At the recent ISHRS meeting last week in Bangkok, the value of ketoconazole shampoo was also echoed by one of the guest experts in the field of hair loss.
In a 21-month study for 39 male patients aged 21 to 33 years with Hamilton Grade III AGA, treatment with 2% KTZ shampoo two to four times weekly resulted in progressive increase in pilary index (defined as hair shaft diameter in µm 1.5 cm from bulb obtained from computerized MOP Videoplan Kontron image multiplied by percentage of hairs in anagen phase obtained from trichogram) while unmedicated shampoo demonstrated slow linear pilary index decrease. 61 In another sixmonth study on 150 patients aged 18 to 65 years, 1% KTZ shampoo two to three times weekly increased hair shaft diameter significantly, but did not significantly modify mean hair density.45 A final study described the Accepted Manuscript Page 9 of 33 comparison of oral finasteride 1 mg/day only and 2% topical minoxidil only to combination therapies of oral finasteride with 2% topical minoxidil and oral finasteride with 2% KTZ shampoo for a year in 100 male patients with Hamilton Grades II to IV AGA. Oral finasteride with topical KTZ demonstrated significant clinical improvement compared to oral finasteride or topical minoxidil alone (p<0.01) and was comparable combining oral finasteride and topical minoxidil (p=0.3).
So 20 years after the 1998 study, and we only got 2 more studies. Not super duper definitive, but very promising. I’m basically convinced to ad it to my routine.