Home / Ingredients / Ketoconazole

 Ketoconazole is the active ingredient in Nizoral shampoo, which has been shown to be effective in treating hair loss resulting from androgenic alopecia, or male-patterned and female-patterned hair loss. It is available in both prescription and non-prescription strengths. Ketoconazole is FDA approved for treating fungal infections of the scalp, but it has not been approved to treat hair loss. However, because many people have found it to be quite successful in treating hair loss, doctors will often recommend it for that reason.

When I attempted to define Ketoconazole, I went to Wikipedia for a definition I could understand. This is what I found:

“As with all azole antifungal agents, ketoconazole works principally by inhibition of an enzyme, cytochrome P450 14-alpha-demethylase (P45014DM). This enzyme is in the sterol biosynthesis pathway that leads from lanosterol to ergosterol. Fluconazole and itraconazole have been found to have a greater affinity for fungal cell membrane than ketoconazole and thus lower doses of these azoles are required to kill fungi. “

I don’t know about you, but if I am going to use a chemical on my head every day, I would feel a lot better if I understood a little more than that. I had to add 11 words to my spell checker just to get enough red lines out of the way so I could read it!

Clinical Studies About Ketoconazole

Some studies have shown ketoconazole to be as effective as Minoxidil. Other studies say more studies should be done before any real conclusions can be drawn.

I did find one clinical study regarding ketoconazole that supported its use to prevent hair loss and encourage hair growth. Almost.

“Results: Hair density and size and proportion of anagen follicles were improved almost similarly by both KCZ and minoxidil regimens. The sebum casual level appeared to be decreased by KCZ. Conclusion: Comparative data suggest that there may be a significant action of KCZ upon the course of androgenic alopecia and that Malassezia spp. may play a role in the inflammatory reaction. The clinical significance of the results awaits further controlled study in a larger group of subjects.”


That study included 37 men. Yeah, a larger group of subjects might just be a good idea. What was this- an aging football team?

Interestingly enough, I also found this study:

Evans, K. C.; A. C. Peterson, H. E. Ruiz and R. A. Costabile (August 2004). “Use of oral ketoconazole to prevent postoperative erections following penile surgery“. International Journal of Impotence Research 16 (4): 346–349. doi:10.1038/sj.ijir.3901160. PMID 14973533.

If ketoconazole has that kind of side effects, you may want to remember that a lot of people think bald is sexy.


Ketoconazole is available both with and without a prescription. You can purchase it in a shampoo over the counter or online. You can get a prescription for a stronger version from your doctor. Nizoral A-D costs about $10 for a 4-ounce bottle, compared to about $2 for a 16-ounce bottle bargain shampoo.

Ketoconazole Dosage

Use it in a shampoo that has anywhere from a 1% to 2% concentrate. The brand name has 1%.

Side Effects of Ketoconazole

Read the title of that second study and notice the two words in bold. If that’s not enough for you, other side effects include a decrease in testosterone, which has the extreme positive of making it beneficial for treating prostate cancer.


While it certainly seems that ketoconazole may or may not help you regain your lost hair, it also seems quite certain that you may or may not like the side effects. It’s up to you, but I’d advise you might want to take a pass on ketoconazole.

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