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Fluconazole
Potential efficacity for hair loss : ⭐⭐⭐⭐⭐

My recommendation

I believe that Fluconazole could be a highly effective treatment for Tinea capitis, serving as an alternative to treatments such as Griseofulvin and terbinafine.

It could also be utilized in cases of seborrheic alopecia caused by seborrheic dermatitis.
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Fluconazole

Fluconazole is an antifungal drug that works by preventing the growth and spread of fungi that can cause infections. Fluconazole works by interfering with the cell membranes of fungal cells, damaging the cell walls and preventing the fungus from growing and thriving.

It is used to treat fungal infections like:

  • Candidiasis (thrush)
  • Cryptococcal meningitis
  • Coccidioidomycosis
  • Histoplasmosis
  • Infections caused by susceptible strains of Candida and Cryptococcus

By disrupting fungal cell structures, fluconazole kills fungi or stops fungal overgrowth, helping to clear up uncomfortable fungal infections in the body. It’s an effective oral treatment usually well-tolerated.

Is it effective against hair loss?

To date, we have studies that confirm the effectiveness of fluconazole in cases of Tinea Capitis, a form of scarring alopecia. We also have studies demonstrating its efficacy against seborrheic dermatitis, implying that it will be effective in cases of hair loss related to this condition.

Incidentally, according to some case studies, fluconazole could potentially cause hair loss in certain individuals. However, researchers do not unanimously agree on this matter.

Fluconazole in the treatment of Tinea Capitis

Some forms of scarring alopecia are caused by fungal infections and can take on very severe forms. Generally, oral antifungals are used along with antifungal shampoos such as ciclopirox.

Here is an example of cicatricial alopecia of the Tinea Capitis type :

Antifungal medications such as griseofulvin or terbinafine are considered the best treatments for this type of alopecia. However, in some cases where infections are resistant, other antifungals like Fluconazole may be used.

We have numerous studies on Fluconazole and Tinea-type infections. This includes infections that occur on various areas of the body and not just the scalp.

Here is one of them:

2014 study : Griseofulvin vs fluconazole in tinea capitis

In a 2014 study, researchers conducted a comparison between Fluconazole and Griseofulvin as treatments for tinea capitis (tinea infection on the scalp). Their objective was to determine which medication proved to be more effective and safer in addressing this condition.

The study involved 60 children, aged 3 to 16 years, who were afflicted with tinea capitis. These children were divided into two distinct groups:

  • Group A : Griseofulvin 10 mg/kg per day for 6 weeks
  • Group B : Fluconazole 5 mg/kg per day for 6 weeks

The findings revealed that, after a span of 12 weeks, a higher number of patients in the Fluconazole group exhibited a noteworthy improvement in their condition compared to those in the Griseofulvin group. Furthermore, fewer adverse effects were reported among the subjects receiving Fluconazole.

In summary, it can be concluded that Fluconazole represents a superior treatment option for tinea capitis. This assertion is based on its higher efficacy, quicker onset of action, reduced occurrence of side effects, and improved patient compliance when contrasted with Griseofulvin.

Fluconazole in the treatment of seborrheic dermatitis?

Seborrheic dermatitis is a common skin condition that causes flaky, dry, white to yellowish scales on oily areas of the skin. It commonly affects the scalp, causing red, itchy, and greasy flaking that can lead to seborrheic alopecia – a form of hair loss due to inflammation from seborrheic dermatitis.

The prevailing theory posits that seborrheic dermatitis springs from an inflammatory response to the overproduction of Malassezia fungus. Fluconazole is an antifungal medication that has the capability to eradicate these types of fungus.

We have several studies that mention these effects, here are a few examples  :

  • 2009 : oral fluconazole 200mg weekly has been effective in treating seborrheic dermatisis on four patients suffering from a Malassezia spp. overgrowth
  • 2012 : In this two-year study at a medical university in Bangladesh, 65 patients with seborrheic dermatitis were treated with a weekly dose of oral fluconazole for 4 weeks. After 4 weeks of treatment, 35% showed very good improvement, and after 8 weeks, 39% showed very good improvement. 
  • 2006 : In this study, one group of patients took oral fluconazole (50 mg/day ) and applied a corticosteroid cream. At the end, 31.5% of the patients were cured and 68.5% showed clinical improvement. 

Closing thoughts and verdict

I believe that Fluconazole could be considered as a potentially effective treatment for Tinea Capitis, provided that treatments such as griseofulvin and terbinafine have been tried first.

As for seborrheic dermatitis and the resulting seborrheic alopecia, Fluconazole proves to be an effective treatment. Whether it’s used in combination with other treatments or not, the results are consistently positive.

Precautions & side effects

Side Effects:

  • Nausea, vomiting, diarrhea
  • Abdominal pain
  • Headache
  • Rash
  • Liver problems

Precautions:

  • Tell your doctor if you have liver or kidney disease
  • Can cause birth defects – avoid taking if pregnant
  • Interacts with many medications like warfarin, phenytoin, HMG-CoA reductase inhibitors
  • Monitor liver function if taking for a long time
  • Avoid driving or operating machinery if dizziness occurs
  • May cause sun sensitivity – use sunscreen
  • Call your doctor if rash, itching, or swelling develops
  • Drink lots of fluids while taking to prevent dehydration/electrolyte imbalance

Treatment analyses

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