Ketoconazole Shampoo for Hair Loss: Does it Work?

ketoconazole formula and nizoral shampoo

Often, for many people all over the world, hair loss can sometimes leave them feeling depressed and a low sense of confidence within themselves. You see, good hair is one of the essential additives for improving anyone’s aesthetic value, overall good looks, and of course, their self-esteem.

Nevertheless, you shouldn’t be worried about losing all of your hair yet, because we and we will discuss one of the best remedies that you can use for hair loss. You are not alone! Many are dealing with the same struggle, but now, it’s time to change all of that.

Though one thing can be for sure, there are many different products out there for managing and dealing with hair loss. Wrap your mind around how these hair loss solutions can range from natural products, such as apple cider vinegar, to an assortment of over-the-counter drugs.

A great example of one of these drugs is called ketoconazole, which is the main ingredient of shampoos that are specifically made to treat infections, such as fungal infections.

dandruff on the scalp

When ketoconazole is applied directly to the skin, it will help to treat the areas on the scalp, or anywhere on your skin that might, or already is, presenting the issue of you feeling scaly, dry, and uncomfortable.

At this point, we can see how over the past few years, ketoconazole shampoo for hair loss problems has been increasingly receiving more and more attention every day.

Nizoral is the most commonly used ketoconazole shampoo brand for treating hair loss.

But, does it really work? Is there any scientific evidence to back up its use and prove that this product works? What are the potential side effects of using this to treat your hair loss and better yet, how do you use it?

This is the ultimate and in-depth guide to help you understand the importance of the use of ketoconazole and the effects it can have when trying to treat hair loss. Read on and learn all of the facts you need to know to deal with your hair loss.

What is ketoconazole?

Ketoconazole is a prescription medication that is primarily used to treat fungal infections. Technically, it has been classified pharmacologically as an antifungal drug.

It works by managing different forms of fungal infections such as ringworm, candidiasis, and seborrheic dermatitis, which are all more common amongst people than you’d think.

We did come to learn that treating fungal infections is not the only possible indication of using ketoconazole. If you did not know already, ketoconazole is a common ingredient that you will find in most hair loss shampoos.

Can ketoconazole shampoo prevent hair loss?

woman before and after hair loss illustration

Most of the scientific studies that were done when it came to the drug, ketoconazole, have indicated that it does have some inhibitory effects on the loss of hair. However, at this point, there isn’t a massive amount of data on this mechanism, despite the positive results that have been observed and experienced by the ones who suffer from hair loss.

However, note that its effectiveness usually comes down to the ones you can find in the well-established medications for hair loss, such as pharmaceutical drugs: minoxidil and finasteride.

Despite that, one 1998 PubMed comparative study has evaluated the effectiveness of ketoconazole when compared to minoxidil. Researchers were able to find out that 2% of ketoconazole shampoo used for hair loss is sufficient to provide similar results as 2 % minoxidil spray.

In addition, several animal-based studies produce results that are hoped for, that was posted in the International Scholarly Research Notices Journal, which proves that using ketoconazole on a regular basis will significantly increase the rate at which your hair grows.

Thus, it already seems that ketoconazole has some proven effectiveness in managing the issue of hair loss. This study demonstrates that both, ketoconazole and minoxidil, have potent stimulatory effects on the growth of hair and are proven to be very useful when it comes to the management of androgenic alopecia.

Nevertheless, with all of the information that has become available because of these studies, minoxidil is still proven to be more effective.

How does ketoconazole help with hair loss?

man holding nizoral shampoo illustration

While there is an impressive amount of data that supports the use of ketoconazole for stopping and treating hair loss, the mechanism is still not understood to the extent that it could.

As a result, there is no conclusive evidence on the exact mechanism of action, but there are a few researchers who have come up with some of their hypotheses.

1998 PubMed study, which compared the effects of ketoconazole and minoxidil, concluded that ketoconazole stimulates the anagen phase of hair follicle growth. This is very important as the Anagen phase is the active growth phase of hair follicles, which in turn, begins to point out how effective using ketoconazole to treat hair loss really can be.

Traditionally, the human body produces a hormone called dihydrotestosterone, which is abbreviated as ‘DHT’. This hormone is an androgen and is the one that ends up being responsible for the nightmare that we all know as hair loss, especially when it comes down to individuals who are genetically predisposed to baldness.

The constant stimulation by that is being produced by DHT and may eventually cause these follicles to stop producing any hair at all. In such circumstances, your doctor is more than likely going to prescribe you to a drug, such as finasteride, which works by inhibiting the formation of DHT.

The overall outcome is apparent, especially when the hair loss is due to the damage of the hair follicles by DHT.

In some studies that were conducted, it is suggested that ketoconazole can actively inhibit the pathway that forms DHT. This is the reason why ketoconazole may slow down the loss of hair. However, this claim, unfortunately, can still only be viewed as a hypothesis as any conclusive evidence-based research has not substantiated it.

How to use ketoconazole shampoo for hair loss

use nizoral ketaconazole shampoo 2-3x a week

In order for you to benefit from ketoconazole shampoo like Nizoral, it is strongly advised that you use it every three days. That would add up to about three times a week. It is immensely important that you continue using this shampoo on a regular basis.

The reason for this is because if you caused any alterations in the sequence while using this product, it may not yield the results you are hoping for, and in this case, that means losing your hair.

Regardless, you can make use of the additive effects of medications that act in a similar manner, such as, combining Nizoral with finasteride.

On the alternate days, when you are not using ketoconazole shampoo, you can opt for other shampoos, just like Alpecin, to ensure that you develop a holistic approach towards managing and treating your struggles with hair loss.

The best time for you to use ketoconazole shampoo for hair loss prevention is immediately when you get into the shower. Apply first, then rinse quickly. You can then apply it for a second time, but be sure to let it stand for some time and soak while you focus on the rest of your shower.

The reason why you should follow the procedure above is that you have to allow enough time for the shampoo to act upon the areas where you applied it. You can then go ahead and rinse it off with cool water once you have finish showering.

In most cases, your doctor will be the one who will instruct you on how to use your ketoconazole shampoo, especially the 2% formulation, which is a prescription medication (for those who did not know already).

Different formulations

ketoconazole chemical formula

For example, Nizoral shampoo is currently available in two major formulations. There is the one percent formulation, and then there is the two percent formulation. The two percent formulation has been proven to be similarly effective to the minoxidil 2 % spray and is more preferred.

Through all of this, there is still a significant downside when it comes down to the two percent formulation. It was finally determined that the high concentration makes it, so it has more potential side effects in comparison to the one percent formulation.

The one percent formulation can be found at most local stores and can be purchased over-the-counter. It is also very effective for the management of hair loss because of the simple fact that it doesn’t have any significant side effects when being compared with the two percent formulation.

Potential side effects

man with a loudspeaker illustration

Let me help you clear up one misconception that may have been troubling you for quite some time now.

Random online searches can provide you with numerous side effects, and this may discourage you from using ketoconazole, but here is the real deal:

There is a noticeable difference between using ketoconazole topically, rather than using ketoconazole orally. This vast difference is that most people who search online don’t always put these things into account, or ever even really think about it.

The side effects of ketoconazole are very adverse when it is administered orally. They can occasionally be so serious that the Food and Drug Administration has put some restrictions on the oral use of ketoconazole.

So, what’s the good news?

These adverse side effects and restrictions that were put in place by the FDA are not applicable in ketoconazole formulations that are used topically. Topical formulations of ketoconazole are sold as shampoos, gels, creams, and foams.

But here are the things you should be keeping an eye out for:

Most drugs are not safe to take during pregnancy unless a certified doctor authorizes them. It is advised that you do not use ketoconazole shampoo when you are pregnant before receiving authorization from your primary care doctor.

Pharmacologically speaking, certain medications are known to interact with each other when administered concurrently. For instance, there are several drugs that will interact with the ketoconazole shampoo.

Therefore, if you are on any treatment regimen with another medication, please inquire with your doctor to see if it is safe for you to use Nizoral.

Moreover, you should carefully monitor how your body responds to therapy with ketoconazole. At times, sensitive individuals may experience allergic reactions. If you notice that your face is suddenly becoming swollen or you are having difficulty breathing after taking using ketoconazole, then you should stop immediately and seek prompt medical attention.

Other manifestations of an allergy to ketoconazole shampoo include severe itching, rash, swelling in the tongue and throat, and dizziness.

Also, try to consider that the safety of ketoconazole has not been observed or studied well enough in children below the age of 12 years. As a result, you should not administer any ketoconazole products to your children if they are under the age of 12 years.

Mothers who are breastfeeding should also be wary about using ketoconazole and should contact a doctor for advice before use.

Cost and availability of Nizoral shampoo

nizorall shampoo bottle with price tag

Creams are the most commonly prescribed formulations, though the shampoos and ointments are always available over-the-counter. Of all the different brands of ketoconazole shampoo available in the market, Nizoral is now the most common. It is available in both one percent and two percent formulations.

The cost of Nizoral can be somewhat pricey. An 8 oz. bottle costs about $15.00. Conveniently, you will only have to use this product a few times a week. The intermittent use ensures that you maintain a longer duration of therapy, which is sufficient to manage your condition.

The takeaway

For safety purposes, only use ketoconazole shampoo for hair loss as instructed by a professional doctor or pharmacist. Maintain a regular regimen while also making a point not to use it more often, or less frequently.

When used correctly, you are more than likely to start observing results within two to four weeks after the initiation of treatment. Consequently, if you haven’t noticed any change within a month, then you should contact your doctor and inquire about whether you should consider another treatment plan.

If you are part of the percentage of individuals whose skin type does not respond to ketoconazole shampoo for relief hair loss, do not lose hope. There are still other solutions. Some of the alternatives that you can try are shampoos that contain: salicylic acid, coal, tar, and pyrithione zinc.

  • Aldhalimi, M. A., Hadi, N. R., & Ghafil, F. A. (2014). Promotive effect of topical ketoconazole, minoxidil, and minoxidil with tretinoin on hair growth in male mice. ISRN pharmacology, 2014. DOI:
  • Pierard-Franchimont, C., De Doncker, P., Cauwenbergh, G., & Pierard, G. E. (1998). Ketoconazole shampoo: effect of long-term use in androgenic alopecia. Dermatology, 196(4), 474-477. DOI:
  • Perez, B. H. (2004). Ketocazole as an adjunct to finasteride in the treatment of androgenetic alopecia in men. Medical hypotheses, 62(1), 112-115. DOI:

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