Role of Topical Ketoconazole in Therapeutic Hair Care Beyond Seborrheic Dermatitis and Dandruff

March 2025 in “ JEADV Clinical Practice ”

Aditya K. Gupta, Piet De Doncker, Mesbah Talukder

ketoconazole minoxidil finasteride androgenetic alopecia anti-androgen hair follicle scalp inflammation hair shedding Nizoral Rogaine Propecia

TLDR Ketoconazole shampoo may help reduce hair loss and improve hair health.

The article discusses the expanded use of topical ketoconazole, traditionally used for seborrhoeic dermatitis (SD) and dandruff, in promoting hair growth and treating hair loss conditions like androgenetic alopecia. Ketoconazole's antifungal, anti-inflammatory, and anti-androgenic properties, along with its ability to inhibit 5-alpha reductase and modulate retinoic acid metabolism, make it effective in managing SD and dandruff, with success rates of 63%-90% in 40 studies involving 4,566 patients. Additionally, 64 clinical trials with over 8,189 patients confirmed the efficacy of a 2% ketoconazole shampoo, which is superior to other treatments and suitable for long-term use due to its strong keratin adherence and minimal systemic absorption.

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Research cited in this study

17 / 17 results

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All three shampoos reduced dandruff and hair loss, but ketoconazole and piroctone olamine also made hair thicker.

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A 23-year-old male experiencing worsening hair loss has tried topical Minoxidil, Finasteride, Progesterone, Hydrocortisone butyrate, and Ketoconazole. He is considering switching to oral Finasteride due to concerns about side effects and lack of improvement.

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