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 Ketoconazole for pattern baldness
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Diazoxide is a potent and rarely anti-hypertensive agent, nondiuretic benzothiazide; it has diverse pharmacologic effects such as:

  • Hypertrichosis (hair growth)
  • Hyperglycemia (increase blood sugar) associated with associated with suppression of insulin release, which is why it is used to treat hypoglycemia of infancy
  • Increase of serum levels of androgens.

The hypertrichotic effect of the application of topical diazoxide was examined by several authors to take advantage of the side effect to treat pattern baldness. In 1989, a topical formulation of diazoxide was reported to show efficacy in treating male pattern baldness. A study made with 19 male subjects with “early to mid-stage” pattern baldness treated with 3% diazoxide solution twice daily for 2 to 11 months showed four men had dense growth by way of some new terminal veins, one had vellus hair growth, and seven had no re-growth at all. Moreover, one patient developed local irritation.

Phosphodiesterase (PDE), an enzyme that catalyzes the hydrolysis of phosphodiester bonds, is inhibited by diazoxide. This inhibiting action of diazoxide is believed to be the potential mechanism of action of the compound in hair growth. Moreover, PDEs cause the degradation of the cyclic nucleotides cAMP and cGMP. PDEs are therefore important regulators of signal transduction mediated by these molecules. In all probability, energy production is hindered by dihydrotestosterone by keeping phosphodiesterase relatively inactive and by suppressing various protein (enzyme) syntheses. Growing hair follicles at premature stages are terminated by relatively high concentration of cAMP, and repetition of such process over several years presumably transforms terminal follicles to vellus type follicles and ultimately causes baldness. This theory on the metamorphosis of terminal hair to vellus hair, however, is not yet proven.

As researchers studied hair growth, they provided correlative evidence that the opening of potassium channel is an important regulatory mechanism for hair growth. Diazoxide, like Minoxidil, has been shown to be a potassium channel opener. Although with far less frequency, oral diazoxide can induce hypertrichosis in a distribution similar to that caused by oral minoxidil.

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