Ketoconazole is a relatively new and particularly potent anti androgen drug. Since 1985 there have been various studies suggesting that ketoconazole could be used to treat androgenetic alopecia as well as hirtusim. Ketoconazole works by blocking the production of hormones by the gonads and the adrenal glands when it is take orally .Also , the important of this drug is that it works topically ( apply it as a cream or as a lotion ) but ,what it is even more unique , is that also works apply it as a shampoo (Nizoral) Ketoconazole comes in three basic forms; Nizoral cream 2%, Nizoral shampoo 2%, and Nizoral tablets all are made by Janssen Pharmaceutica, also there are several generic version and a new Foam version named Extina. The shampoo is a bright red color where the active ingredient is a 2% concentration of the antifungal Ketoconazole, an imidazole derivative. Ketoconazole acts to stop the formation of fungal cell membranes.
The shampoo is used to treat dandruff where it is believed fungal infection can exacerbate the condition. Both shampoo and cream are used for skin fungal infections. These topical applications are tolerated very well and rarely have side effects.
The tablets are used for systemic fungal infections. Oral use has been associated with potential side effects including hepatotoxicity. This has led to death in a few individuals who took too much of the drug. Consequently, people using the tablets are very carefully monitored. Headache, fever, and hypersensitivity have also been suggested as potential side effects of tablet use.
Although Ketoconazole is officially an antifungal agent it has also been shown to lower serum testosterone when taken in tablet form. As a result some people with androgenetic alopecia have used the drug in an attempt to counteract hair loss by reducing free testosterone. Other individuals use the cream and/or shampoo in the hope of locally reducing the testosterone levels around hair follicles. However, no research has been conducted to show whether topical application is truly effective in treating androgenetic alopecia.