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Ketoconazole


Matthew (PHH)

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Ketoconazole is an antifungal medicine used to treat skin infections caused by a fungus (usually yeast). You can buy 1% ketoconazole over the counter, but 2% ketoconazole usually requires a doctor’s prescription. Although not FDA-approved, ketoconazole is generally thought of as one of the “big three” treatments for pattern hair loss alongside minoxidil and finasteride.

Key insights:

  • The in vitro evidence suggests that ketoconazole has anti-fungal, anti-androgenic, and anti-inflammatory properties which may benefit those with either telogen effluvium or androgenetic alopecia. 
  • The in vivo (in mice) evidence suggests that 2% ketoconazole topically applied once daily for three weeks significantly stimulated hair growth compared to the vehicle control.
  • The clinical evidence suggests that ketoconazole has anti-inflammatory properties, which may be beneficial for hair follicle growth. Furthermore, ketoconazole has been found to enhance hair thickness and proportion of anagen follicles at a similar rate to minoxidil in patients with androgenetic alopecia. Furthermore, ketoconazole was able to improve hair density nearly twice as well as minoxidil. 
  • The best candidates for ketoconazole shampoo are hair loss sufferers who are comfortable using the shampoo 2-3 times per week and who are dealing with dandruff and/or excessive hair shedding from androgenetic alopecia or telogen effluvium.
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