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Q: selsun blue moisturizing treatment ( Answered 5 out of 5 stars,   1 Comment )
Subject: selsun blue moisturizing treatment
Category: Health > Beauty
Asked by: anonymous777-ga
List Price: $80.00
Posted: 16 Jan 2003 14:53 PST
Expires: 15 Feb 2003 14:53 PST
Question ID: 144417
i want you to look up the ingreadents of this shampoo and find out if
its chemicals can cause hair loss. i use rogaine and my scalpe gets a
flake build up, so i need a anti dandruff shampoo thats not going to
cause my scalpe to get real dry or cause hair to fall out. find out if
this shampoo causes hair loss, remember i use the selsun blue
moisturizing treatment. can you do the same with the neutrogena anti
residue formula shampoo??? does rogaine and either of theses shampoos
ingreadents interact????
Subject: Re: selsun blue moisturizing treatment
Answered By: kevinmd-ga on 16 Jan 2003 16:56 PST
Rated:5 out of 5 stars
Thanks for asking your question.  You asked the following:
1) Look up the ingredients of this shampoo (Selsun blue).
2) Find out if this shampoo causes hair loss.
3) Repeat questions 1 and 2 with neutragena residue formula shampoo.
4) Does Rogaine and the ingredients from these 2 shampoos interact.

1) Look up the ingredients of this shampoo (Selsun blue).

The ingredients list is from
“Active Ingredients: Contains: Selenium Sulfide Lotion (1%)
Inactive Ingredients: Ammonium Lauryl Sulfate, Ammonium Laureth
Sulfate, Citric Acid, Cocamide DEA, Ditallow Phthalic Acid Amide,
Dimethicone, DMDM Hydantoin, Hydroxypropyl Methylcellulose, Purified
Water, Sodium Citrate, Fragrance”

2) Find out if this shampoo causes hair loss.

It has been documented that selenium sulfide (the active ingredient in
selsun blue) causes hair loss.  Here are the details.

“In decreasing order of severity: skin irritation; occasional reports
of increase in normal hair loss; discoloration of hair (can be avoided
or minimized by thorough rinsing of hair after treatment). As with
other shampoos, oiliness or dryness of hair and scalp may occur. “

“SIDE EFFECTS, that may go away during treatment, include increase in
mild hair loss or thinning, hair discoloration, or oiliness or dryness
of hair and scalp. If they continue or are bothersome, check with your
skin irritation or rash. If you notice other effects not listed above,
contact your doctor, nurse, or pharmacist.”

From the Physician’s Desk Reference:
“In decreasing order of severity: skin irritation; occasional reports
of increase in normal hair loss; discoloration of hair (can be avoided
or minimized by thorough rinsing of hair after treatment). As with
other shampoos, oiliness or dryness of hair and scalp may occur.”

“This medication may cause skin irritation, dry skin, or hair loss.”

I also did a Medline search.

Srivastava (1995) connected selenium with alopecia (i.e. hair loss):
“The manufacture and maintenance of drums used in photocopy machines
involves use of a selenium alloy. A worker employed in this type of
job for 6 mo presented with alopecia aereta which later deteriorated
to alopecia universalis. As selenium intoxication is known to present
with a similar clinical picture, selenium levels in blood and nails of
this subject were estimated and compared with those found in other
workers. We report a case of alopecia universalis due to occupational
selenium intoxication.” (1)

Vinceti (2001) also connects chronic exposure to selenium to hair
“Epidemiologic studies and case reports have shown that chronic
exposure to selenium compounds is associated with several adverse
health effects in humans. An early toxic effect of selenium is on
endocrine function, particularly on the synthesis of thyroid hormones
following dietary exposure of around 300 micrograms Se/d, and on the
metabolism of growth hormone and insulin-like growth factor-1. Other
adverse effects of selenium exposure can be the impairment of natural
killer cells activity and at higher levels, hepatotoxicity and
gastrointestinal disturbances. Dermatologic effects, such as nail and
hair loss and dermatitis, occur after exposure to high levels of
environmental selenium. Assessing the toxicity and morbidity after
long-term exposure to environmental selenium is difficult:
neurotoxicity, particularly the degeneration of motor neurons leading
to increased risk of amyotrophic lateral sclerosis, might occur after
chronic exposure to both organic and inorganic selenium compounds. The
results of laboratory investigations and cohort studies suggest that
selenium species exhibit a bivalent effect in cancer, either
increasing or decreasing risk. Current environmental selenium exposure
limits appear to be inadequate for averting adverse health effects.”

Wirth (1980) performed an experiment where a selenium solution was
associated with diffuse hair loss:
“A standard surfactant solution was applied to one side of the back in
29 male guinea pigs and the same surfactant solution with an addition
of 2.5% selenium disulfide to the other side. The application was
carried out a total of six times at three-day intervals. The detergent
was not washed away to provide an intense exposure to the active
substance. Investigations of the hair root status before and after
treatment showed significant increase in telogen hair. The present
results of animal experiments cannot be transferred without
reservations to conventional application in man. However, they may
explain isolated observations of diffuse hair loss after treatment
with selenium disulfide if one presupposes an especially intense
penetration of active substance in these cases.” (3)

3) Ingredients of Neutrogena Anti-residue formula shampoo, does this
cause hair loss?

“Purified Water, Ammonium Lauryl Sulfate, Cocomide DEA, Cocamidopropyl
Betaine, Glycerin, Imidazolidinyl Urea, Methylparaben, Propylparaben,
Citric Acid, Fragrance”

Unlike Selsun Blue, there are no active ingredients in the Neutrogena
shampoo. I was unable to find a connection between hair loss and the
Neutrogena shampoo.  This was confirmed via multiple search engines as
well as a Medline search (i.e. searching each of the inactive
ingredients cited above with the terms “hair loss or alopecia”).

4) Does Rogaine interact with these 2 shampoos?

It is highly unlikely that the Neutrogena shampoo interacts with
Rogaine since it has no active ingredients.  Selsun blue is the one
that has the active ingredient (selenium sulfide).

Rogaine is also known as minoxidil.  Drug information from the Drug
Information Handbook is as follows:
“Minoxidil: Drug information
U.S. BRAND NAMES — LonitenŽ; RogaineŽ Extra Strength for Men [OTC]; 
PHARMACOLOGIC CATEGORY Topical Skin Product Vasodilator 
USE — Management of severe hypertension (usually in combination with a
diuretic and beta-blocker); treatment (topical formulation) of
alopecia androgenetica in males and females” (4)

To determine drug interaction, I will use two tools:

A) Epocrates Multicheck:
"MultiCheck allows you to quickly check for multiple drug interactions
simultaneously. This feature is integrated with our proprietary drug
interactions database to provide you with concise and
clinically-relevant drug interactions." 

Running “selenium sulfide topical” and “minoxidil” yielded the
following result:
“No significant interactions found or known.”

B) PDRŽ Electronic Library™ Drug Interactions 
"This useful tool checks for drug-to-drug interactions cited in the
PDR database. Simply enter the names of two or more drugs (either by
brand or generic name). In minutes, MerckMedicus displays the critical
interaction information that you and your patients need to know."

Running “minoxidil” and “selenium sulfide” yielded the following
“The labeling of this product lists no interactions with the other
products or foods entered.”

To be safe, I ran each inactive ingredients in the Neutrogena shampoo
with minoxidil and yielded no drug interactions.

Please use any answer clarification before rating this answer. I will
be happy to explain or expand on any issue you may have.   
Kevin, M.D.          
Internet search strategy:     
Using FAST, Google, Inktomi and Teoma via  
Ingredients of selsun blue
Selsun hair loss
Selsun alopecia
Selenium sulfide hair loss
Selenium sulfide alopecia
Ingredients of neutrogena residue formula shampoo
neutrogena residue formula shampoo hair loss

Medline search:
selenium sulfide OR selsun AND hair loss OR alopecia

1) Srivastava AK. Gupta BN. Bihari V. Gaur JS. Generalized hair loss
and selenium exposure. Veterinary & Human Toxicology. 37(5):468-9,
1995 Oct.
2) Vinceti M. Wei ET. Malagoli C. Bergomi M. Vivoli G. Adverse health
effects of selenium in humans. [Review] [159 refs] Reviews on
Environmental Health. 16(4):233-51, 2001 Jul-Sep.
3) Wirth H. Dunsing W. Gloor M. [Telogen effluvium following
application of selenium disulfide in the guinea pig]. [German]
Hautarzt. 31(9):502-4, 1980 Sep.
4) Lacy, C.  Minoxidil – Drug Information.  Drug Information Handbook.
 Lexi-Comp., 2002.

Request for Answer Clarification by anonymous777-ga on 16 Jan 2003 18:33 PST
thank you! i will pay anthor 100.00 because i need a couple more
important questions answered.  I need to know what, if any,
anti-dandruff shampoo I can use that WILL NOT cause any additional
hair loss.  The reason why I liked Selsun Blue is because it had a
moisuturizeing formula for chemically treated hair, and it was mild,
while still performing the anti-dandruff job.  So I need a shampoo
that will moisturize my scalp and perform the anti-dandruff job that I
need from using Rogaine, while not causing any more hair loss.  This
question is very important to me,, and I will pay another $100.00 for
a sufficient and detailed answer, as well as a suggesstion for which
shampoos I can use to get rid of the flaky buildup and drying that the
Rogaine causes  (I NEED to continue using the rogaine).

Clarification of Answer by kevinmd-ga on 16 Jan 2003 20:28 PST
Thank you for the opportunity to answer your further questions. 
However, after much searching, I am unable to find a shampoo that is
guaranteed NOT to cause hair loss.  I suggest that you use the extra
$100 you offered me and ask that specific question to the open forum.

Another Researcher has brought to my attention an oversight.  It
appears that one of the ingredients in the Neutrogena shampoo
(Ammonium Lauryl Sulfate) can indeed cause hair loss:

"Sodium laureth sulphate (SLES), soium lauryl sulphate (SLS) and
ammonium lauryl sulfate (ALS)
Effects skin, eyes, hair, liver, brain, heart and immune system,
dandruff causing, hair loss, carcinogen." 

"The Sulfate Group. Sodium Lauryl Sulfate, Ammonium Lauryl Sulfate,
DEA (DEA Lauryl Sulfate), Sodium Laureth Sulfate, Ammonium Laureth
Sulfate, Alpha Olefin Sulfonate. These synthetic substances are used
in shampoos for their detergent and foaming abilities. They can cause
eye irritations, skin rashes, hair loss, a scalp condition similar to
dandruff, and allergic reactions." 

My apologies.  Good luck in your search for the right shampoo.  

Kevin, M.D.

Request for Answer Clarification by anonymous777-ga on 17 Jan 2003 09:30 PST
i read that nizoral is good for hair loss. in ur research did u find
out anything that might say thats its bad??? can u look up nizpral for
me and ill give u a good tip!!! thanks for ur help!

Clarification of Answer by kevinmd-ga on 17 Jan 2003 19:24 PST
Thanks for your answer clarification.  You asked the following:
"i read that nizoral is good for hair loss. in ur research did u find
out anything that might say thats its bad??? can u look up nizpral for
me and ill give u a good tip!!! thanks for ur help!"

There is conflicting data regarding nizoral and hair loss
(Ketoconazole).  Reading the side effects labels, it says that hair
loss (alopecia) is one of the side effects of ketoconazole.  However,
there are studies (I have listed 2 of them below) that show that
nizoral indeed helps hair loss.

1) Nizoral CAUSING hair loss (alopecia)

First, I looked at the Drug Information Handbook for the side effects
of the Nizoral Shampoo - it suggests that it increases normal hair
"ADVERSE REACTIONS Oral: 1% to 10%: Dermatologic: Pruritus (2%)
Gastrointestinal: Nausea/vomiting (3% to 10%), abdominal pain (1%)
<1%: Headache, dizziness, somnolence, fever, chills, bulging
fontanelles, depression, gynecomastia, diarrhea, impotence,
thrombocytopenia, leukopenia, hemolytic anemia, hepatotoxicity,

Cream: Severe irritation, pruritus, stinging (~5%) 

Shampoo: Increases in normal hair loss, irritation (<1%), abnormal
hair texture, scalp pustules, mild dryness of skin, itching,
oiliness/dryness of hair" (1)

As you are aware, a fellow Researcher has thoroughly documented
sources that list hair loss as a side effect of Nizoral:

2) Nizoral REDUCING hair loss (alopecia)

Khandpur (2002) suggests that ketoconazole reduces hair loss:
"Our understanding of the aetiology of androgenetic alopecia (AGA) has
substantially increased in recent years. As a result, several
treatment modalities have been tried with promising results especially
in early stages of AGA. However, as far as has been ascertained, there
is no comprehensive study comparing the efficacy of these agents alone
and in combination with each other. One hundered male patients with
AGA of Hamilton grades II to IV were enrolled in an open, randomized,
parallel-group study, designed to evaluate and compare the efficacy of
oral finasteride (1 mg per day), topical 2% minoxidil solution and
topical 2% ketoconazole shampoo alone and in combination. They were
randomized into four groups. Group I (30 patients) was administered
oral finasteride, Group II (36 patients) was given a combination of
finasteride and topical minoxidil, Group III (24 patients) applied
minoxidil alone and Group IV (10 patients) was administered
finasteride with topical ketoconazole. Treatment efficacy was assessed
on the basis of patient and physician assessment scores and global
photographic review during the study period of one year. At the end of
one year, hair growth was observed in all the groups with best results
recorded with a combination of finasteride and minoxidil (Group II)
followed by groups IV, I and III. Subjects receiving finasteride alone
or in combination with minoxidil or ketoconazole showed statistically
significant improvement (p<0.05) over minoxidil only recipients. No
signifcant side-effects related to the drugs were observed. In
conclusion, it is inferred that the therapeutic efficacy is enhanced
by combining the two drugs acting on different aetiological aspects of
AGA." (2)

Pierard-Franchimont (1998) also suggests that nizoral shampoo reduces
"BACKGROUND: The pathogenesis of androgenic alopecia is not fully
understood. A microbial-driven inflammatory reaction abutting on the
hair follicles might participate in the hair status anomaly.
OBJECTIVE: The aim of our study was to determine if ketoconazole (KCZ)
which is active against the scalp microflora and shows some intrinsic
anti-inflammatory activity might improve alopecia. METHOD: The effect
of 2% KCZ shampoo was compared to that of an unmedicated shampoo used
in combination with or without 2% minoxidil therapy. RESULTS: Hair
density and size and proportion of anagen follicles were improved
almost similarly by both KCZ and minoxidil regimens. The sebum casual
level appeared to be decreased by KCZ. CONCLUSION: Comparative data
suggest that there may be a significant action of KCZ upon the course
of androgenic alopecia and that Malassezia spp. may play a role in the
inflammatory reaction. The clinical significance of the results awaits
further controlled study in a larger group of subjects." (3)

Kevin, M.D.

1) Lacy, C.  Nizoral - Drug information.  Drug Information Handbook. 
Lexi-Comp, 2002.
2) Khandpur S. Suman M. Reddy BS. Comparative efficacy of various
treatment regimens for androgenetic alopecia in men. Journal of
Dermatology. 29(8):489-98, 2002 Aug.
3) Pierard-Franchimont C. De Doncker P. Cauwenbergh G. Pierard GE.
Ketoconazole shampoo: effect of long-term use in androgenic alopecia.
Dermatology. 196(4):474-7, 1998.
anonymous777-ga rated this answer:5 out of 5 stars and gave an additional tip of: $20.00

Subject: Re: selsun blue moisturizing treatment
From: kevinmd-ga on 18 Jan 2003 11:01 PST
Thank you for the generous rating and the tip.  

Kevin, M.D.

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