Nizoral shampoo is a topical treatment for dandruff. It contains the active ingredient ketoconazole, which is commonly used to treat fungal infections like athlete’s foot. In addition, it’s also used to treat scalp conditions including pityriasis versicolor, seborrheic dermatitis, and dandruff.
However, some evidence now shows that Nizoral may also be an effective treatment for hair loss [1-3].
In this article, you’ll find out:
Nizoral may help improve hair loss. Studies suggest that ketoconazole can improve hair loss caused by fungal infections or androgenetic alopecia. Ketoconazole stimulates hair growth and is the active ingredient in Nizoral shampoo, so there are promising signs that using Nizoral will help stimulate hair regrowth if you’re losing hair.
Ketoconazole can inhibit 5-alpha reductase, the enzyme that converts testosterone to DHT [2]. DHT is the hormone that triggers hair loss in those who are genetically predisposed to male pattern baldness or female pattern hair loss. That’s why Nizoral may be one of the best shampoos for menopausal hair.
By reducing the activity of this enzyme, ketoconazole shampoo may be able to prevent the conversion of testosterone to DHT. Finasteride and Dutasteride, two of the most popular hair loss treatments for men, use a similar mechanism to prevent male pattern hair loss.
Nizoral may also reduce hair loss by reducing follicle inflammation caused by the pityriasis fungus on the scalp [2]. So if your hair loss is related to a fungal condition like pityriasis amiantacea or seborrheic dermatitis, Nizoral shampoo may help.
That said, it’s important to note that these studies are relatively small. The results may not be applicable to all or even most Nizoral users. The topical formulation used in the studies may also differ from Nizoral (although they have the same ketoconazole content).
First, make sure you have the right product. Nizoral produces lots of different hair products. Some Nizoral products for treating hair loss will need to contain ketoconazole. Check the ingredients list before you buy.
When you are ready to try Nizoral shampoo for hair loss, you will need to apply it as follows:
You’ll need to use the ketoconazole shampoo over several months to see a visible improvement. Androgenetic alopecia may also resume if you stop using this treatment.
Research shows that overuse of Nizoral (in terms of quantity or frequency) won’t necessarily produce better results [2]. Some users report that using Nizoral too often leaves their hair dry and brittle, so it may not be one of the best shampoos for dry hair.
Instead, concentrate on dosage. For best results, use a Nizoral shampoo containing at least 2% ketoconazole.
There are some reported side effects of Nizoral, including [4]:
Anaphylaxis has been reported in extremely rare cases. If you have symptoms of anaphylaxis, see a doctor urgently.
These Nizoral side effects are mostly mild, and only affect a small proportion of users. One study found Nizoral had significantly fewer side effects than Minoxidil, another topical hair loss treatment [5]. However, it’s still important to be aware of potential side effects before you use any product.
Alopecia is listed as a side effect of Nizoral shampoo. There are very few reports of this within the research literature, suggesting Nizoral-related hair loss is relatively rare. In one study, all 10 patients who used ketoconazole shampoo said they would continue to use it indefinitely [2].
However, it is possible for this shampoo to cause hair loss, or make it worse. This is likely due to telogen effluvium caused by scalp stress. Telogen effluvium is a temporary condition, but it can be distressing while it’s happening.
If you’re using Nizoral to control hair loss and find that it gets worse after Nizoral use, stop using the product. If you’re using Nizoral for another purpose (i.e. to treat seborrheic dermatitis or another fungal condition), speak to your trichologist before you stop using it. They can help find an alternative treatment for your condition.
Both Nizoral and Minoxidil can help treat hair loss, but they work in different ways. Nizoral works by eliminating fungi and inhibiting 5-alpha reductase enzymes, while Minoxidil increases blood flow to the hair follicles, stimulating hair growth.
One study compared a topical ketoconazole solution with Minoxidil for treating female pattern hair loss [5]. Both treatments worked well, though topical ketoconazole took 2 months longer to generate similar results.
But there’s no doubt that the topical ketoconazole treatment visibly improved the diffuse thinning caused by this hereditary hair loss condition:
Please be aware that the above comparisons refer to topical Minoxidil which is not the same as Minoxidil shampoo.
Nizoral is available over-the-counter (otc) in most pharmacies and some supermarkets. You’ll likely find it shelved along with other otc dandruff shampoos. You may also be able to get Nizoral on prescription if you have a fungal infection on your scalp.
Doctors won’t usually prescribe Nizoral for cosmetic hair loss (such as male pattern baldness).
Anecdotal reviews offer mixed opinions on using Nizoral shampoo for hair loss. These Reddit users share their Nizoral shampoo reviews and experiences. (We’re unable to verify how much product these users applied, or how often, so your results may differ.)
“Nizoral is just a supplement, it’s not really going to give any big results on its own. If you have some kind of fungal issue on your scalp that’s causing you to lose hair, that might be a different story.
“The shampoo itself is kind of harsh, and honestly my scalp hated it. I think I would have actually lost hair if I continued to use it just from irritation and dryness. My hair felt a lot healthier, darker, and stronger when using a good shampoo and conditioner. The trade-off of “it might grow your hair back” wasn’t enough for me to use it over my nice products.”
“I personally swear by Nizoral (1%), am able to use it every other day (not everyone’s scalp can take that kind of use), and along with Nioxin system 2’s shampoo and conditioner have re-grown at least 50% of my crown.”
The only way to find out if Nizoral will work for you is to try it. However, there are more reliable, evidence-based hair loss treatments available on the market.
There are plenty of other options to try if Nizoral doesn’t work. In fact, many of these hair loss treatments have far more evidence than Nizoral to back up their effectiveness:
These treatments require ongoing application to maintain your hair growth. If you’re looking for a more permanent hair loss fix, a hair transplant is one of the best options. Find out more about FUE hair restoration and FUT strip surgery to see how they can treat your hair loss.
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