Frequently asked questions about Nizoral (ketoconazole) Shampoo prescription strengthNIZORAL SHAMPOO: Questions and Answers
 
WHAT IS MALE PATTERN HAIR LOSS?
Male pattern baldness,  androgenic alopecia,  is a very common condition in which men begin to experience thinning of the hair on the scalp.  These changes often start slowly in men in their 20’s and often progress to a receding hairline and/or balding on the top of the head.  Male pattern baldness is believed to be hereditary and dependent on hormonal effects.  The primary cause of Male Pattern hair loss and baldness is due to Dihydrotestosterone (DHT) which is produced by 5-alpha reductase conversion of testosterone to DHT and leads to miniaturization of the hair follicle.
WHAT IS 2% NIZORAL SHAMPOO?
Nizoral Shampoo is a clean pleasant fragrant shampoo that is PH balanced and leaves your hair soft, healthy and clean.  Ketoconazole, an anti-fungal agent, is the key ingredient.  Nizoral is the # 1 choice of doctors to treat dandruff and recent research has shown that prescription strength Nizoral Shampoo has benefits in the treatment of Male Pattern Hair loss.  Regular use of 2%  prevent hair loss. 
HOW DOES NIZORAL SHAMPOO WORK?
Nizoral Shampoo in addition to being an anti-fungal agent has anti-androgenic effects that benefit in  the treatment of Male Pattern Hair Loss.  Nizoral helps to increase hair thickness and decrease shedding by two mechanisms: 
1.  Nizoral reduces scalp DHT by inhibiting the binding of DHT to hair follicles and helps block the conversion of testosterone to DHT. 
2.  In addition Nizoral is believed to remove sebum deposits that are not removed with normal scalp cleansing techniques.  These fatty sebum deposits lie on the scalp and appear to clog the hair follicles and reduce the nutritional supply to the follicle.
WILL NIZORAL WORK FOR ME?
Nizoral shampoo is prescribed online for MEN 18 years or older experiencing gradual thinning and hair loss - ANDROGENIC  Male Pattern Baldness.  Research studies presented at the American Academy of Dermatology who that 2% Nizoral increased hair thickness, decreased shedding, and increased the number of anagen-growth phase hair follicles on the scalp.  When used regularly Nizoral helps prevent hair loss and improves the scalp condition.   The response to Nizoral varies greatly for each person and can not be predicted.
CAN NIZORAL BE USED ALONG WITH  PROPECIA OR AVODART OR MINOXIDIL?
Treating male pattern hair loss with multiple modalities  - topical Nizoral  and systemic 5-alpha reductase inhibitors Propecia or Avodart may work synergistically to enhance the effectiveness of treatment and promote hair regrowth.

Oral ketoconazole is absolutely contraindicated with Propecia and Avodart.  Topical Nizoral ketoconazole  shampoo, when used as directed, has no significant systemic absorption and can be used along with other medications including Propecia or Avodart or topical Minoxidil. 

Topical prescription strength Nizoral helps to reduce scalp DHT levels and removes sebum deposits allowing more nutrients to reach the hair follicle.   Propecia and Avodart, both 5 alpha- reductase inhibitors, work by inhibiting the enzymatic conversion of testosterone to DHT.  DHT is responsible for the miniaturization of the hair follicles in the balding areas. Topical prescription strength Minoxidil works by increasing blood flow and enlarging miniaturized follicles and extending the hair's growth phase. Therefore  Nizoral Shampoo, topical Minoxidil and systemic Propecia or Avodart work synergistically on the key factors in the development of androgenic male pattern baldness.   Nizoral reduces scalp DHT by inhibits the binding of DHT to the hair follicle and Propecia and Avodart  decrease  levels of DHT responsible for the miniaturization of hair follicles, while Minoxidil works to increase blood flow to the area and enlarge and restore the follicles that have been miniaturized.

Although  @% Nizoral  Shampoo can be used as a sole treatment modality (Nizoral alone is as effective as Rogaine), combining Nizoral shampoo with topical Minoxidil with systemic DHT inhibitors - Propecia  or Avodart  would maximize  the effectiveness of both,  and result in the best opportunity to slow hair loss and regrow new hair.

Avodart or Propecia and 15% - 12.5% Minoxidil  prescriptions are available through Medical Wellness Center
HOW LONG BEFORE I SEE RESULTS?
Hair grows only about ½ inch per month, therefore patients start to notice results after first 3 months of treatment.  It takes time to see improvement.  Initially one may start to notice very fine, soft, colorless hairs.  With further use the new hairs will gradually become thicker and the same color as the other hairs on your scalp.   Up to 12 months of use may be needed to see your best results.  Also, for those just starting to have hair thinning, using Nizoral and other intervention  in the early stages will yield the  most dramatic results. 
HOW LONG DO I HAVE TO USE NIZORAL SHAMPOO?
The underlying predisposition to baldness is always present. Therefore, if a patient discontinues use of treatment, he will gradually lose the new hair that grew in response to  treatment and will experience the progression of his underlying predisposition to baldness.  Newly regrown hairs will probably be lost in 3  - 4  months after stopping medication  use.
WHEN & HOW DO I USE  NIZORAL SHAMPOO ?

Avoid contact with the eyes.   Do not use on wounds or damaged skin.
If you miss an application of shampoo, do not worry.  Just resume your treatment as soon as you remember. Nizoral's effect is long lasting and keeps working for several days.  Therefore you do not need to use it every day.

NIZORAL SHAMPOO FOR MALE PATTERN HAIR LOSS:
In order to help prevent hair loss and improve the scalp condition, 2% prescription strength Nizoral shampoo must be used regularly.   Do not get in eyes.   Using  Nizoral Shampoo more frequently or in higher doses will NOT make it work better or faster.  If you miss a Nizoral treatment, just continue use the next day .  DO NOT use  a double dose of the medication.

  • Wet your hair & scalp with water
  • Apply 1 - 2 teaspoons to your scalp. Work into lather.
  • Leave on for 3 - 5 minutes before rinsing.
  • Rinse thoroughly and follow by a conditioner.
  • Do NOT use more frequently than prescribed
  • Apply daily in place of your usual shampoo for 14 days and thereafter apply 1 -2 times weekly.
NIZORAL SHAMPOO FOR DANDRUFF:
Dandruff is actually associated with increased numbers of a type of fungus/ yeast called Pityrosporum.  Nizoral is a potent  #1 recommended prescription anti-dandruff shampoo.  For treating dandruff apply twice a week  for 2 - 4 weeks, then use once every 1 - 2 weeks to prevent dandruff symptoms from returning.
  • Wet your hair & scalp with water
  • Apply 1 - 2 teaspoons to your scalp. Work into lather.
  • Leave on for 3 - 5 minutes before rinsing.
  • Rinse thoroughly and follow by a conditioner.
  • Do NOT use more frequently than prescribed
  • Apply twice weekly for 2 - 4 weeks, then use once every 1 - 2 weeks to prevent dandruff symptoms from returning.
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    CAN I CONTINUE TO USE SPRAYS, MOUSSES, GELS and STYLING AIDS  WITH NIZORAL ?
    There is no need to change your usual hair care routine when using Nizoral .  If combining with  Minoxidil, use Nizoral shampoo in the morning when you wash hair and  use Minoxidil on a dry scalp at night. 
    CAN I HAVE MY HAIR CHEMICALLY TREATED - PERMANENTS, TINTS, RELAXED WHILE USING NIZORAL?
    There is no evidence that chemical treatment of hair changes the effect of  Nizoral.  However, chemical treatments can result in scalp irritation.  Therefore do not use Nizoral shampoo the day you chemically treat your hair.  Although rare, discoloration has been reported in colored, dyed,  tinted or permed hair .  If you experience any irritation, sensitivity or scalp redness after a chemical treatment, wait until the scalp is 100% healed before applying Nizoral.  Do NOT make up for missed doses. 
    WHAT IS THE MOST IMPORTANT INFORMATION I SHOULD KNOW ABOUT ABOUT NIZORAL?
    • Do NOT use Nizoral on wounds or damaged skin
    • Store in a SAFE place where children can not reach it!  Store away from heat and direct light.  Do not freeze.
    • Pregnant women should NOT use Nizoral shampoo.
    • Minoxidil is indicated as a topical treatment for male pattern hair loss which occurs gradually and runs in families.  If you experience sudden hair loss, or you are experiencing patchy areas or hair loss or hair loss from medication or after pregnancy Nizoral is NOT for you.
    • Male  pattern hair loss in women can be a sign of a serious or life-threatening underlying medical condition from hormonal problems to even cancer.  Therefore women with male pattern hair loss or hair loss need to be directly followed by his/her own physician.
    • Nizoral  is for TOPICAL use ONLY!  Never take Nizoral orally. The active ingredient, ketoconazole, when taken orally can cause toxicity and liver damage.
    WHAT ARE THE SIDE EFFECTS OF NIZORAL?
    Undesirable  side effects are unlikely.  The most common side effects are itching, irritation, redness, or burning sensation of the scalp and dry or greasy hair.  Nizoral Shampoo should ONLY be applied to the scalp.  Rarely, hair discoloration of gray, tinted, dyed, colored or permed hair may occur.  If undesirable side effects persist discontinue use. 

    Do not get in eyes - if accidentally gets in eyes flush with water immediately.

    Stop taking Avodart and seek emergency medical attention if you experience an allergic reaction such as difficulty breathing, closing of the throat, swelling of the lips, tongue or face.

    The side effects listed above may not include all of the side effects reported by the drug's manufacturer.  For more information about any other possible risks associated wit  this medicine, please read the package insert provided with the medication from the pharmacy. 
     WHO SHOULD NOT USE  NIZORAL SHAMPOO?
    WHAT ARE THE CONTRAINDICATIONS FOR NIZORAL?
    • NIZORAL SHAMPOO IS FOR EXTERNAL USE ONLY!
    • Do NOT use if your are pregnant or breast feeding, ketoconazole has been shown to cause birth defects in animals.
    • Avoid contact with eyes. If any gets in your eyes bathe them gently with cold water.
    • Nizoral   is prescribed online for Men  with Male Pattern Hair Loss over age 18 only. 
    • Do NOT use  Nizoral if you are not sure of the reason for your hair loss. 
    • Do NOT use  Nizoral  if you experienced Sudden hair loss.
    • Do NOT use  Nizoral  if you experience or patchy hair loss.
    • Do NOT use  Nizoral  if you are experiencing hair loss secondary to medication use or a severe illness.
    • Do NOT use  Nizoral  if you have a red, inflamed, infected, irritated or painful scalp.
    • Do NOT apply  Nizoral if to a sunburned scalp. 
    • Do NOT use  Nizoral  if you have any scalp condition such as psoriasis or eczema as Minoxidil can be  very irritating.
    • Do NOT use  Nizoral  if you are allergic to to Ketoconazole, anti-fungal medicines, imidazoles or any of the ingredients in Nizoral.
    • Nizoral  will NOT prevent or reverse hair loss due to chemotherapy, or nutritional problems, low thyroid states, or disease which cause scarring of the scalp.
     CONTRAINDICATIONS:  In order to proceed to the medical consultation, you must proceed to the next page and read the contraindications and verify that you do not have any of the contraindications and understand that any pregnant or potentially pregnant woman  or women breast-feeding must not use Nizoral

    Under NO circumstance do we prescribe Nizoral to any child under the age of 18 .
    Next to read contraindications fo Nizoral Shampoo Male Hair Loss Prescription

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