Ketoconazole Shampoo: Effect of Long-Term Use in Androgenic AlopeciaPiérard-Franchimont C.a · De Doncker P.b · Cauwenbergh G.c · Piérard G.E.a
aDepartment of Dermatopathology, University of Liège, and bJanssen Research Foundation, Beerse, Belgium; cJohnson and Johnson Research and Development, Skillman, N.J., USA
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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.
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