Does Ketoconazole Work as a Hair Loss Treatment?

Sun 11 Nov 2007

Ketoconazole for Hair Loss:

Though there is no shampoo to date that has been FDA approved as a hair loss treatment, there is some scientific evidence to suggest that ketoconazole, an ingredient found in shampoos such as Nizoral and Revita may help combat hair loss due to its “weak” anti-DHT binding properties in the scalp to hair follicles.

Ketoconazole when ingested orally, inhibits the binding of androgens to receptors in the body which includes the binding of dihydrotestosterone (DHT)  to hair follicle receptors.    It is NOT recommended to take ketoconazole orally  because it  is a toxin that will most likely cause liver damage.

Because ketoconazole seems to work quickly (if at all) when applied topically  compared to  other DHT inhibitors such as Propecia, it is suspected that ketoconazole may combat alopecia due to it’s  sebum removal properties.   Sebum is a fatty substance that accumulates around the hair follicles in the scalp.     It has been speculated that the removal of sebum may help  unclog the hair follicle (similarly to unclogging a drain), improving blood supply and exposing it to more nutrition.   Topical ketoconazole is known for removing and reducing  sebum deposits.

I would suspect that ketoconazole may be a weak stand alone hair loss treatment (though it’s still better than nothing at all), however, it may indeed be a nice compliment when used in conjunction with Propecia  (finasteride) and/or Rogaine  (minoxodil).

Below is the “abstract” of the study performed on ketoconazole 2%:


Hair Loss Study Abstract: Ketoconazole shampoo: effect of long-term use in androgenic alopecia (genetic hair loss).

Authors: Pierard-Franchimont C. De Doncker P. Cauwenbergh G. Pierard GE.
Institution: Department of Dermatopathology, University of Liege, Belgium.
Title: Ketoconazole shampoo: effect of long-term use in androgenic alopecia.
Source: Dermatology. 196(4):474-7, 1998.


BACKGROUND: The pathogenesis of androgenic alopecia is not fully understood. A microbial-driven inflammatory reaction abutting on the hair follicles might participate in the hair status anomaly.

OBJECTIVE: The aim of our study was to determine if ketoconazole (KCZ) which is active against the scalp microflora and shows some intrinsic anti-inflammatory activity might improve alopecia.

METHOD: The effect of 2% KCZ shampoo was compared to that of an unmedicated shampoo used in combination with or without 2% minoxidil therapy.

RESULTS: Hair density and size and proportion of anagen follicles were improved almost similarly by both KCZ and minoxidil regimens. The sebum casual level appeared to be decreased by KCZ.

CONCLUSION: Comparative data suggest that there may be a significant action of KCZ upon the course of androgenic alopecia and that Malassezia spp. may play a role in the inflammatory reaction. The clinical significance of the results awaits further controlled study in a larger group of subjects.


I hope this helps.

Associate Publisher of the Hair Transplant Network and the Hair Loss Learning Center
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4 Comments so far:

  1. Steven says:

    The above article mentions Ketoconazole and Nizoral as the shampoo that uses the Ketoconazole in 1% over the counter. Another ketconazole shampoo that I have been using instead of Nizoral is Regenepure DR. The difference is that Regenepure does not have harmful cleansers like sulfates. Regenepure has other beneficial ingredients that are all spelled out on their website. I am a firm believer in Regenepure DR.It also make my hair thicker immediately after the first use!

  2. Mike says:

    Since when does the FDA license anything that doesn’t make big bucks for the Pharma industry? I have found that Keto (in cream form, as well as shampoo)is a great anti hair loss treatment.

  3. Mike says:

    @ “Steven”. Making the hair shaft appear “thicker” will not stop hair loss. That effect, although desirable, is just temporary / cosmetic. I guess you must be linked to “Regenpure” commercially as it’s expensive and pretty average. I’d recommend the topical use of Keto in cream form.

  4. Tony says:

    I have been using Regenepure DR for almost a
    Year now and I DEFINITELY have more hair growth. I used to
    Have hair in the drain often, now none! It does make my hair dry out but
    I would rather have the dry hair than hair loss!

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