Topical ketoconazole shampoos: Are they helpful for hair loss?

Ketocaonzole shampoos promotes hair growth

Ketocaonzole is a an antifungal agent and effective for the treatment of seborrheic dermatitis and "dandruff". But research over the past many years has suggested that they help hair loss as well. I often recommend that individuals with genetic hair loss consider use of anti-inflammatory shampoos.

What were the results of ketoconazole studies for hair loss?

A 21 month study  compared the use of topical minoxidil to ketoconazole 2 % shampoo. Study participants received the 2 % shampoo or an unmedicated shampoo with or without minoxidil 2 %. Interestingly, hair density and follicle size improvements were similar with both ketoconazole and minoxidil regimens.

How do ketoconazole shampoos help hair loss?

The mechanism by which topical ketoconazole improves hair density and hair growth is unclear, but may be due to is anti-inflammatory effects against T cells and the yeast of the scalp which create inflammation (Malassezia yeast). Ketoconaozle also inhibits steroidogenesis and decreases DHT levels.

References

Inui.  J dermatol Sci 2007; 45: 66-8.

Pierar Franchimont Dermatology 1998; 196: 474-7