What it is
Ketoconazole is an antifungal compound available as a medicated shampoo in 1% (over the counter) and 2% (prescription) concentrations. It is primarily used to treat dandruff and seborrheic dermatitis, but some evidence suggests it may have mild anti-androgenic properties at the follicular level, leading to its use as an adjunct in hair loss treatment regimens.
Who it's commonly used by
Ketoconazole shampoo is often used alongside primary treatments like finasteride or minoxidil rather than as a standalone hair loss therapy. It may be particularly helpful for individuals who also experience scalp inflammation, dandruff, or seborrheic dermatitis — conditions that can exacerbate the appearance of thinning.
Typical timeline
As an adjunct treatment, ketoconazole shampoo is not expected to produce dramatic hair regrowth on its own. Anti-dandruff and anti-inflammatory benefits may be noticeable within weeks of regular use. Any contribution to hair density is gradual and best assessed over time in combination with primary treatments.
Common side effects
Ketoconazole shampoo is generally well tolerated when used as directed.
- Scalp dryness
- Temporary hair texture changes
- Mild irritation or burning sensation
- Itching at application site
- Discoloration of chemically treated hair (rare)
Questions to ask a clinician
If you are considering adding ketoconazole shampoo to your regimen, a clinician can help determine whether it is a useful addition.
- Is the 1% or 2% concentration more appropriate for me?
- How often should I use it, and for how long each session?
- Will it interact with my other hair or scalp treatments?
- Is there evidence that it adds meaningful benefit to finasteride or minoxidil?
- Should I use it long-term or cycle on and off?