Lipogaine Big 3 does contain ketoconazole, but only a couple other hair loss/thinning related ingredients. Their Big 5 does not contain ketoconazole, but it does contain a proprietary mix of 17 ingredients for hair loss/thinning. It seems to be a more complete shampoo overall, aside from the hair loss aspects. My initial thought is to go with a combination of Big 5 and Nizoral.
There are many potential causes of hair loss in women , including medical conditions, medications, and physical or emotional stress. If you notice unusual hair loss of any kind, it's important to see your primary care provider or a dermatologist, to determine the cause and appropriate treatment. You may also want to ask your clinician for a referral to a therapist or support group to address emotional difficulties. Hair loss in women can be frustrating, but recent years have seen an increase in resources for coping with the problem.
Hair changes about as fast as grass grows, which is to say it’s extraordinarily slow and not visible to anyone checking impatiently in the mirror every day. But during regular follow-up appointments, Harklinikken uses high-tech equipment to photograph and magnify the scalp and count new hairs and active follicles, which motivates users to adhere to the regimen. Too many people give up on treatments like Rogaine and low-level-light devices before they’ve had a chance to work, Dr. Senna said.
But in November, after 10 years of research, Rogaine introduced a new 5 percent minoxidil formulation for women. It’s a mousse (instead of a liquid) that needs to be applied only once a day instead of twice, which means that it can be more easily incorporated into a woman’s evening skin-care routine. Teal replaces the blue and silver palette of the men’s Rogaine, and the packaging bears a lotus flower. (Also last year, Pantene introduced its Hair Regrowth Treatment for Women, which is 2 percent minoxidil.)
Men may also experience some sexual and emotional side effects while taking it: In a study published in the June 2011 issue of The Journal of Sexual Medicine, Dr. Michael Irwig of George Washington University found as many as 92 percent of test subjects reporting problems in the bedroom. The study also reported that “the mean duration of finasteride use was 28 months and the mean duration of persistent sexual side effects was 40 months,” meaning that side effects lingered long after subjects stopped taking the pill.
Unfortunately, as with the aforementioned minoxidil, you’ll begin to lose your hair again if you ever stop taking Finasteride. Additionally, it may cause erectile dysfunction and other sexual problems in men although that’s uncommon. Men who experience these side effects from taking this pill can reverse them; however, that can take up to three months to occur.
Hair multiplication. Similar to the idea of cloning, this treatment involves taking out donor cells from the hair follicles and then growing and multiplying them in a laboratory. Once sufficient samples have been multiplied, these hair cells are then injected into the bald patches to stimulate hair growth. As a relatively new treatment, hair cloning is still in its research phase.
Women with androgenic alopecia may consider trying prescription ketoconazole at a strength of 2 percent. This drug comes in the form of a shampoo and also goes by the name Nizoral. It’s an antifungal agent and may help reduce the body’s production of testosterone and other androgens that lead to hair loss. You can also find 1 percent strength at your local pharmacy, but it may not be as effective.
Trichorrhexis nodosa occurs when hairs break secondary to trauma or because of fragile hair (Figure 7). It affects the proximal hair shaft, although the distal shaft may also be involved.20 Causative traumas include excessive brushing, heat application, tight hairstyles, trichotillomania, and conditions that cause excessive scalp scratching. Chemical traumas include harsh hair treatments (e.g., excessive use of bleach, dye, shampoo, perms, or relaxers21) and excessive exposure to salt water. Examples of congenital or genetic conditions that may cause trichorrhexis nodosa include trichorrhexis invaginata (bamboo hair), intussusception of the hair shaft at the keratinization zone, Menkes disease, keratinization defects due to defective copper metabolism, and argininosuccinic aciduria.22 Rarely, trichorrhexis nodosa can be a manifestation of hypothyroidism.23
Beyond that, things get more controversial, with some doctors saying there's inadequate evidence for other treatments. Saxena thinks there is enough scientific evidence to support some of the alternatives and recommends them to patients. But they are not for women on tight budgets. There's Nutrafol, a "nutraceutical" that costs about $80 a month. Women can also get injections in the scalp of platelet-rich plasma made from their own blood. The first four treatments cost about $2,000 at Saxena's practice in Fort Washington or Lansdale. Maintenance injections, done every three to six months, cost $515 each. Women can also buy Theradome, a light-emitting helmet, for $895 online.  Saxena, who has hair loss herself, said she has had the injections and currently uses minoxidil, spironolactone, and Nutrafol.
I must have had about 5 readers email me today about the fascinating research coming out of Yokohama National University in Japan. Professor Junji Fukuda lead the efforts to successfully prepare “hair follicle germs” at large scale simultaneously. Essentially, the researchers prepared a cellular formulation with the right culturing materials to promote successful growth and development of tiny “hair follicle starter kits.” Source article here. 
Laser treatments. Low-level laser therapy (LLLT) is used for the prevention and reversal of hair loss. Also known as red light therapy, cold laser, and soft laser, it is a form of light/heat treatment (therefore generally safer) that is used on cases of pattern baldness and alopecia areata. The procedure uses a device that emits light that penetrates into the scalp. The more commonly used lasers are the excimer, helium-neon and fractional erbium-glass. The procedure can increase the blood flow in the scalp to stimulate the follicles that are in resting or dormant phase to go into anagen, and at the same time, prevent the production of DHT, which destroys the hair follicles.
A little something for you all to nibble on. I’ve recently discovered a stem cell therapeutic company who has an interest in putting out cosmetic hair growth products. The company, Stemedica, is working on treating a wide range of diseases through clinical stem cell therapies. I counted 6 clinical trials in progress on their pipeline page. Perhaps more interesting for this audience, the company is also developing skin and hair growth cosmetic products from their core stem cell technology. Stemedica has a specific subsidiary in place to roll out dermatology cosmetics called StemCutis. Their website mentions the use of stem cell-derived growth factors to to be used in the products. It’s not clear what stage of development the hair growth product is at, but it’s good to have it listed in Stemedica’s sights. 
With those pinned down, it wasn’t hard to determine which don’t actually work. Pretty much all the “active” ingredients listed in ineffective treatments — from biotin and zinc to emu oil and saw palmetto — have never been proven, and are instead marketed based on logical-seeming correlations. It would make sense that biotin, a B vitamin readily found in hair, skin, and nails, could help hair grow more quickly. And caffeine is a stimulant that works in coffee, so rubbing some on your scalp might wake some of those sleepy follicles… right?
After the new article featuring Medipost’s hair growth cosmetic was published, Jay Lee PhD of Medipost, began chiming in on the comments section. He first shared that Medipost is currently engaging in a larger clinical trial for the CM3 product which would include higher scale Norwood’s. Then, in a following comment he revealed that Medipost is developing a potentially more advanced hair growth product as well. Here are his words:

Learn to get used to it. Men with balding hair would like to wear caps as a way to mask or cover-up their thinning hair. But while this is understandable, wearing a cap will not make the issue go away. Rather, by teaching oneself to get used to your new look, the easier it will be to accept and the less awkward you'd feel if you're out in public. Wear a hat only when necessary, that is, if you need scalp protection.
“Curis (now-dormant company) had performed a lot of studies on targeting the Hedgehog pathway for hair growth with very promising results, however, their compounds caused orthosteric activation of the pathway (turning it on everywhere and robustly which is not safe) vs. Oxy133 which causes a much more regulated and limited allosteric activation of the pathway only in stem cells. This could make Oxy133 a blockbuster. Let’s see what happens.” 
There have also been studies on the effects of 1% pyrithione zinc shampoo and a 5% minoxidil solution. In one study, 200 men between the ages of 18 to 49 who experienced baldness between type III and type IV on the Norwood scale were given this treatment for a six-month period. They found that minoxidil, when used on its own, was approximately twice as powerful as pyrithione zinc at stimulating hair growth, but that both products were successful at increasing the amount of visible hair when used over a 26-week period.
The cause of female-pattern hair loss is unknown, but doctors said there is a strong genetic component. The risk can come from male or female relatives. Though it looks as if the hair is falling out, that's not really what's happening. Cotsarelis said hair follicles are becoming smaller and producing hairs that may be so small that you can't see them.  Women tend to retain more normal, thick hairs than balding men do. 

I recently published an article covering a story in the press of SkinTE helping to possibly save the life of a burn patient (see Articles). In that post I shared an image from SkinTE’s website which shows an application for hair growth. What some may not be aware of is the fact that Dr. Denver Lough, CEO of PolarityTE, has done some legitimate hair follicle research while at Johns Hopkins University. Whether or not this will increase the chances of a “HairTE” product to become a success, we can’t say. However, it may be of interest to recall two peer reviewed articles that Lough and colleagues published involving the proteins LGR5+ and LGR6+ stem cells and hair growth.
Beware online stores selling Propecia without a prescription.Finasteride is FDA approved, but buying it online without a prescription can be illegal and dangerous. Prescription-free online stores have a reputation for selling placebos or dangerous replacements. We recommend speaking with a doctor about prescriptions or sticking to save over-the-counter treatments.

Always shampoo and condition your hair regularly. Let your hair breath by avoiding wigs that are made with cotton and nylon caps that absorb moisture and lead to drier and more damaged hair. Instead, choose those with netted caps. Make sure your wig isn't too tight. Secure it with hypoallergenic double-sided tapes. Do not put your wig on over wet hair to avoid the growth of mildew and bacteria.


That said, there are products that don’t have FDA approval or clearance, but may help prevent hair loss. For example, shampoos with ketoconazole, a chemical with anti-DHT properties, is widely used to treat fungal infections but has become popular among consumers as a hair loss treatment. It makes sense — research shows that ketoconazole actually has beneficial effects on hair growth (especially for those with seborrheic dermatitis).
Along with male pattern baldness, there is also a condition known as female pattern baldness, in which hair thins on the top of the head. Less is known about this type of hair loss, but it is more common in women who have been through the menopause. Female pattern baldness cannot be treated with finasteride (as with male pattern baldness), but it can be treated with minoxidil. Minoxidil is rubbed into the scalp once or twice a day and should start to show results after about four months. After ceasing treatment with minoxidil, hair loss should resume within a few months.
Because hair concealers work like wigs, choosing one that's right for you is important. More than anything, it should be as natural looking and as subtle as possible. Pick one that matches your natural hair color. Most hair fibers come in nine colors, and if you want to achieve a good color fit, you can blend two colors. Apply first the dark color and then the lighter color.
Follicum announced yesterday it has successfully completed the development of a topical formulation for FOL-005. The company had been working in parallel to develop an optimal topical version of FOL-005 while an injectable version of the peptide was being used in a clinical trial. Now that the topical formula is completed it will be trialed in a further phase 2 clinical trial which will likely begin very late 2018 or early 2019.

In our research and our conversations with experts, one name kept popping up repeatedly: Rogaine. As the first topical brand FDA-approved to help regrow hair (all the way back in 1988), Rogaine benefits from more than 20 years of clinical trials and consumer feedback. Rogaine was the first brand to offer a 5 percent minoxidil foam solution when it debuted Men’s Rogaine Unscented Foam in 2006, and virtually every treatment developed since (for both men and women) has been an imitation or derivation of that formula.

Literally jumping right out of the woodwork, the company “HCell” has announced they have been granted an orphan designation from the US FDA for their novel treatment of pediatric alopecia areata. The treatment itself it described as a “topical Injection by regenerating hair through a proprietary blend of commercially procured biologic and autologous tissue.” The company also mentions having a treatment for androgenic alopecia in the works as well. More info to come soon. News release here. 
“There’s the ‘I don’t date bald men’ line – hard to argue with, but still an injury to one’s pride.” Then there are a surprising number of people who call out “baldie!” in the street, or equate a shaved head with homosexuality and/or neo-Nazism. “I’ve had baldist/homophobic abuse in the street a couple of times and I’ve even been asked on the Tube: ‘Are you BNP, mate?’ When I expressed bewilderment at this, I was told: ‘It’s the hair, innit.’”

The Holy Grail remains a drug that will promote regrowth, but this might not be so far away. Earlier this year, Manchester University announced that an osteoporosis drug had been found to have “dramatic results” promoting hair growth when applied to tissue samples in pre-clinical trials. The resultant frenzy left the PhD student responsible, Dr Nathan Hawkshaw, a little dazed. “Every other week, something comes out about hair loss and it doesn’t generate as much media coverage as what I experienced,” he grumbles. He’s in this for the science – there aren’t many fields where you get to mess around with real human tissue – but such is the distress caused by hair loss and such is the potential customer base that interest is always high.
A popular skin care drug—which is intended to target eczema—was just found to have an unusual side effect: hair growth. According to an article on Newsweek, the FDA-approved drug dupilumab was given to a 13-year-old alopecia sufferer to treat her eczema. The patient, who hadn’t grown hair on her scalp since she was two, suddenly grew a significant amount of hair on her head after continual use of the drug, a study in the journal JAMA Dermatology reports.
The Rogaine rep we spoke to explained that the different packaging (and therefore different prices) has to do with the FDA-approval process: “We discovered in clinical trials that the hair loss patterns between men and women are different,” she said by way of explanation. “Men typically have that bald spot on the crown of their head, where women generally have a general thinning throughout, but concentrated more on the top of the head. So for FDA approval, we had to come up with two different, gender-specific products, so the directions were more explanatory.”
Weinstein has big dark eyebrows and a kind face. Kind of an Elliott Gould vibe. I looked at his head. There was a spotty, thatchy outcropping of gray-black hair. Not exactly an overflowing abundance, but hair, to be sure. “I had nothing on top,” Weinstein said. “You can see—I grew my hair back! And it grew back more or less the color I had when I was young.”
1. Minoxidil. It’s the only FDA-approved topical nonprescription medication that can claim to regrow hair — and it should be part of any hair-loss plan if you have serious thinning, says Rogers. Minoxidil has loads of research to back it, but it requires commitment. If you quit using it, your hair will start to lose ground again. Use a 5 percent strength, like Women’s Rogaine 5% Minoxidil Foam ($30), once daily to see results in three to four months, says Rogers.
Alopecia areata. This condition, called patchy hair loss, is the opposite of pattern baldness. Whereas in the former, thinning hair follows a pattern, alopecia areata is marked by smooth and bald patches anywhere on the scalp. The bald patches are circular, and can be as small as a pencil eraser or as big as a quarter. It begins with one or two spots that multiply on other parts of the head. The condition is caused by an autoimmune disease where the antibodies mistake the hair as the "enemy" and start attacking it, resulting into hair loss.

Patients with tinea capitis typically present with patchy alopecia with or without scaling, although the entire scalp may be involved. Other findings include adenopathy and pruritus. Children may have an associated kerion, a painful erythematous boggy plaque, often with purulent drainage and regional lymphadenopathy. Posterior auricular lymphadenopathy may help differentiate tinea capitis from other inflammatory causes of alopecia. If the diagnosis is not clear from the history and physical examination, a skin scraping taken from the active border of the inflamed patch in a potassium hydroxide preparation can be examined microscopically for the presence of hyphae. Skin scrapings can also be sent for fungal culture, but this is less helpful because the fungi can take up to six weeks to grow.
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