Can Topical DHT Blockers like Finasteride or Ketoconazole Work for Hair Loss?
The latest trend in treating hair loss is using topical DHT blockers like finasteride for hair loss. Could they be helpful for fighting hair loss?
There are two ways to block DHT from causing hair loss. You can either prevent the production of DHT or block DHT itself from from interacting with hair follicles and causing hair loss. Blocking the production of DHT is accomplished by blocking the enzyme that produces DHT from testosterone. That enzyme is called 5-alpha reductase.
5-alpha reductase is usually blocked by taking medications and herbs orally but recently companies have started offering topical prescription DHT blockers such as finasteride. One meta-study1 reviewed 7 case reports, randomized controlled trials (RCTs), and prospective studies. All 7 studies noted positive results for finasteride used topically. Positive results included significant decrease in the rate of hair loss, increase in total and terminal hair counts, and positive hair growth assessments.
Unfortunately, finasteride is a controlled substance that requires a prescription so it does require a doctor’s visit or e-visit. Another problems with blocking 5-alpha reductase is that it is an indirect way of blocking DHT. DHT is not just produced in the scalp but it is produced all over the body2.
A more direct topical DHT blocker is ketoconazole. Ketoconazole is an antifungal medication used to treat a variety of fungal infections like dandruff. Ketoconazole also has anti-androgenic effects. It can inhibit the interaction between DHT and DHT receptors. Instead of blocking the production of DHT, ketoconazole blocks DHT from binding to hair follicles. Ketoconazole is also available over the counter without a prescription.
A review article that examined 5 human studies and found that ketoconazole produced positive results such as being able to increase hair shaft, increase pilary index (percent anagen phase × diameter), or demonstrate clinical improvement of androgenetic alopecia based on photographic assessment and subjective evaluation.
With this information in mind, we formulated our HairOmega Shampoo with ketoconazole along with biotin and saw palmetto to help support hair growth, reduce dandruff, and block DHT. It is a gentle sulfate-free formula to reduce inflammation and irritation which can also worsen hair loss.