You’re probably familiar with ketoconazole shampoo, though you might not know it. Ketoconazole shampoo is commonly used to fight and prevent seborrheic dermatitis (dandruff) and other types of skin conditions caused by fungal infections. Interestingly enough, there is a growing amount of evidence is starting to show that ketoconazole, ingredient ketoconazole, which is commonly found in Nizoral shampoo and used to treat dandruff, could actually also help regrow hair. Talk about performing double duty!

For a better understanding of how this might be possible, let’s look at how ketoconazole works and how the ingredient performs compared to other medications that are used to reverse hair loss.

How Nizoral and Ketoconazole Work

Nizoral shampoo is a popular brand of the generic form of ketoconazole shampoo. Nizoral is reddish-orange in color and primarily used as an antifungal. It targets several different forms of fungi, including the Pityrosporum ovale fungus that plays a role in causing dermatitis. The ketoconazole contained in the shampoo inhibits the formation of a substance known as ergosterol, which fungi need in order for their cells to properly develop. Without the formation of ergosterol, the Pityrosporum ovale fungus cannot grow or thrive and as a result immediately dies. Ketoconazole was first discovered in the mid-1970s, and first marketed as an oral drug to fight skin infections.

In fact, it was so effective, doctors commonly recommend it for people suffering from compromised immune systems due to illnesses such as AIDS and cancer. Ketoconazole isn’t limited to oral application, though. It’s also used in topical creams, as well as shampoo. The fatty tissues of the body can easily absorb ketoconazole, which is one of the reasons why it’s so effective as a topical treatment. The drug is used to treat not only dandruff and dermatitis, but also other fungal infections, such as jock itch, ringworm, athlete’s foot, and more.

Is Nizoral Safe?

Nizoral shampoo is considered safe for most people, since very little of the product gets absorbed into the bloodstream. However, there haven’t been very many studies performed on its safety. Due to this lack of research, it is recommended that women who are pregnant and women who are breast feeding do not use Nizoral shampoo unless they are certain the benefits will outweigh the potential and unforeseen risks.

Anyone thinking of using Nizoral should talk to his or her doctor first.

There haven’t been any reports or evidence of toxic reactions when skin affected by the product is exposed to direct sunlight. This has led to the conclusion that sunlight does not adversely affect skin that has been exposed to ketoconazole, and that Nizoral shampoo can typically be safely applied at any time of the day. Some people have reported mild skin irritations by the product, and Nizoral shampoo may also cause irritation if it comes in contact with the eyes. Although uncommon, there have been rare instances where incidents such as facial swelling and skin reactions have occurred. ketoconazole shampoo | Juvetress

Comparing Ketoconazole With Other Hair Loss Medications

Research indicates that ketoconazole performs as well or better than other medications used to treat hair loss. For example, one group of researchers compared ketoconazole shampoo with both a placebo shampoo as well as another shampoo containing minoxidil, an ingredient found in the popular hair loss product Rogaine. According to the results, both the shampoos containing ketoconazole and minoxidil stimulated the growth of hair.1 These shampoos not only increased the density of the hair, but also the number of follicles as well.

Over time, this inflammation can hinder the ability of the follicle cells to properly do their job, which in turn disrupts the growth of hair.1 Researchers believe that the ketoconazole ingredient was effective because it killed off that certain type of fungi found on the scalp that causes inflammation of the hair follicles. Without inflammation, hair was free to grow once more.

More Studies To Find a Solution

Another study involved a trial of 100 men who were suffering from a form of hair loss known as androgenetic alopecia, which is otherwise known as male-pattern baldness. This condition occurs due to the accumulation of a substance known as dihydrotestosterone, or DHT. When testosterone converts to DHT in hair follicles over time, this results in a substantial decline in follicle development – and then ultimately leading to a reduction in hair growth. For the study, researchers divided the men into four groups, giving each group a different mixture of treatment options. One group received oral doses of a drug known as finasteride, which is used to treat hair loss as well as enlarged prostate. The second group received finasteride plus a minoxidil solution. The third group received only minoxidil. Finally, the fourth group took finasteride and used ketoconazole shampoo. The results showed that while all groups experienced substantial regrowth of hair, the groups taking the finasteride/minoxidil and finasteride/ketoconazole combinations saw the most growth.2

The combination of finasteride and ketoconazole also proved effective in another study that showed ketoconazole helps to increase the inhibition of DHT, which, again, has been linked to the death of hair follicles. Researchers found that finasteride is good at beginning the inhibition of DHT, while ketoconazole is good at accelerating the inhibition process.3

Finally, another study compared the effectiveness of 1 percent ketoconazole (the type that is available over the counter) with that of other ingredients found in shampoos used to treat dandruff, such as piroctone olamine and zinc pyrithione. A group of 150 men with androgenetic alopecia took solutions containing the different ingredients two to three times a week for a six-month period. Researchers periodically measured the thickness of the subjects’ hair, finding that all of the shampoos were effective at eliminating the itchiness associated with dandruff. However, they also found that ketoconazole did a better job at not only increasing hair thickness but also reducing hair loss.4 ketoconazole shampoo | Juvetress

How to Use Nizoral

There are two versions of Nizoral – one contains 1 percent ketoconazole and is available over-the-counter. The other contains 2 percent ketoconazole and is only available through a prescription. It’s very important that people using Nizoral shampoo realize that they will probably need to apply it every three or four days in order to obtain any potential benefits.

The frequency will depend on what you’re trying to accomplish.

It you are trying to regrow hair, you should plan on using it at least twice a week.

If you are just trying to keep from losing hair, then you should use the shampoo once every 7 to 10 days. It will probably take about 6 to 8 months to determine whether or not the product will work for you.

To get the best results from the shampoo, users should first wash the scalp in order to remove any oil or debris, and then apply the ketoconazole shampoo by massaging it gently into the scalp. The shampoo needs to soak the scalp for at least five minutes before you wash it off. For maximum effect, you will then need to repeat the process.

Precautions Before Using

There are some precautions that you will need to take before using Nizoral shampoo or another shampoo with ketoconazole. For example, you should always wash your hands before and after applying the shampoo. Do whatever you can to keep from getting the product in your eyes, mouth, or nose – if you do, wash them with a great deal of water as soon as possible.

Don’t use Nizoral if you have any sort of cut on your head, and don’t combine it with any sort of soap, hair dye, or detergent.

Also, Nizoral shampoo is not intended for use in children under the age of 12 unless recommended by a doctor. Again, while the ketoconazole in Nizoral has been shown to be effective in helping to regrow hair and to prevent hair loss, prevent hair loss and regrow hair, and has been shown to be safe for a vast majority of users, it is important for you to have a detailed discussion with your doctor before starting a treatment regimen with Nizoral shampoo or any other ketoconazole shampoo product.

Article Updated on August 30th, 2017.

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1 Piérard-Franchimont C e. Ketoconazole shampoo: effect of long-term use in androgenic alopecia. – PubMed – NCBI. Ncbinlmnihgov. 1998. Accessed June 22, 2017.

2 Khandpur S e. Comparative efficacy of various treatment regimens for androgenetic alopecia in men. – PubMed – NCBI. Ncbinlmnihgov. 2002. Accessed June 22, 2017.

3 BS H. Ketocazole as an adjunct to finasteride in the treatment of androgenetic alopecia in men. – PubMed – NCBI. Ncbinlmnihgov. 2004. Accessed June 22, 2017.

4 Pierard-Franchimont C, Goffin V, Henry F, Uhoda I, Braham C, Pierard G. Nudging hair shedding by antidandruff shampoos. A comparison of 1% ketoconazole, 1% piroctone olamine and 1% zinc pyrithione formulations. International Journal of Cosmetic Science. 2002;24(5):249-256. doi:10.1046/j.1467-2494.2002.00145.x.