How does Nizoral work for hair loss?

Hair loss is a problem for millions of men and women worldwide. When it comes to hair loss treatments, most people think of finasteride or minoxidil. But there’s another product that has gained a bit of a cult following: Nizoral shampoo.

Best known for treating dandruff and fungal infections, Nizoral has been linked to hair loss prevention. But how does a medicated anti-dandruff shampoo help with hair regrowth? And is it a proven treatment or just a myth?

Let’s break down the science behind Nizoral and whether it’s worth adding to your routine.

What is Nizoral shampoo?

Nizoral is a medicated shampoo containing ketoconazole, an antifungal ingredient that can treat many yeast infections (1). When used as a shampoo, the drug targets fungal scalp infections. It can get rid of dandruff and treat conditions like seborrheic dermatitis.

Nizoral shampoo works by killing or slowing the growth of fungi on the scalp. This reduces inflammation, itching, and flaking within a few weeks (1). But while its primary use is for fungal infections, some studies suggest that ketoconazole may also help with hair loss, particularly in cases of male pattern baldness (androgenetic alopecia; AGA) (2).

Nizoral shampoo and hair loss: Does it work?

Research into whether Nizoral shampoo works for hair loss is still ongoing. However, a review published in 2020 that looked at the results from nine separate studies shows it has the potential to help (2).

The review found that applying ketoconazole topically to the skin of mice increased hair regrowth. In humans, the diameter of individual hairs became thicker, potentially giving the illusion of thicker, healthier hair. This was backed up by several studies included in the review, which reported improvement of AGA based on before-and-after photos (2).

How does Nizoral shampoo help hair loss?

If Nizoral is an antifungal shampoo, how does it work for hair loss? Researchers are still trying to find this out, and the link between Nizoral and hair loss isn’t crystal clear.

Some research suggests ketoconazole may have mild DHT-blocking properties (3). DHT (dihydrotestosterone) is a testosterone-derived hormone linked to male pattern baldness (4). People with AGA have higher levels of DHT in the body; the hormone binds to the hair follicles and disrupts the growth cycle, causing hair to thin (4)(5).

This possible DHT-blocking property of ketoconazole could explain why many people swear by Nizoral shampoo for hair regrowth. However, most experts agree that Nizoral works best when combined with other proven treatments like minoxidil or finasteride.

How can I use Nizoral shampoo for hair loss?

If you want to try using Nizoral shampoo for hair regrowth, follow these steps:

1. Apply Nizoral shampoo to the scalp: Apply a small amount of Nizoral shampoo to wet hair and massage it gently into the scalp. The hair loss shampoo works at the root, so try to cover all parts of your scalp in a nice lather.
2. Let it sit for 3 to 5 minutes: Unlike regular shampoos, you don’t want to immediately wash Nizoral from your hair. Leave it to sit for around 3 to 5 to allow the ketoconazole to penetrate your scalp and work its magic.
3. Rinse your hair thoroughly: Once the time is up, rinse the Nizoral shampoo from your hair. Make sure you wash it out thoroughly. Nizoral can cause scalp dryness, so you don’t want any residue left.
4. Continue with your usual hair care routine: Follow Nizoral shampoo with whatever haircare products you normally use, such as conditioners. If you use minoxidil or other topical treatments, apply these after your hair and scalp are dry.

Importantly, you don’t need to follow this routine daily. Overuse of Nizoral shampoo can dry out the scalp and cause irritation, worsening your hair problems (6). Aim to use the product twice weekly for the perfect balance of maximal results and the fewest side effects.

How long does Nizoral shampoo hair regrowth take?

Ketoconazole can clear up fungal infections within a few weeks (1). However, when treating hair loss, results don’t come this quickly. Nizoral shampoo isn’t a fast-acting hair loss solution, but with consistent use, you may notice benefits in 3 to 6 months.

However, its effects will likely be mild compared to minoxidil or finasteride. If you’re looking for significant regrowth, Nizoral alone won’t be enough—but it might be a helpful addition to your routine.

Nizoral shampoo hair loss: Can it cause hair thinning?

You might have heard that Nizoral shampoo can cause hair loss. In fact, Nizoral even lists hair loss as a potential side effect in its patient information leaflet (7). This seems contradictory: How can something thought to help hair regrowth also be responsible for hair thinning?

Although possible, you probably will see more benefit from using ketoconazole shampoos than not. Hair loss caused by Nizoral is rare, affecting fewer than 1 in 100 people (7). We all respond to medications differently, and some people are simply more sensitive to ketoconazole. In these individuals, the shampoo can cause dryness, irritating the hair follicles and causing shedding.

The good news is that if you notice your hair getting thinner, it will grow back once you stop using Nizoral. If you experience severe irritation or continued hair loss, consider using the shampoo less frequently or switching to a milder alternative.

What other hair loss treatments are available?

Nizoral shampoo can support hair health, but it’s not generally regarded as a standalone hair loss treatment. Here are some other options you might want to consider, either in replacement of or combination with Nizoral.

• Minoxidil: Minoxidil increases blood flow to the scalp to encourage hair growth. You can apply minoxidil lotions or foams directly to the scalp, sold under the brand name Regaine. Another option could be tablets containing 2.5mg of minoxidil, which are just as effective (8).
• Finasteride: Finasteride (brand name Propecia) is another hair loss tablet. The drug works by lowering DHT levels to slow hair loss and promote growth (9). As Nizoral and finasteride work on lowering DHT, these might be good to use together (3).
• Dutasteride: Dutasteride is another hair loss pill. It improves male pattern baldness by slowing the production of DHT, lowering the levels in the body (10). It is sold under the brand name Avodart, or can be bought for cheaper as generic dutasteride.

Is Nizoral shampoo right for you?

Nizoral shampoo may be a valuable addition to a hair loss routine, particularly for:

• Men suffering from hair loss: While studies suggest Nizoral may help block DHT, the hormone responsible for hair thinning in male pattern baldness, there isn’t much research into Nizoral shampoo and female hair loss.
• People using minoxidil: Minoxidil can create a moist scalp environment that makes fungal infections more likely. Nizoral’s antifungal properties can help minimise this side effect while also boosting hair regrowth.
• Those using DHT-blocking treatments: If you’re already using treatments like finasteride and dutasteride, Nizoral may boost the effects of these medications. All work by blocking the DHT hormone, leading to fuller, healthier hair.
• People with dandruff or seborrheic dermatitis: Since Nizoral was designed to treat scalp conditions linked to irritation and hair shedding, it may help people with dandruff create a healthier environment for hair growth, improving hair thickness.

You can buy Nizoral shampoo directly from Oxford Online Pharmacy, along with clinically proven hair loss treatments like minoxidil and finasteride, available via our online doctor service.

Buy Nizoral shampoo here or browse our full range of hair loss treatments to find the solution for you.

References

1. NHS Choices. About ketoconazole - Brand names: Daktarin Gold, Daktarin Intensiv, Dandrazol, Nizoral [Internet]. National Health Service. 2024.
2. Fields JR, Vonu PM, Monir RL, Schoch JJ. Topical ketoconazole for the treatment of androgenetic alopecia: A systematic review. Dermatologic Therapy. 2020 Jan;33(1).
3. Hugo Perez BS. Ketocazole as an adjunct to finasteride in the treatment of androgenetic alopecia in men. Medical Hypotheses. 2004 Jan;62(1):112–5.‌‌
4. Kinter KJ, Anekar AA. Biochemistry, Dihydrotestosterone [Internet]. PubMed. Treasure Island (FL): StatPearls Publishing; 2020.‌
5. Ho CH, Zito PM. Androgenetic Alopecia [Internet]. Nih.gov. StatPearls Publishing; 2019.‌
6. NHS Choices. Side effects of ketoconazole - Brand names: Daktarin Gold, Daktarin Intensiv, Dandrazol, Nizoral [Internet]. National Health Service. 2024.
7. Nizoral ® 2% shampoo [Internet]. Nizoral. 2022.
8. Randolph M, Tosti A. Oral minoxidil treatment for hair loss: A review of efficacy and safety. Journal of the American Academy of Dermatology [Internet]. 2020 Jul 2;84(3).
9. Zito PM, Bistas KG, Syed K. Finasteride [Internet]. PubMed. Treasure Island (FL): StatPearls Publishing; 2022.
10. Al-Horani RA, Patel P. Dutasteride [Internet]. PubMed. Treasure Island (FL): StatPearls Publishing; 2024.