The active ingredient of Nizoral is ketoconazole.
I have found several references to hair loss as a side-effect of
ketoconazole:
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"Side Effects: GI: N&V, abdominal pain, diarrhea. CNS: Headache,
dizziness, somnolence, fever, chills, suicidal tendencies, depression
(rare). Hematologic: Thrombocytopenia, leukopenia, hemolytic anemia.
Miscellaneous: Hepatotoxicity, photophobia, pruritus, gynecomastia,
impotence, bulging fontanelles, urticaria, decreased serum
testosterone levels, anaphylaxis (rare). Topical cream: Stinging,
irritation, pruritus. Shampoo: Increased hair loss, irritation,
abnormal hair texture, itching, oiliness or dryness of the scalp and
hair, scalp pustules."
Nurses' PDR: Ketoconazole
http://www.nursespdr.com/members/database/ndrhtml/ketoconazole.html
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"What are the common side effects of this medicine?
Oral:
Belly pain and cramps.
Nausea or vomiting. Small frequent meals, frequent mouth care, sucking
hard candy, or chewing gum may help.
Diarrhea.
Headache. Mild pain medicine may help.
Rash. Talk with healthcare provider if one develops.
Shampoo:
Removal of the curl from wavey hair.
Increase in hair loss.
Irritation.
Cream:
Severe irritation, itching, and stinging."
Health and Age: Ketoconazole
http://www.healthandage.com/html/res/com/ConsDrugs/Ketoconazolecd.html
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"Adverse Reactions: Ketoconazole 2% shampoo causes minimal skin and
scalp irritation. During clinical trials, 33 (3.7%) of 892 patients
treated with the shampoo and 12 (3.6%) of 330 patients treated with
placebo reported side effects. The adverse effects reported by
patients treated with ketoconazole 2% shampoo consisted mainly of:
greasy hair or scalp (1.2%); dry (brittle) hair or scalp (0.9%);
irritation (0.5%); burning sensation and dryness (eyebrows) (0.2%).
All other adverse experiences were reported with an incidence of 0.1%:
exfoliative dermatitis; dandruff; irritation around mouth (acne
perioralis); contact allergy; worsening of acne; burning sensation or
pruritus (scalp); cosmetological disorder; hair loss; tiny pustules on
scalp; dryness and itching of forehead and cheeks."
RxMed: Nizoral Shampoo
http://www.rxmed.com/b.main/b2.pharmaceutical/b2.1.monographs/CPS-%20Monographs/CPS-%20(General%20Monographs-%20N)/NIZORAL%20SHAMPOO.html
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Note that side effects of any kind were reported by only 3.7% of the
patients treated with the prescription-strength Nizoral (which
contains twice as much ketoconazole as the nonprescription shampoo.) A
side effect of hair loss was reported by only 0.1% (one-tenth of a
percent) of patients. This is the equivalent of saying that one person
out of a thousand might be expected to experience hair loss as a
result of using Nizoral.
Compare these statistics against those for Rogaine:
"The occurrence rates for adverse reactions derived from the total
adverse reactions of all patients (placebo [one-third of these
patients received placebo treatment for 4 months] 2% minoxidil and 3%
minoxidil treated) enrolled in 2 pivotal efficacy/safety studies (2
326 patients), are as follows: Dermatological: itching (3%); scaling,
erythema, dermatitis, dry skin (1 to 2%); hypertrichosis, burning
sensation, rash, folliculitis, desquamation, alopecia (hair loss),
skin abscess, acne, eczema, eruptions, excoriation, flaking scalp,
hair abnormalities, nail disorders, seborrhea, other skin irritations
(0.1 to 1.0%)."
RxMed: Rogaine
http://www.rxmed.com/b.main/b2.pharmaceutical/b2.1.monographs/CPS-%20Monographs/CPS-%20(General%20Monographs-%20R)/ROGAINE.html
Regarding the use of both Nizoral and Rogaine, I have found no studies
to indicate that the products should not be used concomitantly.
Indeed, many sites recommend the use of Nizoral, Rogaine, and Propecia
as part of a three-pronged strategy to combat hair loss:
"In the US, many doctors and dermatologists recommended 5% minoxidil
(or Rogaine Extra Strength) plus Propecia and Nizoral shampoo as the
"core" treatment for hair loss."
Hair Site: Articles on Hair Loss
http://www.hairsite.com/library/abst-58.htm
It is true that both Rogaine and Nizoral can cause the loss of hair
(as can many thousands of other drugs and hair care products.) But,
although the possibility exists, it is unlikely that these products,
either separately or in tandem, will worsen hair loss.
A highly detailed report on ketoconazole and minoxidil is available
here:
http://www.hairlosstalk.com/download/nizoral.pdf
( NOTE: The file linked above is in .pdf format. You will need to have
Adobe Acrobat Reader software installed on your computer in order to
view .pdf files. If you do not already have this software, a free
download is available here:
http://www.adobe.com/products/acrobat/readstep2.html )
There is one other chemical that should be mentioned here. In addition
to ketoconazole (its active ingredient,) Nizoral Anti-Dandruff Shampoo
also contains the following inactive ingredients:
Water, Sodium Laureth Sulfate, Cocamide MEA, Sodium Cocoyl
Sarcosinate, Glycol Distearate, Acrylic Acid Polymer (Carbomer 1342),
Fragrance, Sodium Chloride, Tetrasodium EDTA, Butylated
Hydroxytoluene, Quaternium -15, Polyquaternium-7, Sodium Hydroxide,
Hydrochloric Acid, FD&C Blue No. 1
There has been much written about sodium laureth sulfate and similar
surfactant detergents (which are present in most shampoos, including
therapeutic shampoos prescribed by dermatologists.) On this page you
will find a selection of postings, bot pro and con, on the subject of
Sodium Laureth Sulfate and hair loss:
Hair Site: Sodium Laureth Sulfate
http://www.hairsite.com/late-sls.htm
You might be interested in reading comments from Nizoral users, some
positive and some negative. This isn't a scientific study, of course,
and one should keep in mind that newsgroup posts tend to express
opinions and experiences that may be far from the norm:
Thread from alt.baldspot newsgroup
http://groups.google.com/groups?hl=en&lr=lang_en&ie=UTF-8&oe=UTF-8&newwindow=1&safe=off&th=26f29d4a8031fde5&rnum=7
When selecting any kind of personal-care product, it is useful to have
information on the "worst-case scenario." In the case of Nizoral, it
can exacerbate hair loss in some users. The chance of this is small,
however. It is easy to become alarmed when reading lists of
complicated chemical names and details of possible side-effects that
may occur on rare occasions. Please keep in mind that a product with
no side-effects (if such a thing were to exist) would very likely be
inert, or ineffective. The field of hair care products, like other
areas where we are confronted with choices, has risks that must be
weighed against potential benefits.
Search terms used in locating this information:
"nizoral"
"ketoconazole"
"rogaine"
"minoxidil"
"causing hair loss"
"side effects"
"adverse effects"
"alopecia"
I hope this is helpful to you. If anything I've said needs
explanation, or if any details are unclear, please request
clarification, and I'll be glad to help.
Best wishes,
pinkfreud |
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