6 Shampoos that Contain Ketoconazole - which is the best? - nicehair.org

6 Shampoos that Contain Ketoconazole — which is the best?

Ketoconazole is an anti androgen. When used topically it is thought to reduce scalp DHT. Using a ketoconazole shampoo like Nizoral two or three times per week may help reduce the damage DHT does to hair follicles.

  • Nizoral (see below) is the shampoo with the highest concentration of ketoconazole (2%)
  • Male pattern hair loss is caused by the hormone DHT. Ketoconazole is believed to reduce DHT in the scalp
  • If you have dandruff or male pattern baldness use Nizoral twice a week.
  • Massage the shampoo into your scalp and leave for 2 minutes before rinsing. Rinse Well…
  • The active ingredient, ketoconazole, is toxic. At 2% it’s not harmful, so don’t worry, but don’t over use the shampoo or leave it on your scalp for more than 2 minutes
  • If you have hair loss that is not caused by DHT, use a milder shampoo with less ketoconazole (see the list of shampoos below). Please note: manufacturers change their ingredients from time to time and some shampoos on this list may no longer contain ketoconazole. Check the ingredients before you buy.

If you have dandruff one of the best things you can do is start using a shampoo that contains ketoconazole. Most people have heard of Head and Shoulders, which uses zinc to control dandruff, but actually ketoconazole shampoos are more effective at treating scalp conditions. Furthermore, ketoconazole (the active ingredient) is a mild ‘5-alpha-reductase inhibitor’, which may help reduce DHT in your scalp, which in turn may help reduce hair loss in men experiencing male pattern baldness.

Ketoconazole is a toxic chemical at sufficient volumes, but at the small volumes contained in these shampoos it effectively kills the common fungi that cause dandruff.

  • Nizoral Anti Dandruff Shampoo

    Nizoral Anti Dandruff Shampoo

    Around $11 for 3.5oz

    Nizoral is by far the most well-known ketoconazole shampoo. It’s also probably the best because it contains the highest concentration of ketoconazole (2%). You should only use Nizoral 2 or 3 times a week because ketoconazole is a toxic chemical. If you use it too much you may experience mild poisoning.

    • Contains 2% ketoconazole — the highest available concentration and therefore probably the most effective for stopping dandruff and fighting against male pattern baldness.

    Buy online (USA)

    Buy online (UK)

  • Lipogaine hair loss shampoo

    Lipogaine Big 3 Premium Hair Loss Prevention shampoo for Men and Women Best shampoo for male hair loss

    Around $25 for 8oz

    In my view this is now the best shampoo for male hair loss, due to inclusion of the ingredient ketoconazole, as well as several other key ingredients. And it’s also a lot cheaper than the other crazily expensive anti-hair loss shampoos. However, if you want the most powerful ketoconazole shampoo, I recommend Nizoral, which has 2% ketoconazole. Overall, I’d go for Lipogaine. But you might consider using Nizoral twice a week as well for the higher concentration keotconazole.

    When I previously reviewed this shampoo it wasn’t great. However, Lipogaine have recently changed their formula and this is now a far better shampoo, with loads of anti-hair loss ingredients. However, when I bought a bottle in the UK a few years back it didn’t contain any of these great new ingredients. Providing you use the link below you should get the much better new version. This is actually a really good shampoo — perhaps the best anti-hair loss shampoo of all. What’s more it’s much cheaper than some of the other shampoos on this page.

    Buy online (USA)

    Buy online (UK)

  • Ultrax Labs Hair Surge shampoo

    Ultrax Labs Hair Surge for male pattern hair loss

    Around $28 for 16oz

    Buy online (USA)

    Read next

    Best hair loss shampoos Whats the best shampoo for hair loss?

    Buy online (UK)

    Buy online (India)

  • Wick and Strom Premium hair loss shampoo

    Wick & Ström Premium Hair Loss Shampoo with Ketoconazole
    for male pattern hair loss

    Around $16 for 12oz

    • Contains ketoconazole, which kills the fungi that causes dandruff and other scalp conditions and is thought to promote hair growth by inhibiting DHT
    • Contains saw palmetto, which may reduce DHT in the scalp
    • Contains aloe vera, which contains many vitamins and minerals and enzymes that may benefit hair growth
    • Contains niacin, which may help increase blood circulation in the scalp
    • Contains biotin, which may aid in the production of cells in the scalp

    Buy online (USA)

  • Perfect Hair Shampoo Review

    Perfect Hair Anti Hair Loss Shampoo Around $20 for 8oz

    On paper this is a really great shampoo. It contains loads of great ingredients for hair loss prevention (see below), including ketoconazole, which reduces dandruff and scalp conditions and is also a mild 5-alpha-reductase inhibitor. However I have noticed that this shampoo has had some really bad reviews on Amazon, so it’s worth checking those out. Click the blue button to view the Amazon reviews.

    • Contains ketoconazole, which kills the fungus that causes dandruff and other skin conditions and may reduce DHT
    • Contains saw palmetto, which blocks 5-alpha reductase, which may reduce DHT when applied topically
    • Contains emu oil, a mild anti-inflammatory, which may also reduce DHT
    • Contains salicylic acid, which helps keep the pres clear of sebum
    • Contains biotin and horsetail (a source of silica), which are thought to help nourish hair
    • Contains niacin, which may help increase blood circulation to the scalp
    • Contains zinc, which kills the fungus that causes dandruff and other skin conditions
    • Contains pygeum, evening primrose oil and borage oil — all of which help inhibit 5-alpha reductase, thus potentially reducing DHT levels.
    • Contains caffeine, which has been shown in studies to promote hair growth


    Buy online (USA)

  • Regenepure DR anti DHT ketoconazole shampoo

    RegenePure Doctor Recommended Anti Hair Loss Shampoo Around $28 for 16oz

    Regenpure DR is a really great anti hair loss shampoo. It’s not marketed as an anti-dandruff shampoo, but does contain ketoconazole. This is really a great shampoo for hair loss sufferers, who sometimes have scalp conditions as well as the common causes of hair loss. Regenpure also contains saw palmetto (which may help block DHT in the scalp), zinc (which may help clear up skin conditions), salicylic acid (which helps clear the pores of dirt and sebum), niacin (which may increase blood circulation in the scalp, plus other ingredients that benefit the hair.

    • Contains niacin, which may help increase blood circulation in the scalp
    • Contains ketoconazole, which kills common scalp fungi and may also reduce scalp DHT
    • Contains saw palmetto, which may reduce DHT in the scalp
    • Contains linolenic acid, which may inhibit DHT locally
    • Contains emu oil, which is an anti-inflammatory. DHT is thought to cause inflammation in the scalp, leading to hair loss
    • Contains jojoba oil, which may increase hair growth
    • Contains salicylic acid, which helps clear sebum and dead skin cells from the scalp
    • Contains zinc, which helps reduce fungal infections in the scalp


    Buy online (USA)

    Buy online (UK)

  • Boots Ketoconazolw Shampoo

    Boots Anti Dandruff Shampoo Around GBP 8.19 for 20mg

    This is a bog standard ketoconazole shampoo with no added extras. Only available in the UK.

    • Contains 2% ketoconazole


  • Ketozal Anti Dandruff Shampoo

    Ketozal Anti-Dandruff Shampoo

    • Contains 2% ketoconazole

    Around $9 for 2.1oz

    Ketozal is a lesser known brand of ketoconazole shampoo. Like Nizoral, it’s nothing special but will do the job just fine.

Which is the best?

I recommend the RegenePure shampoo for anyone who is suffering from hair loss. If you also have a flaky, inflamed, irritated or itchy scalp purchase the RegenePure anti hair loss shampoo with the RegenPure DR scalp treatment with ketoconazole.
The Perfect Hair Shampoo contains all the best possible ingredients for a hair loss shampoo. However, due to its bad reviews I can’t recommend it at this moment. If anyone has any good or bad stories about any of these shampoos please leave a comment.

What else can you do to clear up dandruff and improve scalp condition?

Braggs Organic Apple Cider Vinegar
One of the best natural remedies for dandruff is an apple cider vinegar rinse. This is very easy to do. Simply dilute apple cider vinegar in water in a 1:1 ratio. Then apply the diluted solution to your scalp. Leave for 15 minutes and rinse. Do this every day until the dandruff clears up.

If you use an apple cider vinegar rinse, make sure you use an apple cider vinegar that contain something called “the mother”. This is removed from some apple cider vinegars during the manufacturing process, but is an important ingredient for this rinse.

Ketoconazole shampoo for Hair loss: How Does It Work?

Ketoconazole is an imidazole anti-fungal agent that is also effective in topical applications for treating seborrheic dermatitis and dandruff.  Recently, topical use of 2% ketoconazole shampoo has been reported to have had a clinically therapeutic effect on androgenetic alopecia.

To investigate the possible benefits of 2% ketoconazole shampoo on hair growth in mouse models, a group of Japanese researchers applied ketoconazole or a placebo on the dorsal skin of 7 week-old genetically modified (C3H/HeN) mice after shaving off the hair. The results of this study were published in The Journal of Dermatology in 2005. These results showed that 2% ketoconazole clearly stimulated hair regrowth.

How Ketoconazole Stops Hair Loss and Promotes Hair Regrowth

Anti-inflammatory and Sebum Reduction

A 1998 study published in the Swiss journal, Dermatology, by a group of Belgian researchers compared the efficacies of 2% ketoconazole shampoo and a placebo shampoo mixed with or without 2% minoxidil.

The results showed that both 2% ketoconazole and 2% minoxidil were effective for stimulating hair growth. These topical agents increased hair density as well as the size and population of hair follicles during the anagen phase of the hair growth cycle.

The researchers believed that ketoconazole was able to increase hair growth because of its broad antifungal activities against the microbes colonizing the scalp flora; and its anti-inflammatory properties.

The 2% solution of ketoconazole has been proven to reduce local inflammation on the scalp. This inflammation is mostly caused by colonizing fungi and the immune response to the damage done to hair follicles by androgens such as DHT as well as these causative fungi. Ketoconazole has a direct anti-inflammatory property that can help stop these inflammatory reactions. Such inflammations will definitely reduce the output of the hair follicle cells and, therefore, disrupt the hair growth cycle.
Besides its anti-inflammatory properties, ketoconazole can also reduce sebum production in the scalp. By turning down the secretion of sebum from the sebaceous glands attached to the hair follicles, ketoconazole prevents the skin pores of the scalp from clogging up. It frees the path of hair follicles and provides the right environment for new hair growth.

As an Anti-androgen

Androgenetic alopecia causes hair loss at the crown of the head and temples in men and thinning hair over the entire scalp in women. Eventually leading to full hair loss in men. Hair loss occurs due to an excess of dihydrotestosterone (a derivative of the male hormone testosterone) binding to hair follicles receptors. While testosterone is a hormone associated with men, women also have low levels of testosterone in their bodies. Dihydrotestosterone binds to receptors in scalp follicles, shrinking follicles and making it impossible for healthy hair to survive, according to the American Hair Loss Association. Follicles are the small openings in the skin that produce hair. In our bodies Dihydrotestosterone (DHT) is made from testosterone by an enzyme called 5-alpha reductase (5AR). Ketoconazole, inhibits this enzyme and reduces hair loss as a result.

As an Antifungal

Ketoconazole is primarily used to treat fungal infections, including those of the scalp. Some researchers believe that certain scalp conditions, such as dandruff and seborrheic dermatitis, can contribute to hair loss. By addressing the underlying fungal or microbial imbalances on the scalp, ketoconazole may help reduce inflammation and improve overall scalp health.

Possible increased blood circulation in the scalp

Improved blood circulation to the scalp is crucial for healthy hair growth. Some studies have indicated that ketoconazole may increase blood flow to the hair follicles, leading to better nutrient delivery and oxygen supply. This enhanced blood flow can potentially promote hair growth and reduce hair loss.


You may notice itching burning or irritation when you first use ketoconazole shampoo. Oily or dry scalp can be seen as well. If the side effects continue inform your doctor.


  1. https://www.ncbi.nlm.nih.gov/pubmed/1526623
  2. https://www.ncbi.nlm.nih.gov/pubmed/15863844
  3. Downs M. Nizoral shampoo for hair loss. DERMAdoctor,
  4. https://www.ncbi.nlm.nih.gov/pubmed/10234078