Nudging hair shedding by antidandruff shampoos. A comparison of 1% ketoconazole, 1% piroctone olamine and 1% zinc pyrithione formulations

Abstract

Hair shedding and hair thinning have been reported to be affected by dandruff and seborrhoeic dermatitis. The present study was conducted in 150 men presenting with telogen effluvium related to androgenic alopecia associated with dandruff. They were randomly allocated to three groups receiving each one of the three shampoos in the market containing either 1% ketoconazole (KTZ), 1% piroctone olamine (PTO) or 1% zinc pyrithione (ZPT). Shampoos had to be used 2-3 times a week for 6 months. Hair shedding during shampoo was evaluated semiquantitatively. Hair density on the vertex was evaluated on photographs using a Dermaphot. Trichograms were used for determining the anagen hair percentage and the mean proximal hair shaft diameter using computerized image analysis. The sebum excretion rate (SER, mug cm(-2) h(-1)) was also measured using a Sebumeter. The three treatments cleared pruritus and dandruff rapidly. At end point, hair density was unchanged, although hair shedding was decreased (KTZ: -17.3%, PTO: -16.5%, ZPT: -10.1%) and the anagen hair percentage was increased (KTZ: 4.9%, PTO: 7.9%, ZPT: 6.8%). The effect on the mean hair shaft diameter was contrasted between the three groups of volunteers (KTZ: 5.4%, PTO: 7.7%, ZPT: -2.2%). In conclusion, telogen effluvium was controlled by KTZ, PTO and ZPT shampoos at 1% concentration. In addition, KTZ and PTO increased the mean hair shaft thickness while discretely decreasing the sebum output at the skin surface.

EEMCO Guidance for the Assessment of Hair Shedding and Alopecia

“…The complex interactions between hair growth, sebaceous gland functions, angiogenesis [69,70], micro-inflammation and its counterpart immuno-suppression [51][52][53][54][55][56][57] and neuroendocrine influences [41,71] are incompletely characterized. The environmental impact including solar irradiation [49,50] and commensal microorganisms [56,59,72,73] cannot be neglected either.…”

“…Placing a piece of nylon netting over the drain, will usually trap hairs lost during washing. An entire day collection should be placed in a clear envelope or sandwich bag [57,73,86]. The date and information on whether shampoo has been used should be recorded.…”

Topical ketoconazole for the treatment of androgenetic alopecia: A systematic review

“…There were positive results even with the most infrequent use of 2-3 times per week (Henry et al, 2003), suggesting that this may be an adequate regimen for the use of topical ketoconazole in the treatment of AGA. Of the reviewed studies, all supported the use of ketoconazole for the treatment of AGA in some regard.…”

Effects of a new mild shampoo for preventing hair loss in Asian by a simple hand-held phototrichogram technique

“…Zinc pyrithione is known for its use in treating dandruff and seborrhoeic dermatitis. Recent studies of anti-dandruff shampoos containing zinc pyrithione have been reported to reduce hair loss [13,18]. Dexpanthenol (vit.…”