Can Ketaconazole cause permanent hair loss

[chet atkins]

I'm not your typical hair loss forum visitor. I'm 44 and have at least 95% of the hair I had in high school.

About 10 years ago I had a severe bout of dermatitis on my scalp. I left it untreated for about three months before finally getting a doctor to look at it. He prescribed Ketaconazole 2%. I used it as recommended and it quickly cleared the condition. Unfortunately, I noticed in the temple and surrounding area where the condition was most severe my hair thinned a very, very slight amount. I did some reading and discovered that the follicles may have become permanently damaged by the dermatitis. Nine years passed and no change since the bout of dermatitis. Then I did something foolish: Despite having 99.9% of my original hair I began using the Ketaconazole I was given in 2005 on my temples as a preventive measure. After about 2 months an entire square inch of hair completely fell out on one side and a slightly smaller area on the other. That was several months ago. Though I do see a few dozen short hairs growing at the new hairline, the area where the hair disappeared completely remains dormant.

I've read Ketaconazole can accelerate shedding in the early stages of use but can it cause permanent irreversible damage in cases where there was no previous hair loss problem?

Believe me, I'm very attentive to my hairline. I've watched it like a sentinel since contracting dermatitis. I would have noticed even minor thinning or recession. It was like a light switch, though. One month there was thick, plentiful hair on my temples, the next, a bald patch the size of a silver dollar.