In the world of hair loss treatments, ketoconazole began life as an anti-dandruff remedy. Not long after its introduction, scientists began to see that its ability to tackle fungi and reduce inflammation allows it to play a role in reducing hair loss and promoting hair growth. Understanding more about this substance, where you’ll find it, and which conditions it treats will help you decide whether to use it to regrow your hair.
What is Ketoconazole?
Ketoconazole belongs to a group of medications called the ‘azole antifungals.’ It’s available as an oral and topical medication, with the aim of treating certain fungal conditions. Its role is to stop the growth of fungus, but you must remain wary of applying the wrong product to your skin, as it can irritate.
Shampoos that contain ketoconazole stop fungus from spreading by killing their cell membranes. In other words, they break down the cell walls. When the fungi no longer have active cell walls, they find it difficult to spread. It achieves this by stopping them from producing a substance called ‘ergosterol,’ which they need to prevent holes from appearing in the cell membrane.
When holes appear in the cell membrane, substances that fungi would otherwise love to keep out start to filter in. Interestingly, scientists have found the ergosterol serves similar purposes to cholesterol.
What is Ketoconazole used for?
In the hair loss world, ketoconazole treats dandruff. By proxy, it also reduces the flakiness, scaling, and itching that comes with the condition. In 1993, clinicians began testing its efficacy. One study published in the American Journal of Dermatology found that it significantly reduced dandruff amongst participants. At the time, Selenium Sulfide was the treatment of choice for reducing dandruff. Not only did the study reveal that ketoconazole was just as active, but it also demonstrated that there were fewer side effects.
Medics may also use it to treat a condition called Pityriasis, which causes patches of the skin to become scaly and discolored. Over time, this disease causes patients to experience spots of discoloration throughout their skin. While this condition doesn’t usually arise on the scalp, those who suffer with it can apply a ketoconazole shampoo, allow it to settle in for a few minutes, and rinse it off to treat the condition.
Ketoconazole for Hair Loss: The Link Between the Two
After identifying its success in treating dandruff, scientists began looking into its ability to manage seborrheic dermatitis. They found that using a shampoo containing a 2% concentration for two to four weeks resulted in an 88% reduction in the condition. When the study’s participants continued to use it following the end of the trial period, their hair loss didn’t return.
It’s therefore fair to assume that ketoconazole is useful for treating seborrheic dermatitis. As this is a condition that involves temporary hair loss, using ketoconazole ability to break down the cell membrane of fungi will restore any temporary hair loss you encounter.
Ketoconazole and DHT receptors
A further study looked into the possibility that it could treat androgenic alopecia too. Unlike dandruff and seborrheic dermatitis, androgenic alopecia involves hair loss as a result of producing too many DHT receptors. It’s usually a genetic condition, which causes the hair loss we see with male pattern baldness.
Those who suffer from androgenic alopecia experience some physiological processes:
- The hair follicles shrink in size
- Their hair follicles spend less time in the anagen phase of hair growth, which is where it grows long and thick.
- Instead, they spend more time in the telogen phase of hair growth, which is where the follicles remain dormant.
- Because of this, the terminal to vellus hair ratio drops. Terminal hair is the hair that’s thick and strong, whereas vellus is thin and wispy.
For reasons we don’t understand, the terminal to vellus hair ratio will then increase in other areas of the body. One study from Japan found that those who have androgenic alopecia also have higher lipid profiles. When we have high lipid profiles, we’re even more likely to encounter harmful inflammatory processes that don’t allow cells to thrive or heal. As high serum lipid concentrations have a connection with increased inflammatory markers, it’s clear our hair follicles need all the help they can get.
How does Ketoconazole shampoo work?
As we’ve already mentioned, ketoconazole shampoo breaks down the fungi’s cell membrane. However, to understand how that’ll reverse your temporary hair loss and how it may address androgenic hair loss, you need to know more about why fungal conditions produce these effects in the first place.
Dermatitis, dandruff, and hair loss
As we’ve already discussed, ketoconazole works its way into the cell membranes of fungi and breaks them apart by stopping them from producing their form of testosterone. When the fungus is present on your scalp, it induces inflammation, which reduces your scalp’s ability to grow hair.
This is especially troublesome if you develop ‘folliculitis.’ As a condition that’s difficult to distinguish from seborrheic dermatitis, folliculitis can lead to permanent hair loss when you don’t treat it quickly enough. As such, disrupting the membranes of the fungi causing your dermatitis or dandruff reduces inflammation, with the following benefits:
- Your scalp’s follicles become healthier, allowing for better hair growth
- You slow down the inflammatory processes, which means you reduce the risk of permanent damage to the hair follicles
Ketoconazole, Androgenic alopecia, and hair loss
While you may feel as though Minoxidil is your best bet when it comes to reducing the effects of androgenic alopecia, don’t write Ketoconazole off entirely. In the study we mentioned earlier, the participants found that it was just as efficient as Minoxidil for strengthening the hair follicles, shifting them into the right growth stage, and increasing the type of hair growth.
There are several reasons for this:
Ketoconazole reduces inflammatory processes at the scalp. As androgenic alopecia causes inflammation that results in weak hair growth, using this shampoo essentially fights against it.
For reasons the paper’s researchers didn’t understand, those with androgenic alopecia spent more time in the anagen phase of growth. This is where the hair follicle is priming itself for growing healthy hair.
Overall, it looks like using ketoconazole could have benefits for those with androgenic alopecia too as well as those with dermatitis.
Top three Ketoconazole Shampoo
If you feel like Ketoconazole will treat your hair loss, you want to make sure you pick the best product. As such, we’ve found the best ones on the market, and we’re going to explain why they’re so useful.
Hair surge contains a low ketoconazole concentration of 0.2%, which means you’re less likely to experience irritation if you have sensitive skin. Additionally, it contains caffeine. As studies demonstrate that caffeine successfully increases hair follicle size amongst those with androgenic alopecia, using caffeine alongside ketoconazole is ideal. Also, it contains saw palmetto. In studies that focus on testosterone’s role in prostate cancer, saw palmetto reduces testosterone levels. The same principle could apply to your scalp.
- Highly Effective Micro Blend Caffeine shampoo technology
- TOP RATED 2018 SHAMPOO FOR HAIR REGROWTH STIMULATION -
- Contains powerful caffeine compounds which have been shown to reduce hair loss, stimulate hair growth and block effects of testosterone within the skin
- Most effective topically available shampoo formula for men and women
- Made in the USA & Cruelty free (Never tested on animals)
In addition to its ketoconazole content, DS Labs Revita Shampoo contains Procyanidin B-2, which fights the free radicals we encounter in day-to-day life. As a result, you’re providing your follicles with extra protection while they’re healing from conditions such as dermatitis. Similarly, it contains emu oil, which can act as a DHT blocker. By blocking DHT at the earlier stage of androgenic hair loss, you increase your chances of reviving your hair follicles and encouraging growth. DS Labs Revita Shampoo also contains fewer human-made chemicals, which means you may prefer to use it if you like natural products, but you want to try ketoconazole too.
- Ds Laboratories Revita Hair Growth Stimulating Shampoo 925 Ml
With a higher concentration of ketoconazole than the Ultrax Labs product, Nizoral A-D Anti Dandruff Shampoo reduces inflammation faster, breaks down the fungi cell walls quickly, and potentially leads to a faster reduction of conditions such as dermatitis. Thanks to the higher ketoconazole concentration, you only need to use it twice a week.
- 7-fl. oz bottle of Nizoral A-D Anti-Dandruff Shampoo containing ketoconazole 1% to relieve flaking, scaling, and itching caused by dandruff
- This powerful dandruff control shampoo is made with ketoconazole 1%, an effective ingredient that is proven to help fight dandruff outbreaks
- Salon-tested, this dandruff treatment shampoo is specially formulated to be gentle and is safe enough to be used on color-treated, chemically processed and gray hair
- The rich, thick lather of this itchy scalp shampoo rinses clean, leaves hair smelling fresh and helps relieve scalps that are flaky, itchy and scaling
- The freedom will go to your head with our dandruff control shampoo, and by using it just twice a week in between your regular shampoos you'll experience effective dandruff relief
Does Ketoconazole come with any side effects?
While it’s rare for ketoconazole to induce side effects, you should stop treatment and consult a doctor if you experience any of the following:
As ketoconazole falls under FDA’s category C for pregnant and breastfeeding women, it’s not clear whether it will cause harm to them or not. As such, you should consult a doctor before using it. Finally, as the gel is flammable, don’t light a cigarette while it’s on your head.
Overall, ketoconazole is most appropriate for dermatitis conditions that affect the scalp. Its ability to deprive fungi of their cell wall strength reduces their presence, allowing your scalp to heal and hair to grow. At the same time, it has anti-inflammatory properties, which means it could mitigate androgenic hair loss too. There are plenty of over-the-counter products that contain ketoconazole. The one you choose should depend on the strength, which condition you’re treating, and whether you prefer to include natural products too. Finally, always follow instructions to the letter to see the best results.