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.
This article was reviewed by Ho Anh, MD.
Important Safety Information
IMPORTANT SAFETY INFORMATION
Finasteride is for use by MEN ONLY and should NOT be used by women or children.
Read this Patient Information before you start taking Finasteride and each time you get a refill. There may be new information. This information does not take the place of talking with your healthcare provider about your medical condition or treatment.
What is Finasteride?
Finasteride is a prescription medicine used for the treatment of male pattern hair loss (androgenetic alopecia).
It is not known if Finasteride works for a receding hairline on either side of and above your forehead (temporal area).
Finasteride is not for use by women and children.
Who should not take Finasteride?
Do not take Finasteride if you:
- are pregnant or may become pregnant. Finasteride may harm your unborn baby.
- Finasteride tablets are coated and will prevent contact with the medicine during handling, as long as the tablets are not broken or crushed. Females who are pregnant or who may become pregnant should not come in contact with broken or crushed Finasteride tablets.
- If a pregnant woman comes in contact with crushed or broken Finasteride tablets, wash the contact area right away with soap and water. If a woman who is pregnant comes into contact with the active ingredient in Finasteride, a healthcare provider should be consulted. If a woman who is pregnant with a male baby swallows or comes in contact with the medicine in Finasteride, the male baby may be born with sex organs that are not normal.
are allergic to any of the ingredients in Finasteride. See the end of this leaflet for a complete list of ingredients in Finasteride.
What should I tell my healthcare provider before taking Finasteride? Before taking Finasteride, tell your healthcare provider if you:
have any other medical conditions, including problems with your prostate or liver
Tell your healthcare provider about all the medicines you take, including prescription and nonprescription medicines, vitamins, and herbal supplements.
Know the medicines you take. Keep a list of them to show your healthcare provider and pharmacist when you get a new medicine.
How should I take Finasteride?
- Take Finasteride exactly as your healthcare provider tells you to take it.
- You may take Finasteride with or without food.
If you forget to take Finasteride, do not take an extra tablet. Just take the next tablet as usual.
Finasteride will not work faster or better if you take it more than once a day.
What are the possible side effects of Finasteride?
decrease in your blood Prostate Specific Antigen (PSA) levels. Finasteride can affect a blood test called PSA (Prostate-Specific Antigen) for the screening of prostate cancer. If you have a PSA test done you should tell your healthcare provider that you are taking Finasteride because Finasteride decreases PSA levels. Changes in PSA levels will need to be evaluated by your healthcare provider. Any increase in follow-up PSA levels from their lowest point may signal the presence of prostate cancer and should be evaluated, even if the test results are still within the normal range for men not taking Finasteride. You should also tell your healthcare provider if you have not been taking Finasteride as prescribed because this may affect the PSA test results. For more information, talk to your healthcare provider.
There may be an increased risk of a more serious form of prostate cancer in men taking finasteride at 5 times the dose of Finasteride.
The most common side effects of Finasteride include:
- decrease in sex drive
- trouble getting or keeping an erection
a decrease in the amount of semen
The following have been reported in general use with Finasteride:
- breast tenderness and enlargement. Tell your healthcare provider about any changes in your breasts such as lumps, pain or nipple discharge.
- decrease in sex drive that continued after stopping the medication;
- allergic reactions including rash, itching, hives and swelling of the lips, tongue, throat, and face;
- problems with ejaculation that continued after stopping medication;
- testicular pain;
- difficulty in achieving an erection that continued after stopping the medication;
- male infertility and/or poor quality of semen.
in rare cases, male breast cancer.
Tell your healthcare provider if you have any side effect that bothers you or that does not go away.
These are not all the possible side effects of Finasteride. For more information, ask your healthcare provider or pharmacist. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA1088.
How should I store Finasteride?
- Store Finasteride at room temperature between 59˚F to 86˚F (15˚C to 30˚C).
Keep Finasteride in a closed container and keep Finasteride tablets dry (protect from moisture).
Keep Finasteride and all medicines out of the reach of children.
General information about the safe and effective use of Finasteride.
Medicines are sometimes prescribed for purposes other than those listed in this Patient Information. Do not use Finasteride for a condition for which it was not prescribed. Do not give Finasteride to other people, even if they have the same symptoms you have. It may harm them.