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. But it’s also used to treat scalp conditions including pityriasis versicolor, seborrheic dermatitis and dandruff.
But some evidence now shows that Nizoral may also be an effective treatment for hair loss [1-3].
In this article, you’ll find out:
- which types of hair loss can be treated with Nizoral shampoo
- how to use Nizoral for best results
- which Nizoral shampoo side effects to look out for.
Does Nizoral shampoo help with hair loss?
Nizoral may help improve hair loss. Studies suggest that ketoconazole can improve hair loss caused by fungal infections or androgenetic alopecia. Ketoconazole 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 . DHT is the hormone that triggers hair loss in those who are genetically predisposed to male pattern baldness or female pattern hair loss. So by reducing the activity of this enzyme, Nizoral may be able to prevent conversion of testosterone to DHT. Finasteride and Dutasteride, two of the most popular hair loss treatments for men, use a similar mechanism to prevent pattern baldness.
Nizoral may also reduce hair loss by reducing follicle inflammation caused by the pityriasis fungus on the scalp . 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).
How to use Nizoral shampoo for hair loss
First, make sure you have the right product. Nizoral produces lots of different hair products — to treat hair loss, you need a product that contains ketoconazole. Check the ingredients list before you buy.
Ready to try Nizoral shampoo for your hair loss? Here’s how it should be applied.
- Wet your hair as you normally would to wash it.
- Massage Nizoral shampoo into the scalp for 100 seconds.
- Leave shampoo on the scalp for no less than 5 minutes (ideally 10) before washing out.
- Repeat 2-3 times every week.
You’ll need to use the shampoo over several months to see a visible improvement. Androgenetic alopecia may also resume if you stop using this treatment.
How much Nizoral should you use to tackle hair loss?
Research shows that overuse of Nizoral (in terms of quantity or frequency) won’t necessarily produce better results . Some users report that using Nizoral too often leaves their hair dry and brittle.
Instead, concentrate on dosage. For best results, use a Nizoral shampoo containing at least 2% ketoconazole.
Side effects of Nizoral shampoo
There are some reported side effects of Nizoral, including :
- Changes to hair colour and texture
- Itchy, burning, or irritated scalp
- Hypersensitivity on the scalp
- Dry skin
- Allergic reaction (hives and/or rash).
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 . But it’s still important to be aware of potential side effects before you use any product.
Does Nizoral cause hair thinning?
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 .
But 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.
Nizoral vs Minoxidil
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 . 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.
Where to get Nizoral shampoo
Nizoral is available over-the-counter in most pharmacies and some supermarkets. 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).
Nizoral shampoo hair loss reviews
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. But there are more reliable, evidence-based hair loss treatments available on the market.
What to do if Nizoral shampoo doesn’t help with your hair loss
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:
- Finasteride — a DHT blocker that’s highly effective for male pattern baldness. Find out if Finasteride works
- Minoxidil — a topical or oral treatment that can be used to treat multiple types of hair loss
- Caffeine shampoo — some topical caffeine solutions have been shown to reduce hair loss. Find out if Alpecin works
- Low level laser therapy — lasers are directed towards the scalp, stimulating cellular activity to promote hair regrowth.
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.
- Topical ketoconazole for the treatment of androgenetic alopecia: A systematic review
- Pilot Study of 15 Patients Receiving a New Treatment Regimen for Androgenic Alopecia: The Effects of Atopy on AGA
- Ketoconazole shampoo: effect of long-term use in androgenic alopecia
- NIZORAL® (KETOCONAZOLE) 2% SHAMPOO | FDA
- Trichogenic effect of topical ketoconazole versus minoxidil 2% in female pattern hair loss: a clinical and trichoscopic evaluation
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