When you're experiencing hair loss, there are lots of products you can use to help slow down the rate of loss and to make hair grow fuller and thicker. One of those products is ketoconazole. Ketoconazole is most commonly advertised as an over-the-counter solution for forms of dandruff caused by dry scalp and seborrheic dermatitis, but it may also support healthy hair growth.
You can access ketoconazole in shampoo form, gel form, cream, and more. If you're looking for an effective way to stop hair loss and stimulate hair growth, here's what you should know about how ketoconazole can help you with hair loss.
Does Ketoconazole Shampoo Work to Stop Hair Loss?
According to recent research, ketoconazole can significantly improve symptoms of androgenic alopecia, which is a common type of hair loss that occurs in both men and women.1 Not only has ketoconazole been shown to stop hair loss, it has also been shown to result in a significant amount of hair growth when used in conjunction with other products known for treating alopecia.
In one study, researchers aimed to determine if the long-term usage of ketoconazole could improve androgenic alopecia. This was based on ketoconazole’s effect on scalp microflora and its natural anti-inflammatory properties. Researchers compared the effects of 2% ketoconazole shampoo to regular shampoos without ketoconazole. Both shampoos were used either with or without 2% minoxidil (a medication designed to promote hair growth). Results of the study found that the combination of ketoconazole and minoxidil increased hair size and density and improved overall proportion of anagen hair follicles. Ketoconazole also reduced excess sebum levels.7
In a mouse study, researchers aimed to compare the effects of ketoconazole, minoxidil, and minoxidil with tretinoin on hair growth in mice. Four groups of seven-week old mice had their fur coated with either 2% ketoconazole solution, 5% minoxidil solution, minoxidil with 0.1% tretinoin solution, or 95% ethanol solution (the control). These were applied once a day for a total of three weeks. Researchers photographed the areas treated and calculated the ratio of regrown coat areas. Results of the study found that all three of the treatments significantly increased hair growth compared to the control group, the most effective treatment being minoxidil.8
How Does Ketoconazole Help Stop Hair Loss?
The causes of androgenic alopecia and other types of hair loss are not fully understood yet. However, researchers believe that ketoconazole may be extremely effective in combating hair loss because it takes significant action on Malassezia yeast - a type of fungus that can cause dandruff, cause an inflammatory reaction on the scalp, and worsen hair loss.3
In an open, randomized parallel-group trial, researchers aimed to compare the effects of 1% ketoconazole and 2% ketoconazole shampoo formulations on dandruff and seborrheic dermatitis. A total of 66 subjects with seborrheic dermatitis or severe dandruff were randomly assigned to either 1% or 2% ketoconazole formulations for four weeks followed by a four-week follow-up. Efficacy was evaluated based on fungal counts and clinical assessments.
The 2% formulation was significantly more effective than the 1% formulation in decreasing Malassezia fungal counts and general flakiness. During the follow-up, those who had used the 2% ketoconazole formulation also showed fewer relapses. This all suggests that topical ketoconazole is effective in reducing severe dandruff and seborrheic dermatitis in the scalp and that the effects are related to the concentration of the formula.11
Several reports also suggest that ketoconazole has powerful anti-inflammatory effects. One study tested this hypothesis by applying both living and dead Staphylococcus aureus to the backs of guinea pigs, resulting in inflammation, hyperkeratosis, and erythema. Researchers then applied either 0.5% or 2% ketoconazole formulations to the backs of the guinea pigs once per day, either on its own or with 1% hydrocortisone acetate.
Researchers found that, in animals with dead Staphylococcus aureus, topical ketoconazole had anti-inflammatory effects comparable to hydrocortisone acetate. Ketoconazole activity on living bacteria was even more effective and apparent than that of steroid therapy. This suggests that topical ketoconazole has anti-inflammatory activity in addition to antibacterial activity.12
Other studies also suggest that ketoconazole hair loss solutions act as a DHT blocker. DHT, or dihydrotestosterone, is a natural hormone that has necessary functions in the human body. Unfortunately, excess levels of DHT have been linked to hair loss in men and women in addition to prostate issues in men. In terms of hair, high levels of DHT may gradually shrink the hair follicle, which results in a shortened growth phase and lengthened rest phase. This ultimately prevents the growth of new hairs and contributes to male pattern baldness.9
In one study from 2007, researchers found evidence that suggests that a 2% ketoconazole shampoo has DHT Blocking ability by blocking androgen receptors. This mechanism would prevent DHT from binding to hair follicles which could potentially prevent hair loss and support healthy hair growth.10
How to Use Ketoconazole Shampoo for Hair Growth
Try shampooing as little as often, 3-4 times per week to minimize dryness and irritation of the scalp. Keep a close eye on the ingredients in your ketoconazole shampoo for dandruff. Sulfates, which include sodium lauryl sulfate and sodium laureth sulfate, are commonly included in shampoos and other personal care products as a detergent agent. This allows for a thicker lather to create the illusion of a deeper clean. However, sulfates can irritate sensitive skin and may potentially dry out your scalp.13
Use a quality conditioner after every time you shampoo. Choose a conditioner infused with oils such as argan, coconut, or jojoba to help protect scalp and hair. Jojoba oil best mimics human oil (sebum). Peppermint oil has been found to effectively promote hair growth.
In a four-week trial, mice were given a topical solution of either saline, jojoba oil, minoxidil, and peppermint oil. Researchers evaluated these applications based on hair growth, histological analysis, and known biomarkers of enhanced hair growth. Of these groups, the one that used peppermint oil showed the most significant hair growth effects, including increased follicle numbers and depth and greater dermal thickness. This suggests that peppermint oil may stimulate a rapid anagen (growth) stage.14
Ketoconazole shampoo side effects are minimal, and it is generally safe for use. When used in conjunction with essential oils, a DHT Blocker, and minoxidil, ketoconazole shampoo can improve hair regrowth more than using the other products alone.6
- https://www.ncbi.nlm.nih.gov/pubmed/16997533 https://www.ncbi.nlm.nih.gov/pubmed/11306850