Why ketoconazole only 1x per week?

[25 going on 65]

So I read on this forum a lot of suggestions not to use 2% keto shampoo more than once every week. However my understanding is that the controlled studies showing keto's effectiveness as a MPB treatment had subjects using it 2-4x every week (about every 2-3 days)
I wonder then, why should we use it only one time each week? I understand concerns baout irritation but if we are using it to treat hair loss shouldn't we copy what actually was effective in the studies?

I am very appreciative to anyone who can shed light on this

[ChrisM]

So I read on this forum a lot of suggestions not to use 2% keto shampoo more than once every week. However my understanding is that the controlled studies showing keto's effectiveness as a MPB treatment had subjects using it 2-4x every week (about every 2-3 days)
I wonder then, why should we use it only one time each week? I understand concerns baout irritation but if we are using it to treat hair loss shouldn't we copy what actually was effective in the studies?

I am very appreciative to anyone who can shed light on this

To my understanding at least with the product Nizoral.. the fact is it also contains a special chemical ingredient called sodium laureth sulfate (SLS) a product found in most commercial shampoos to help build the lather effect of when you vigorously apply it and rub in on your scalp. The double edged sword of this chemical is that it is incredibly harsh on the newly growing and in some cases vellus hairs on the scalp as well as the mature terminal hairs that you see growing thickening as your hair is some areas of your scalp has a greater density and it is so harsh it causes those hairs to fall out in addition to the ones you would normally lose through a shedding process so in effect it worsens shedding and it negates the positive effects you would normally derive from it as a topical DHT blocker. Hope that answers your question.

[Tracy C]

I wonder then, why should we use it only one time each week?

Though Ketoconazole is a helpful adjunct medication to proven treatments for hereditary hair loss, using it too often can dry out your hair and scalp. Also, using Ketoconozole too often can actually make your hereditary hair loss worsen.

When starting with Ketoconozole shampoo, the instructions on the bottle are to use it once every three to four days for up to eight weeks, then use it once a week after than - or as directed by your doctor.