Ketocazole as an adjunct to finasteride in the treatment of androgenetic alopecia in men.
Dihydrotestosterone (DHT) binding to androgen receptors (AR) in hair follicles is commonly accepted as the first step leading to the miniaturizing of follicles associated with androgenetic alopecia (AGA). Testosterone is converted to DHT by the enzyme 5alpha-reductase. Finasateride a 5alpha-reducase inhibitor blocks the production of DHT and is currently used to treat AGA. The inhibition is not complete but a reduction of DHT systemically and in the scalp is accomplished. Ketoconazole has been clinically shown to be effective in the treatment of AGA. In this paper, evidence is presented to support the hypothesis that ketoconazole 2% shampoo has a local disruption of the DHT pathway. It is proposed that using ketoconazole 2% shampoo as an adjunct to finasteride treatment could lead to a more complete inhibition of DHT and thus better treat AGA.
Hugo Perez
B S
BS
California College of Podiatric Medicine, 371 Columbus Avenue, San Francisco, CA 94133, USA. Hugo2002@yahoo.com
D000284:Administration, Oral; D000287:Administration, Topical; D000505:Alopecia / Q000188:drug therapy*; D000935:Antifungal Agents / Q000008:administration & dosage; D017024:Chemotherapy, Adjuvant / Q000379:methods; D002986:Clinical Trials as Topic; D004359:Drug Therapy, Combination; D004791:Enzyme Inhibitors / Q000008:administration & dosage; D019317:Evidence-Based Medicine / Q000379:methods*; D018120:Finasteride / Q000008:administration & dosage*; D006203:Hair Preparations; D006801:Humans; D007654:Ketoconazole / Q000008:administration & dosage*; D008297:Male; D016896:Treatment Outcome
D000935:Antifungal Agents; D004791:Enzyme Inhibitors; D006203:Hair Preparations; D018120:Finasteride; D007654:Ketoconazole