12 weeks on big 3 (pics). Plz opine!!

[Unterleigen]

There is one study on the 1% formulation that I could find, but it's not directly investigating baldness:

Nizoral 1% Study
The effects of chronic use of 1% ketoconazole or a 1% zinc pyrithione shampoo on the general health of hair and scalp.

G. Piérard 1and G. Cauwenbergh2
1. Dept Dermatopathology, University of Liège, Belgium; 2. Skin research Center, Johnson &Johnson , Skillman, N.J., USA

Hundred male volunteers with mild to moderate dandruff and somewhat oily scalp, have used, in a double-blind fashion, a 1% ketoconazole shampoo or a 1% zinc pyrithione shampoo. The test shampoos were applied 2 to 3 times weekly for a total period of 6 months. Several parameters that affect the general health of hair and scalp were assessed at start, and after 1, 3 and 6 months. These parameters included the percent of hairs in anagen phase, the diameter of the hairs, sebum excretion rate at the hairline, and the number of hairs shed in the 24-hour period prior to each assessment. At the end of the study, the participants were asked to complete a questionnaire regarding the cosmetic acceptability of the test shampoos.

Forty-four ketoconazole users and forty-three zinc pyrithione users completed the 6 month study period. Analysis of the different parameters shows that the hair diameter gradually increases with chronic ketoconazole use (+8.46%) over a 6 month period, whereas the diameter shows a trend to decrease with zinc pyrithione use over the same period (-2.28%). The sebum excretion rate is reduced with ketoconazole (-6.54%) while it increases with zinc pyrithione (+8.2%) over the same period of time. The number of hair shed over a 24-hour period is reduced by 16.46% with ketoconazole and 6.02% with zinc pyrithione after 6 months. Finally, the percentage hairs in anagen phase increased by 6.4% and 8.4% respectively during the study time. Except for the percentage of hairs in anagen, which showed no difference between the two groups, all other parameters were significantly different in favor of the ketoconazole shampoo.

Both shampoos have been shown to be good anti-dandruff ingredients. Assessment of parameters than can affect the health of hair and scalp, suggests that both ingredients show distinct differences in the way they affect the scalp; indicating that ketoconazole increases hair diameter and reduces scalp oil, whereas zinc pyrithione seems to yield opposite effects. This suggests that, besides their effect on the lipophilic yeast Malassezia spp, ketoconazole and zinc pyrithione act though quite different mechanisms. An overall analysis of hair diameter changes as a function of changes in sebum excretion rate suggests that a reduction in scalp oiliness seems to result in an increased hair diameter. This suggests that, in people with oily hair, regular use of ketoconazole shampoo may result in overall hair fullness.

[25 going on 65]

So I just read a post on this forum by Unterleigen, and he says that the MPB studies on keto to date have not actually compared 1% vs. 2% keto shampoo. For some reason I had it in my head that they did, but it would seem that only the 2% was studied (and found to have a mild positive effect). Let that be a lesson to me not to advise from memory.
Since the 1% hasn't been studied as an MPB remedy, we don't know whether it's as effective as 2% or not. I'm going to stay on the safe side and continue the 2% solution, but if you want to try the 1% and see how it goes, it's up to you.

[25 going on 65]

Does it really make that much of a difference between 1 and 2 percent? The 2 percent is meant to be used once a week and the 1 percent is used twice so it theoretically adds up the same.

2% is more effective from what we know. I see what you mean with the numbers, but medication is rarely that simple. To make a comparison, if there was a 1% minoxidil solution, using it 10 times a day would not likely produce equivalent results to using 5% solution 2 times a day.
But keto is more of a supporting treatment anyway. Finasteride (or dut) does the real heavy lifting.

Edit: PatientlyWaiting is right. Seeing your maximum results could take considerably longer than a year. But within a year you will probably see some results if your regimen is working, even if it's only in the form of decreased shedding.

[ravegrover]

Thank you all! I realize it is too early. I intend to continue treatment for at least an year and will be back...

[PatientlyWaiting]

12 weeks is nothing BTW. You didn't lose all that hair in 12 weeks, you're not going to gain it back in 12 weeks. You didn't even lose that hair in 1 or 2 years either. It takes years to get to where you're at. It might take over a year to start seeing noticeable regrowth.

[PatientlyWaiting]

Hate to say it but you need to shave your head..you just dont have enough hair for the big 3 to work or you could get a hair transplant. Sorry man

That's false, I have seen people worse than him get back a lot of hair on the big 3 after more than a year. You need patience.

[WashedOut]

Well some people respond very well to meds, so there's nothing wrong with trying out the regimen for a year and seeing where it gets you. Though at this stage of loss it's best to keep realistic expectations.
I can't see much difference between the photos, but 12 weeks is very early.

If you want to see how far meds can take you, you can consider switching from fin to dutasteride, and also make sure you're using the 2% keto shampoo instead of the 1% OTC stuff.
Concealers like dermmatch and toppik might also help.
Good luck!

Does it really make that much of a difference between 1 and 2 percent? The 2 percent is meant to be used once a week and the 1 percent is used twice so it theoretically adds up the same.

[25 going on 65]

Well some people respond very well to meds, so there's nothing wrong with trying out the regimen for a year and seeing where it gets you. Though at this stage of loss it's best to keep realistic expectations.
I can't see much difference between the photos, but 12 weeks is very early.

If you want to see how far meds can take you, you can consider switching from fin to dutasteride, and also make sure you're using the 2% keto shampoo instead of the 1% OTC stuff.
Concealers like dermmatch and toppik might also help.
Good luck!

[john2399]

Hate to say it but you need to shave your head..you just dont have enough hair for the big 3 to work or you could get a hair transplant. Sorry man

[Widowmaker]

If anything, looks like very slight improvement. I would keep at it for at least a year and re-evaluate at that time.

[ThinningB420]

Honestly, I don't see much of a difference. With that said, it's only been 12 weeks with the additions. Seems like people say you really need to try it for a year.

[ravegrover]

Hi all,

I know its kinda early, but, would appreciate comments. I have been taking Fin. for no of years now. Started Minox 5% and Nizoral as well, 12 weeks ago. 2nd pic taken 12 weeks later. What do you think? Should I carry on?

Rave