Ketoconazole is a fairly popular antifungal medication that is used in the treatment of infections. And although it’s not marketed for hair loss, this ingredient has been used as a treatment for different types of hair loss.

There are a number of ways in which ketoconazole shampoo is believed to help with hair loss. And while there is promising research on it, it is still something you need to have realistic expectations about. In this guide, we’ll take a closer look at what ketoconazole shampoo for hair loss might be able to do for you.

Does Ketoconazole Regrow Hair?

Because of its believed ability to inhibit dihydrotestosterone (DHT) – the hormone associated with pattern baldness – as well its anti-inflammatory effect, ketoconazole might be able to help with hair regrowth. In some ways, it may work more directly, however, in others, it may help treat the underlying problem causing the hair loss.

Here are some ways in which ketoconazole may help with hair growth.

Helps Treat Seborrheic Dermatitis

Seborrheic dermatitis is a skin condition, the exact cause of which is not known. However, it’s believed to likely be the result of fungal overgrowth, particularly a type of yeast called Malassezia. This condition can result in inflammation, flakiness, itchiness, and dandruff as well as hair loss, among other problems, and ketoconazole shampoo is one of the treatments for it. Since it’s anti-fungal, it fights the fungus, and it also helps by reducing inflammation.

Helps Treat Pityriasis Versicolor 

Pityriasis versicolor, also known as tinea versicolor, is another fungal infection of the skin that’s caused by the overgrowth of yeast. In addition to causing itchiness and skin discolouration, among other problems, the condition can also cause hair loss (although this condition commonly affects the neck, trunk and/or arms, according to DermNet). And ketoconazole shampoo is used in the treatment of this condition as well.

May Block The Production Of DHT

It is thought that ketoconazole shampoo can also help with hair loss because of its ability to block the production of DHT. DHT is the hormone that results in the shrinking or miniaturisation of hair follicles in male pattern baldness or androgenetic alopecia.

According to a 2004 study published in Medical Hypotheses ketoconazole 2% shampoo could potentially impede the production of the DHT itself and/or the ability of the DHT to bind to AR (androgen receptors to which DHT binds, eventually causing hair loss).

However, the author proposed using ketoconazole as an adjunct (something that’s to be used together with the main treatment) with finasteride for androgenetic alopecia. Finasteride is an FDA-approved drug for hair loss and has quite a lot of research to support that it works. So, ketoconazole alone might just not be enough to give you satisfactory results for pattern baldness.

There’s also another study comparing topical ketoconazole with 2% minoxidil in the treatment of female pattern baldness. Published in Biomedical Dermatology in 2019, the researchers found that the 2% topical ketoconazole preparation resulted in an improvement, although it wasn’t seen until the 6th month – minoxidil’s could be seen at the 4-month mark.

However, again, it should be noted there needs to be more research into the potential of ketoconazole for the treatment of female pattern baldness. In contrast, minoxidil is also FDA-approved and has extensive research supporting its ability to treat different types of hair loss.

May Help With Telogen Effluvium

Telogen effluvium is a type of temporary hair loss that can be caused by a number of things, such as stress, major surgery, illness, trauma, nutritional deficiency, etc. It usually lasts for 3-6 months and can resolve on its own. However, it can still be quite distressing, and ketoconazole shampoo might be able to help.

One study published in the International Journal of Cosmetic Science found that telogen effluvium was controlled in patients who were treated with the 1% ketoconazole shampoo. Additionally, the researchers found that it also increased the thickness of the hair shaft. So, your hair might also look fuller as a result of this shampoo.

Does Ketoconazole Shampoo Cause Hair Loss?

Hair loss can be a side effect of ketoconazole shampoo. It may also cause some other side effects, such as:

• Itchiness
• Irritation
• Redness
• Oiliness or dryness
• Discolouration of the hair

The NHS also warns of the risk of a rare but “serious allergic reaction” from ketoconazole shampoo.

This is not the entire list of side effects that you might potentially experience from the use of ketoconazole shampoo. It’s important that you discuss it with a medical professional.

How To Use Ketoconazole Shampoo?

A ketoconazole shampoo may be used as follows:

1. Wet your hair.
2. Take a small amount of the shampoo (enough that it lathers well).
3. Let it sit for around 5 minutes.
4. Wash it off with water.

Since it can be drying, you may be advised to follow it up with a conditioner. Whatever you do, make sure you follow the usage instructions on the product or do what your doctor says.

How Often Should You Use Ketoconazole Shampoo For Hair Loss?

The frequency of usage may vary depending on why you’re using the shampoo in the first place. For instance, for seborrheic dermatitis, it’s “twice a week for 2 to 4 weeks” to make the symptoms go away, followed up by “once every 1-2 weeks” so that it doesn’t come back, per the NHS.

For pityriasis versicolor, their advice is to use the shampoo for up to five days, once a day. But, of course, you must consult with your doctor as the treatment plans can vary depending on the problem.

If you’re considering using it daily, it might not be such a good idea because of its potential to cause dryness. According to Nizoral Shampoo UK (Nizoral is one of the brand names of ketoconazole), using the shampoo every day may lead to even more irritation of the scalp, and you can see a difference by using it just “twice a week for 2-4 weeks.”

There are 1% and 2% concentrations of this shampoo, and while the 2% one is believed to give better results, there’s no evidence that “excessive usage of either” gives better results, as explained in a 2011 study published in ISRN Dermatology. So, you don’t need to use too much of it either.

How Long Does It Take For Ketoconazole Shampoo To Work For Hair Loss?

There’s no saying exactly when you’d start growing your hair if you’re using ketoconazole shampoo for hair loss. In the above-mentioned study on telogen effluvium, the researchers measured the results at the 6-month mark and reported an improvement.

On the other hand, if the hair loss is indirectly the result of seborrheic dermatitis, your hair should start to grow back once the condition is treated. It may also depend on the strength of the shampoo that you’re using, whether it’s 1% or 2%.

What Can You Use Instead Of Ketoconazole Shampoo?

With ketoconazole shampoo, you need to have realistic expectations, especially when it comes to the treatment of androgenetic alopecia, as the research on it is still not conclusive enough. There are, however, other hair loss treatments that your doctor may recommend instead, such as:

• Minoxidil
• Spironolactone
• Finasteride
• Dutasteride
• Low-level laser therapy
• Platelet-rich plasma injections

You should also discuss other non-surgical treatment options with your doctor. However, if you want to take the surgical route, you can consider getting a hair transplant, which can permanently cover your bald spots using your own hair.

Is Ketoconazole Shampoo Worth It?

Ketoconazole shampoo can be worth it as it’s used in the treatment of different fungal infections, which can indirectly cause hair loss. There’s also some evidence to suggest that it might help with androgenetic alopecia, but it needs more research. Still, your doctor may consider prescribing it as a supporting treatment. However, you should have realistic expectations from it.

Conclusion

Ketoconazole shampoo for hair loss does have some promising research, but there’s still quite a bit more that needs to be looked into before it becomes a more mainstream treatment for hair loss. It’s also not even marketed for hair loss at present. But it may still help with it either directly or indirectly.

If you are, however, experiencing hair loss, it’s very important that you consult an experienced medical professional, as alopecia can be caused by a number of factors. An effective treatment plan can be prepared following an accurate diagnosis.

Reviewed and approved by Trichologist Yaprak Yazan

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