Can nizoral shampoo help with hair loss?

Doctor Answers 3

Ketoconazole shampoo - does it help hair loss?

Ketoconazole shampoos (Nizoral, etc) promote hair growth

etocaonzole is an antifungal agent and effective for the treatment of seborrheic dermatitis and "dandruff". But research over the past many years has suggested that they help hair loss as well. I often recommend that individuals with genetic hair loss consider use of anti-inflammatory shampoos. Whether these shampoos benefit other types of hair loss is not clear. If you are not sure what type of hair loss you have, please check with your physician. 

What were the results of ketoconazole studies for genetic hair loss?

A 21 month study compared the use of topical minoxidil to ketoconazole 2 % shampoo. Study participants received the 2 % shampoo or an unmedicated shampoo with or without minoxidil 2 %. Interestingly, hair density and follicle size improvements were similar with both ketoconazole and minoxidil regimens.

How do ketoconazole shampoos help hair loss?

The means by which topical ketoconazole helps hair density and hair growth is unclear, but may be due to is anti-inflammatory effects against T cells and the yeast of the scalp which create inflammation (Malassezia yeast). Ketoconaozle also inhibits steroidogenesis and decreases DHT levels.

Medical References

Inui. J Dermatol Sci 2007; 45: 66-8.

Pierar Franchimont Dermatology 1998; 196: 474-7

Nizoral shampoo for hair loss

Dear tommy10,

Your question is excellent. In general, the four-pronged approach most hair loss physicians will use medically to attack genetic male pattern hair loss will include anti-androgen oral medication such as propecia, combined with minoxidil or vasodilatation to increase blood flow to the area, in combination with high-fluence, low-level light therapy and medicated shampoos. Under the medicated shampoo category Nizoral, which is trade name for ketoconazole, is an antifungal agent. As there is some evidence in the literature that the antifungal agent does in fact help hair growth, it may be equivalent to low-strength minoxidil. The actual mechanism of how the antifungal agent enhances hair density and male pattern hair loss is uncertain, although it may decrease the dihydrotestosterone levels.

When seeking solutions, both medical and non-surgical as well as surgical options for male pattern hair loss, it is important to seek physicians with a lot of experience in this area and ketoconazole would be a more specialized prescription, likely from a dermatologist with expertise in scalp conditions and in pattern hair loss.

At our centre, we specialize in hair transplantation, having abandoned the older surgical strip graft technique seven years ago for the high-tech, more modern rotatory and robotic harvesting techniques known as NeoGraft® and ARTAS®. These leave a linear scarless donor site and allow patients to wear their hair short at the back of their occipital donor area and to re-access this site several times over the course of their male pattern hair loss to harvest implantable follicular units as required.

I hope this information has been of some assistance and and best of luck in your medical management of your pattern hair loss.

For more information, please review the link below.

R. Stephen Mulholland, M.D.
Certified Plastic Surgeon
Yorkville, Toronto

R. Stephen Mulholland, MD
Toronto Plastic Surgeon
4.7 out of 5 stars 80 reviews

Inflammation and Hair Loss

If you are suffering from scalp inflammation as manifested by seborrhea, dandruff or an otherwise very highly active scalp, then the Nizoral or other  similar shampoos may help you.  Dr. Donovan's response is very well written and explains this issue concisely.

John E. Frank, MD
New York Hair Restoration Surgeon
4.9 out of 5 stars 47 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.