Zinc Pyrithione Shampoo benefits in Male Balding

Does it help AGA?

Do anti-dandruff shampoos containing zinc pyrithione help male balding?

For many years there has been a debate as to what role scalp inflammation from bacteria and yeast might be having in the so called "follicular microinflammation" that is seen in biopsies of patients with male balding.

In a 2003 study, Berger et al showed a benefit for 1 % zinc pyrithione (found in Head and Shoulders and other shampoos). The researchers performed a 6 month randomized study in healthy men 18-49 with Hamilton Norwood type III vertex or type IV baldness to assess the benefits of daily use of 1 % ZP shampoo. The researchers compared growth with zinc pyrithione shampoo compared with three other groups: 1) those using minoxidil 5 % twice daily, 2)those using a placebo shampoo, and 3) those using a combination of minoxidil and the 1 % ZPC shampoo. 

The results of the study showed hair growth was best with Minoxidil topical. However 1 % ZP shampoo (on its own) promoted growth fairly well too - with improvements being slightly less than one half of the topical minoxidil. Interestingly there was no added advantage in minoxidil + ZP over monxidil alone.

Conclusion: These studies support a benefit for zinc pyrithione in the treatment of male balding. Although we generally think of androgenetic alopecia as a "non inflammatory" alopecia - it is probably best we do not think of in this manner. The follicular microinflammation seen in male balding (and female thinning) may have more relevance than we currently appreciate.

Reference

Berger et al. The effects of minoxidil, 1% pyrithione zinc and a combination of both on hair density: a randomized controlled trial. Br J Dermatol. 2003 Aug;149(2):354-62.