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Reversal of androgenetic alopecia by topical ketoconzole: Relevance of anti-androgenic activity

  • Shigeki Inui
    Correspondence
    Corresponding author. Tel.: +81 6 6879 3960; fax: +81 6 6879 3962.
    Affiliations
    Department of Regenerative Dermatology, Graduate School of Medicine, Osaka University, 2-2, G2, Yamadaoka, Suita-shi, Osaka 565-0871, Japan
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  • Satoshi Itami
    Affiliations
    Department of Regenerative Dermatology, Graduate School of Medicine, Osaka University, 2-2, G2, Yamadaoka, Suita-shi, Osaka 565-0871, Japan
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      Ketoconazole (KCZ), an imidazole anti-fungal agent, is known to be effective for the treatment of seborrheic dermatitis and dandruff. In addition, 2% KCZ shampoo was found to improve hair density and the size and proportion of anagen follicles in androgenetic alopecia (AGA) [
      • Pierard-Franchimont C.
      • De Doncker P.
      • Cauwenbergh G.
      • Pierard G.E.
      Ketoconazole shampoo: effect of long-term use in androgenic alopecia.
      ] and, in combination with finasteride, to have an additive effect for AGA [
      • Khandpur S.
      • Suman M.
      • Reddy B.S.
      Comparative efficacy of various treatment regimens for androgenetic alopecia in men.
      ]. Recently, it has been reported that topical application of KCZ stimulates hair growth in C3H/HeN mice [
      • Jiang J.
      • Tsuboi R.
      • Kojima Y.
      • Ogawa H.
      Topical application of ketoconazole stimulates hair growth in C3H/HeN mice.
      ]. However, whether topical KCZ is effective enough to improve the clinical appearance of AGA is not yet clear. We therefore carried out an open trial of topical 2% KCZ lotion (Nizoral®) in combination with shampoos. Furthermore, to identify the mechanism, which can explain the clinical effect of KCZ on AGA, we performed transient transfection assays using CV-1 cells transfected with androgen receptors (AR).

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