Research shows that ketoconazole (an imidazole) can regrow hair in people with male-pattern-baldness (MPB). Many people on the web claim that miconazole (another imidazole) does the same, also helping to speed the hair itself. I started to look into this and I think I have a pretty good understanding how these compounds work to fight baldness.
People with MPB have certain characteristics happening in their scalps, compared to haired individuals. People with MPB have:
1. More steroidogenesis (and related hormones and enzymes) occurring in the scalp skin.
2. Larger sebaceous glands and sebum secretion.
3. An accumulation of white-blood-cells (mast-cells, T-lymphocytes) and increased inflammation.
4. Often, but not always, fibrosis around the hair-follicles. Fibrosis is an accumulation of collagen, which is used to heal tissues after inflammation or injury... think of fibrosis as scar-tissue.
So I will show how Imidazoles help with the first three issues.
Imidazoles (specifically ketoconazole and miconazole) inhibit the Cytochrome-P450 enzyme complex. P450 is a series of enzymes that is required to convert cholesterol into androgens and other hormones. The skin is actually a steroidogenic-organ, and is able to synthesize a wide array of hormones directly from cholesterol, all by itself! Topical application of imidazoles is thought to inhibit steroidogenesis in the skin. The overstimulation of androgens in the skin leads to enlarged sebaceous-glands, which begin to secrete excess sebum, which causes an overgrowth of fungi, like P-Acnes, which the immune-system attacks with mast-cells and T-lymphocytes, killing the growth of hair in the process. Imidazole's, with their inhibition of steroidogenesis, causes a reduction of androgenic-stimulation of the sebaceous-glands and therefor sebum-secretion and sebaceous-gland size are reduced to normal. Imidazoles also are very powerful anti-fungals (interestingly by inhibiting the P450-complex in fungi as well) and kills off these strains that summon the inflammatory response by the immune-system. Studies show that topical anti-microbials increase hair-growth and reduce the infiltration of inflammatory-cells in the scalp. Imidazoles also have a direct effect on lymphocytes and increase their demise, leading to direct anti-inflammatory effects.
I am thinking this is a very accurate theory on how these imidazole-compounds work to reverse MPB. I would love to hear feedback on this... thanks! I can also PM you the entire PDF studies if anyone is interested.
Edited by misterE, 19 November 2017 - 08:45 PM.
