If you’re here, you’ve probably heard that ketoconazole shampoo (generic Nizoral®) , the medicated shampoo that fights itch and dandruff, could also be beneficial for guys with male pattern hair loss.

While ketoconazole isn’t FDA-approved to treat hair loss and doesn’t block DHT, scientific evidence is mounting that it might be an effective treatment option. And when it comes to a chronic condition like male pattern baldness, it makes sense to look into anything that might be able to help you—especially if experts are the one’s saying it might work (unlike that juice cleanse your uncle won’t stop recommending).

That’s why we’re digging into the science behind using ketoconazole for hair loss. Read on to get to the bottom of whether or not this shampoo really can help you hang onto your hair.

What is ketoconazole shampoo usually used for?

Ketoconazole is an antifungal medication that’s typically used to treat stuff like athlete’s foot and ringworm. When added to shampoo, it helps fight the fungus that causes flakes and itching. (Spoiler alert: That same fungus can also accelerate hair loss.)

Can ketoconazole treat hair loss?

That’s still an open question. The FDA hasn’t approved ketoconazole shampoo for hair loss treatment, but that hasn’t stopped doctors from prescribing it that way for years. In fact, even hair loss expert and Keeps Medical Advisor Dr. Antonella Tosti backs it.

“I recommend ketoconazole shampoo to many of my patients who have androgenic alopecia, even if they don’t have dandruff,” Dr. Tosti says. “The data shows that it can help regrow hair and fight the inflammation that is associated with androgenic alopecia.”

Speaking of data…

What does the clinical evidence say?

The data isn’t fully conclusive, but there is a long record of evidence that ketoconazole can help slow down hair loss and maybe even boost growth.

Back in 1998, a study published in the scientific journal Dermatology found that 2% ketoconazole shampoo increased hair density, as well as the proportion and size of hair follicles. In fact, it’s nearly as effective as the FDA-approved topical treatment minoxidil.

In 2004, researchers discovered a potential explanation for ketoconazole’s follicle-boosting effect: It reduces inflammation known to contribute to male pattern hair loss. That study also found that ketoconazole was more effective when combined with another FDA-approved hair loss treatment, finasteride.

Since then, scientists have kept uncovering more evidence that ketoconazole can effectively treat hair loss, either alone or in addition to a proven treatment option. This review of the medical literature can fill you in if you’re interested in the details.

How does it work?

Remember the fungus that causes dandruff we mentioned earlier? It’s called Malassezia, and it’s found on every human head. But when it builds up too much, it causes inflammation, which in turn causes flakes, itching, and maybe even increased hair loss.

Studies have found that men with male pattern baldness have more Malassezia on their heads than other people. By killing excess Malassezia, ketoconazole soothes the inflammation that’s at the root of dandruff, itch, and hair loss.

That’s why other hair loss shampoos can’t keep their promises: Without ketoconazole, they can’t reduce inflammation, and inflammation is what accelerates hair loss.

How can I get it?

You can get 1% ketoconazole shampoo over the counter, but you’ll need to speak to a doctor to get the 2% version. The percentage refers to the concentration of ketoconazole in the shampoo, which is why you need a prescription for the stronger 2% version.

If you’re a Keeps customer, head here to ask your doctor about trying ketoconazole shampoo.

If you haven’t signed up for Keeps yet, get started here to get a personalized recommendation for hair loss treatment from a licensed doctor. We won’t send you ketoconazole unless your doctor determines it’s a good fit for you.


While ketoconazole shampoo hasn’t been approved by the FDA for hair loss treatment just yet, the record of scientific evidence that shows that it can help is promising. Hair loss experts haven’t waited around for the FDA to give them permission to use an effective treatment, and many already consider ketoconazole a standard part of any treatment plan.

Complete a consultation today if you’re interested in trying ketoconazole shampoo for hair loss (or dandruff!).


The information provided in this article is not a substitute for professional medical advice, diagnosis, or treatment. You should not rely upon the content provided in this article for specific medical advice. If you have any questions or concerns, please talk to your doctor.

Finasteride is an oral medication used to treat male pattern baldness in men only. It is not for use by women. When used by men, finasteride is generally safe but it can also cause serious side effects, including but not limited to allergic reactions, sexual dysfunction, depression, and high-grade prostate cancer. Most patients find that problems with sexual function resolve when they stop taking the medicine. For full prescribing information, view the drug label information.

Ketoconazole is an antifungal medicine used to treat certain kinds of fungal or yeast infections. When used as prescribed, ketoconazole is generally safe, but it also can cause side effects. Contact your doctor immediately if you experience allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue, pain, tingling or numbness. For full prescribing information, view the drug label information.