increased hair thickness and decreased hair shedding. I'm going to use it every 3 days. I'm not expecting much from it but if it can thicken my hair up even a little bit or help me maintain what I have, I'll be happy with that. I also have oily skin & hair so it will be a bonus if nizoral can help with that as well.

[Maxxy]

Hey Lion,

 

Spex wrote an interesting post on Nizoral's use (post-op) - Nizoral

 

Also, I've actually just ordered my first bottle of Rivita shampoo; It contains Ketoconazole, the same active ingredient that is found in Nizoral as well as a whole host of other ingredients that are believed to be beneficial to hair loss/growth. It may be something to look in to, here's the manufacturer's site . It has a page which allows you to view all the ingredients and their claims.

 

On the down side it's around twice the price of Nizoral 2% (at least it is here in the UK), however, there are some pretty expensive ingredients in the product such as emu oil.

 

Edit: Actually, in the UK, Nizoral 2% is ??8.99 and Nizorelle 1% is ??5.99 for 100ml where as the Rivita I have just ordered is ??17.46 for 180ml with free postage. So all in all it's pretty much the same price (I believe Rivita contains 1% Ketoconazole though I'm not 100% certain).

[Dr. Glenn Charles]

Not sure of what percentage of Ketoconazole is in Rivita, but I am interested in what other ingredients are in it. I tell my patients to wait 3-4 weeks post-op before using any products that are medicated. At this time there should be no harmful effects that could change the outcome.

[Maxxy]

Hey Dr. Charles,

 

Here's a list taken from their website:

 

* Apple polyphenol

* Copper peptides

* Spin traps

* Ketoconazole

* Rooibos

* Methylsulfonylmethane (MSM)

* Caffeine

* Carnitine tartrate

* Amino acids

* Emu oil

* Biotin

 

P.S. Sorry, the product is spelt "Revita" not "Rivita". Haha.

[Dr. Glenn Charles]

Thanks, there is a lot of ingredients in the Revita that are recommended for healthy hair. Not familiar with the Apple polyphenol or Rooibos. I will have to do a little research on that.

[Bill - Seemiller]

Dr. Charles,

 

FYI, the amount of ketoconazole in Revita shampoo is 1%. I actually had to call them to obtain this information since I couldn't find it listed anywhere. This is comparible to the regular Nizoral.

 

In my experience with Revita shampoo, unlike Nizoral 2% (I never used the regular 1%), you can use it daily and it keeps your hair feeling soft and healthy.

 

Best wishes,

 

Bill

[Lion]

I don't know if it's the other ingredients in the nizoral shampoo besides ketoconazole that might be to harsh on some people hair to cause it to dry, shed,etc but ketoconzole has been shown to thicken, regrow, and maintain some people hair as well. Look at the following small study I got from another hair loss site. I'm sure it been posted but I'll post just to show what it can do as well. Just to be safe, I'll just use it every 3 or 4 days.

 

Japanese study nizoral CREAM ie Ketoconazole ( with pictures )

Ketoconazole (KCZ), an imidazole anti-fungal agent, is known to be effective for the treatment of seborrheic dermatitis and dandruff. In addition, 2% KCZ shampoo was found to improve hair density and the size and proportion of anagen follicles in androgenetic alopecia (AGA) [1] and, in combination with finasteride, to have an additive effect for AGA.

 

Ketoconazole (KCZ), an imidazole anti-fungal agent, is known to be effective for the treatment of seborrheic dermatitis and dandruff. In addition, 2% KCZ shampoo was found to improve hair density and the size and proportion of anagen follicles in androgenetic alopecia (AGA) [1] and, in combination with finasteride, to have an additive effect for AGA [2]. Recently, it has been reported that topical application of KCZ stimulates hair growth in C3H/HeN mice [3]. However, whether topical KCZ is effective enough to improve the clinical appearance of AGA is not yet clear. We therefore carried out an open trial of topical 2% KCZ lotion (Nizoral?®) in combination with shampoos. Furthermore, to identify the mechanism, which can explain the clinical effect of KCZ on AGA, we performed transient transfection assays using CV-1 cells transfected with androgen receptors (AR).

 

The six Japanese males from 23 to 51 years old were enrolled in this study with their written informed consent. They presented with grade II vertex to IVa AGA according to the Hamilton??“Norwood classification [4]. The subjects applied topical 2% KCZ lotion (Nizoral?®) almost every day during or immediately after hair washing with their own unmedicated shampoos. When they revisited our clinic every several months, clinical pictures were obtained to determine the efficacy of the treatment. Two of the men, one 23 years old with grade II vertex and the other 25 years old with Va AGA, showed remarkable hair regrowth after 6 and 10 months, respectively (Fig. 1). The 23-year-old male stopped using KCZ and 3 months later hair loss recurrence on the vertex was noted (Fig. 1c). When he started using KCZ again during shampooing, hairs on the vertex grew again after 3 months (Fig. 1d). These findings constitute evidence of the clinical efficacy of KCZ for AGA. A 41-year-old male showed a slight increase in vertex hair growth after 1 year. Other three of the men, 31, 38 and 51 years old did not show significant improvement. These findings suggest that topical KCZ with shampoo can be effective for some males with AGA.

 

Fig. 1. A 23-year-old Japanese man who used 2% ketoconazole (KCZ) lotion during shampooing everyday. Six months later, hair regrowth was attained (b) in comparison with the pre-treatment condition (a). Suspension of use for 3 months, however, caused recurrent hair loss ©. Renewed use of KCZ induced renewed growth of vertex hair (d). A 25-year-old Japanese man with AGA (e) applied 2% KCZ lotion immediately after shampooing everyday. Ten months later, hair regrowth was apparent (f).

 

To identify the mechanism, which can explain the effect of KCZ on AGA, we performed transient transfection assays using an androgen-responsive synthetic promoter for CV-1 cells transfected with AR. At 50??“70% confluency in a 24-well plate, the CV-1 cells, maintained in Dulbecco's modified Eagle's medium (DMEM) supplemented with 10% fetal bovine serum, were transfected with the transfection reagent Fugene-6 (Roche Diagnostics Corp., Indianapolis, IN, USA) according to the manufacturer's instructions. For luciferase assays, we transfected 0.1??g of the reporter plasmid, pGL2-GRE3-bG-luc [5], 12.5ng of pCI-neo-BamX-AR(Gly23) [5] and 0.2??g of the pRL-CMV vector, the Renilla luciferase control reporter vector driven by the CMV immediate-early enhancer/promoter, as the internal controls. At 24h after transfection, we added fresh DMEM supplemented with 10% charcoal-treated fetal bovine serum with methyltrienolone (R1881, a stable synthetic androgen) or ethanol as a mock vehicle. The cells were also treated with KCZ (Janssen, L.P., Titusville, NJ) or ethanol as a mock vehicle. At 48h after transfection, the cells were harvested for luciferase assays. Luciferase activities were measured with a luminometer using the Dual-Luciferase?„? reporter assay system (Promega, Madison, WI). The results were summarized from three independent sets of transfections and presented as mean?±S.D.; statistical significance was tested with Student's t-test. The results demonstrated that 10 or 20??g/ml KCZ reduced luciferase activity to 67.5% (p<0.01) or 49.9% (p<0.03), respectively, reflecting its suppressive action on AR (Fig. 2). This finding suggests that KCZ improves AGA through the suppression of AR activity.

 

Fig. 2. KCZ effect on R1881-induced AR transcactivity in CV-1 cells transfected with AR. We used the transfection reagent Fugene-6 (Roche Diagnostics Corp., Indianapolis, IN, USA) to transfect 0.1??g of the reporter plasmid, pGL2-GRE3-bG-luc, 12.5ng of pCI-neo-BamX-AR(Gly23) and 0.2??g of pRL-CMV vector (lanes 1??“6) into CV-1 cells cultured at 50??“70% confluency in a 24-well plate. The infected cells were treated with 10??’9M R1881 (lanes 2??“6) or ethanol as a mock vehicle (lane 1). After overnight incubation, KCZ at the indicated concentration was added to the cultures. The activities of the various reporter genes were compared with the luciferase activity in the presence of R1881 and the absence of KCZ (lane 2).

 

Dermal papilla cells are the main targets for androgen in hair follicles, as evidenced by immunohistochemistry [6] and reporter assays [7] for the detection of AR. Deep penetration of KCZ into dermal papilla is therefore necessary to realize the suppressive action on androgen in vivo. The use of KCZ in combination with detergent containing shampoos in this study may enhance KCZ penetration. On the other hand, a recent study demonstrated that KCZ stimulates hair growth in mice [3], suggesting that its effect on hair is androgen independent. To summarize, KCZ may exert its effect on AGA in both an androgen-dependent and -independent manner.

 

References

return to Article Outline

 

[1]. [1]Pierard-Franchimont C, De Doncker P, Cauwenbergh G, Pierard GE. Ketoconazole shampoo: effect of long-term use in androgenic alopecia. Dermatology. 1998;196:474??“477. MEDLINE | CrossRef

 

[2]. [2]Khandpur S, Suman M, Reddy BS. Comparative efficacy of various treatment regimens for androgenetic alopecia in men. J Dermatol. 2002;29:489??“498. MEDLINE

 

[3]. [3]Jiang J, Tsuboi R, Kojima Y, Ogawa H. Topical application of ketoconazole stimulates hair growth in C3H/HeN mice. J Dermatol. 2005;32:243??“247. MEDLINE

 

[4]. [4]Norwood OT. Male pattern baldness: classification and incidence. South Med J. 1975;68:1359??“1365. MEDLINE

 

[5]. [5]Inui S, Nakao T, Itami S. Modulation of androgen receptor transcriptional activity by anti-acne reagents. J Dermatol Sci. 2004;36:97??“101. Abstract | Full Text | Full-Text PDF (135 KB) | MEDLINE | CrossRef

 

[6]. [6]Itami S, Kurata S, Sonoda T, Takayasu S. Interaction between dermal papilla cells and follicular epithelial cells in vitro: effect of androgen. Br J Dermatol. 1995;132:527??“532. MEDLINE

 

[7]. [7]Inui S, Itami S, Pan HJ, Chang C. Lack of androgen transcriptional activity in human keratinocytes. J Dermatol Sci. 2000;23:87??“92. Abstract | Full Text | Full-Text PDF (106 KB) | MEDLINE | CrossRef

[BrianR]

Interesting....is there a way to save threads like this, for future reference?

[hsrp10]

Be careful not to overuse Nizoral or its other variants, as other posts have mentioned on this forum.

I was in a situation where I had to use it for dandruff issue (SD), and it nearly ruined my hair.

Became brittle and just thinned out after a very amazing life-changing HT by one of the top docs.

[mosd]

should be safe to use it on donor? If i had a FUT?

[drew6000]

On 3/7/2013 at 7:32 AM, hsrp10 said:

Be careful not to overuse Nizoral or its other variants, as other posts have mentioned on this forum.

I was in a situation where I had to use it for dandruff issue (SD), and it nearly ruined my hair.

Became brittle and just thinned out after a very amazing life-changing HT by one of the top docs.

I agree not to overuse it.  ( one shouldn't overuse anything )   However,  I have dandruff issue and it helps me better than any other shampoo,  plus I have been using it for years and my hair and scalp seem pretty healthy.