Ketoconazole is a synthetic drug (typically prescribed) with various uses—anti-fungal cream, anti-dandruff shampoo, topical cream and oral tablet. Early research suggests that in the shampoo form, known as Nizoral, used with male pattern baldness may compare to minoxidil 2% (Rogaine) in effectiveness. One 1998 study indicates that hair density, size, and proportion of angina (growth cycle) follicles show similar enhancement when compared at ketoconazole 2% and minoxidil 2% when ketoconazole shampoo was used two to four times weekly. It’s important to note that there is no need to stop using minoxidil with the shampoo and in fact the combination of the two should be encouraged.
While experts are not certain how ketoconazole (Nizoral) works, they speculate that hormones and the immune system interact and injure hair follicles. Since ketoconazole is used to treat fungal scalp infections, scientists have hypothesized that it may reduce fungal and standard inflammation and, consequently, help prevent hair loss. However, other scientists believe it works as a DHT-blocker. Others believe that ketoconazole’s miraculous effect is due to its anti-sebum impact. Sebum is a fat that gathers around hair follicles in the scalp. Some have considered that by removing the sebum fats, it may aid in unclogging the hair follicle to allow more blood flow and better nutrition absorption.
Professionals agree on a couple of things, however. Ketoconazole’s may not be safe in oral form as opposed to topical use, since it’s a toxin that causes liver damage experts also agree that more research is needed. In 2005 experiments with mice indicate its possible efficacy in these animals. Anecdotal reports support hair loss benefits. However, the FDA has only approved it as a treatment for dandruff and seborrheic dermatitis (unclogging fatty glands around follicles).
Another positive point about ketoconazole’s use is its cosmetic affect. After one to two weeks of regular use, many have reported the hair seems thicker. This is unlikely in such a short period of time; however, with prolonged use, hair thickening may be viable. Like other non- surgical treatments, though, discontinued use results in a loss of the positive effects.
Side effects of ketoconazole in pill form include light headaches, which are normal at the onset of use, but, if they persist after every application, a professional should be contacted. These side effects are not present when the drug is used in shampoo form. Another early side effect is the possibility of shedding hair. This is often the precursor for many hair loss remedies before positive results are seen.
Finally, some experts believe that if ketoconazole is used in conjunction with other aids such as minoxidil or finasteride, its effectiveness may be improved. In reality, many hair loss sufferers use finasteride, minoxidil, and ketaconazole all together for optimal results.