Ketoconazole is an antifungal medicine that’s been shown to improve hair growth in studies. It’s also purported to have some effects on DHT, the hormone responsible for baldness in men.
While ketoconazole is a safe and useful addition to a hair loss prevention stack, it’s also not a miracle hair loss cure. Like many non-prescription hair loss treatments, there are a lot of myths and rumors out there about what ketoconazole can and can’t do for your hair health.
Below, we’ve listed some of the most common myths about ketoconazole as a hair growth and anti-hair loss treatment. We’ve also provided scientific evidence to provide the truth about most ketoconazole myths and explain how ketoconazole can fit into a hair loss prevention routine.
Myth 1: Ketoconazole is More Effective Than Minoxidil
One of the more common myths about ketoconazole is that it’s equally or more effective than proven hair loss treatments such as minoxidil.
The truth is that while ketoconazole is linked to an improvement in hair growth in some studies and even achieved equal results with minoxidil in one study, there just isn’t the same volume of data showing that ketoconazole is as effective as minoxidil.
With this said, most studies that test ketoconazole as a hair growth agent find that it does have a measurable effect on the growth of anagen hair follicles -- hair follicles that are in the active, growing phase.
If you want to improve your hair growth, a ketoconazole shampoo could be a good addition to your hair health stack. Just don’t assume that it’s more effective on its own than minoxidil, as there simply isn’t enough data to support that conclusion.
Myth 2: Ketoconazole Blocks DHT
Another common ketoconazole myth is that it blocks the conversion of testosterone to DHT, or dihydrotestosterone -- the male hormone that damages hair follicles and causes male pattern baldness to develop.
As of 2017, there isn’t any conclusive scientific evidence demonstrating that ketoconazole has any real effect on DHT levels in the body.
This means that you shouldn’t rely on ketoconazole shampoo as a DHT blocker. If your hair is starting to thin or recede and you want to lower your DHT levels, you’ll need to use a proven, FDA approved 5α-Reductase inhibitor like finasteride.
Our guide to DHT and male hair loss goes into more detail about how blocking DHT works to stop baldness, making it a worthwhile read if you want to stop baldness for the long term.
Although there isn’t any scientific evidence showing that ketoconazole blocks DHT, scientists think there could be a link between ketoconazole and the DHT pathway. A 2004 paper noted that ketoconazole could potentially cause local disruption of the DHT pathway.
While this isn’t conclusive proof that ketoconazole blocks local DHT, it is an interesting point to note. For now, it’s best not to rely on ketoconazole as a DHT blocker -- for that, you’ll need to use a proven, FDA approved treatment option like finasteride.
Myth 3: Ketoconazole Shampoo Can Regrow Lost Hair
Another persistent myth about ketoconazole is that it can cause you to regrow the hair you’re already lost due to male pattern baldness.
Like most myths, this one has an ounce of truth to it. While ketoconazole can’t regrow hair that has fallen out as a result of male pattern baldness, it can potentially help you regrow hair that’s thinned out as a result of seborrheic dermatitis.
Seborrheic dermatitis is one of several scalp conditions that can cause temporary hair loss. In this case, hair falls out not because of DHT, but because of scaly, oily and inflamed skin and an excessive amount of sebum that makes hair growth difficult.
Since ketoconazole is an effective treatment for seborrheic dermatitis, it’s easy to mistake the hair you regrow from treating seborrheic dermatitis as "permanent" hair loss that reversed because of ketoconazole.
The truth is that any hair you lose due to male pattern baldness is, for the most part, gone for good. While a small number of hair follicles can grow back with the use of finasteride, the only proven way to "regrow" patches of permanently lost hair is through a hair transplant.
Myth 4: Ketoconazole is the Only Hair Loss Treatment You Need
Finally, one annoyingly common myth about ketoconazole is that it’s the only product you need to take to stop hair loss.
This one is easy to understand. After all, who wouldn’t rather just use a daily shampoo than take a pill and apply a hair growth serum or foam?
Unfortunately, while ketoconazole might be effective in treating hair loss and improving the rate at which you grow new anagen hairs, there’s no proof that it’s an effective hair loss treatment on par with finasteride.
If you’re suffering from severe hair loss caused by male pattern baldness, ketoconazole usually won’t be enough to stop it. This is particularly true for people with hair that’s highly sensitive to DHT and noticeable, worsening hair loss.
To stop male pattern baldness, you need to stop DHT. This means you can’t use ketoconazole on its own with any likelihood of success.
Most studies show that the most effective treatment for preventing hair loss is a combination of finasteride and minoxidil. These treatments both have plenty of scientific data to back them up, as well as millions of successful users around the world, and they are both FDA approved for treating androgenetic alopecia.
While there’s no real harm in using a ketoconazole shampoo, especially one that you can buy over the counter, you shouldn’t ever rely on it as a replacement for finasteride and minoxidil.
Instead, the best option is to talk to your hair loss doctor about using ketoconazole shampoo as well as your existing hair loss products to block DHT and stimulate new hair growth as strongly as possible.