Ketoconazole Shampoo for hair loss

Male pattern baldness, also called androgenetic alopecia (AGA), is the most common form of alopecia found in men. In male pattern baldness, the hair follicles shorten the anagen (growth) phase and reduce follicle size. The main androgen responsible for these changes to the hair follicle is dihydrotestosterone (DHT). Testosterone is converted to DHT by an enzyme, 5-alpha reductase (5AR). 

Research suggests that ketoconazole shampoo may be beneficial for men and women with dandruff and hair loss associated with androgenic alopecia. In this article, we explore

• How effective is Ketoconazole for male pattern baldness?
• Should you use 1% or 2% Ketoconazole shampoo and 
• Will ketoconazole shampoo help with hair loss?

What is Ketoconazole?

Ketoconazole is an anti-fungal medicine that also has anti-inflammatory and some DHT-reducing properties. Ketoconazole shampoo is commonly used to treat a scalp fungal infection caused by Malassezia spp. overgrowth and skin flaking from seborrheic dermatitis.

A study published in 1998 comparing Ketoconazole 2% shampoo with and without Minoxidil therapy showed that Ketoconazole 2% have similar efficacy to minoxidil 2% by increasing hair density and hair shaft diameter. There was a reduction in sebum levels in the Ketoconazole group, but not in the Minoxidil group, suggesting that reducing scalp oiliness might improve alopecia.

Will Ketoconazole shampoo help with hair loss?

Malassezia overgrowths and seborrheic dermatitis are often observed alongside pattern hair loss. These conditions lead to more sebum production and scalp flaking (i.e., dandruff), and thereby may accelerate AGA by increasing overall scalp inflammation. 

 If you have either of these conditions, adding Ketoconazole 2% shampoo to your hair loss regimen can help improve hair count by reducing inflammation to the hair follicles.

References:

• Pierard-Franchimont, C et al. Ketoconazole shampoo: effect of long-term use in androgenic alopecia. Journal of Dermatology (1998);196(4):474-7. doi: 10.1159/000017954.
• Rafi, A et al. Pilot Study of 15 Patients Receiving a New Treatment Regimen for Androgenic Alopecia: The Effects of Atopy on AGA. Journal of Dermatology (2011). doi: 10.5402/2011/241953.