Q: Can dandruff cause hair loss? I have a lot of dandruff and use the Nizoral Shampoo for it. And can the Nizoral be a reason I am losing my hair?

A: Dandruff (the medical term is seborrhea) does not cause hair loss as it is a condition that involves scaling and redness on the surface of the scalp and does not involve the growth parts of the hair follicle that lie deeper in the skin. Although Nizoral is an ineffective treatment for hair loss (it is sometimes prescribed for this) it will not cause hair loss.

Q: Should I use Nizoral every day?

A: The product recommendation is to use Nizoral shampoo twice per week for dandruff, but many patients prefer to use it daily. Other than drying out the scalp, it is safe to use daily. The 1% formulation is over the counter. The 2% requires a prescription.

Q: I use Nizoral for my dandruff. Does it work for hair loss too?

A: The active ingredient in Nizoral is Ketoconazole. This medication, originally developed to treat fungus infections, has slight anti-androgen action. It is supposed to work in hair loss by inhibiting the action of DHT on hair follicles. Although, in theory, it should be useful for androgenetic hair loss, there have not been conclusive scientific studies to show that it works to treat balding when used as a topical application for balding.

Q: I heard that the sexual side effects of Propecia are irreversible. Is this true?

A: The sexual side effects of finasteride (Propecia) begin to subside soon after the medication is discontinued. This would make sense since the drug finasteride is a reversible inhibitor of DHT. Although it is possible for side effects to be persistent after stopping the medication, this situation seems to be very uncommon and a cause and effect relationship is still in question.

Q: I saw your post on the clinical trials of Latisse (bimatoprost) for hair loss on the scalp. What is the status of the study?

A: Allergan, the company that makes Latisse, is conducting safety and efficacy testing of three formulations of the drug for men with androgenetic alopecia (male pattern baldness). The first phase of the trials is now complete and the study has moved into phase II. In this phase, the pharmaceutical company will be studying the results of the same three formulations of the drug, but this time they will be comparing them to results of a control option and also an over-the-counter minoxidil 5% solution.