Ketoconazole is a medication used to treat fungal infections, although there’s some evidence it may also help with pattern hair loss.
Ketoconazole is an antifungal medication that comes in many different products and forms and can be used to treat various fungal infections, including those on the skin.
It is also thought that ketoconazole can block the enzyme 5-alpha reductase, which converts testosterone into dihydrotestosterone (DHT), making it potentially effective for addressing male and female pattern hair loss, although it is not FDA-approved for this purpose.
Ketoconazole is the active ingredient in several medications. It can be taken orally to treat widespread fungal infections or applied directly to the skin as a shampoo, cream, or foam. When used topically, ketoconazole can cause skin reactions such as itching, stinging, and dryness.
The information below is specifically about Nizoral®, an anti-dandruff shampoo that contains 1% ketoconazole.
Controls flaking, scaling and itching associated with dandruff
The drug category for ketoconazole is imidazole antifungal.
Stop use and ask a doctor if:
Rash appears
Condition worsens or does not improve in 2–4 weeks
Do not use on scalp that is broken or inflamed
Do not use if you are allergic to ingredients in this product
For external use only
When using this product, avoid contact with eyes. If product gets into eyes, rinse thoroughly with water
Pregnancy and breastfeeding: Ask a doctor before use
Boxed warning information not available for this drug.
The cost of ketoconazole may vary depending on factors such as your insurance plan, the form of the medication, the quantity, and where you buy it.
Lower-strength topical ketoconazole and ketoconazole shampoo are available without a prescription from many pharmacies and online retailers, while higher-strength versions of the medication require a prescription. The average retail price of over-the-counter ketoconazole is about $30, but coupons or discount cards may be available to reduce the price. Without insurance, prescription-strength ketoconazole may cost about $90, but again, coupons may help lower the price.
Hims can connect you with a provider who will determine, based on your symptoms and medical history, if a prescription for Hair Loss Spray containing the active ingredient ketoconazole is a good fit. The spray blends ketoconazole with other hair-regrowth active ingredients (finasteride, minoxidil, and biotin) and costs $39 per month.
There are other topical antifungal medications used to treat infections caused by fungi and yeast. These include:
Lamisil® (terbinafine)
Lotrimin® (clotrimazole)
Monistat® or Micatin® (miconazole)
Other active ingredients used in shampoos to help manage dandruff and related conditions include:
The FDA has not approved ketoconazole as a hair loss treatment, but there’s some evidence that ketoconazole shampoo may help with hair loss, especially if you experience hair shedding due to a fungal infection. Ketoconazole has also been linked to hair growth, and some older research suggests it affects the hormone dihydrotestosterone, or DHT, which is responsible for male pattern baldness. More research is needed in this area, though.
Hair loss is not a common side effect of ketoconazole shampoo, but it may be possible in rare cases.
Shampoos containing ketoconazole are available both over-the-counter and by prescription from a provider. Typically, higher-strength products require a prescription.
No, ketoconazole is an antifungal medication, not a steroid. However, it is sometimes prescribed along with a steroid in order to treat certain skin conditions.
You can buy lower-strength (1%) ketoconazole products, including creams and shampoos over-the-counter at many pharmacies or via online retailers. High-strength ketoconazole products require a prescription from a provider.
For a more convenient option, you can get Hair Loss Spray containing the active ingredient ketoconazole and other hair regrowth ingredients through the Hims platform, which also connects you with a provider, allows you unlimited access to providers for questions and follow-up visits, and offers free delivery.
For a more convenient option, Hims offers access to ketoconazole in the form of our Hair Loss Spray if a provider on the Hims app deems it an appropriate fit for your needs. When you connect with a provider on the Hims platform, your medication will be shipped directly to your door. You’ll also have ongoing provider support through the app, access to 24/7 customer care, and free shipping.
*This information is from the Nizoral® shampoo label used by Kramer Laboratories. See the full label for more complete information. Ketoconazole, the active ingredient in Nizoral, may be the active ingredient in other medications, and this information may not be accurate for all medications that include the active ingredient ketoconazole.
This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. Learn more about our editorial standards here.
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