Ketoconazole – Available in Prescription and OTC Strengths

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Ketoconazole is the active ingredient in a common antifungal shampoo or cream that is marketed under the brand name of Nizoral and is also available as an oral prescription medication.  Although it is marketed as an antifungal agent, Ketoconazole has broad and significant implications for use as a hair loss treatment.  There appears to be some amount of controversy as to the exact mechanism that makes it an effective hair loss treatment, especially for Androgenetic Alopecia (genetic hair loss), but the end results are promising.  It has been found to have comparable results to Minoxidil (Rogaine, Regaine) but appears to work through some other biological mechanism.

Available Ketoconazole Treatments

Usually Ketoconazole is prescribed to treat and/or prevent dermatological fungal infections.  It has antihistaminic properties, can be taken orally as a broad spectrum antifungal medication and since high doses lower androgen, it is often used as a treatment for advanced stages of prostate cancer as well.  Available as a prescription pharmaceutical, Ketoconazole is often prescribed either as an oral tablet or a shampoo for fungal infections of the scalp and in conjunction with other treatments for Pattern Baldness.  Prescription strength is a 2% solution; however, there is a 1% solution which is available OTC.  It is the contention of the medical community that the OTC formulation lacks the strength to be truly effective in treating infections and/or alopecia.  In treatment of Androgenetic Alopecia, oral tablets are rarely prescribed since the dosage necessary to be effective is well beyond the level of safety of the drug.

How Ketoconazole Works

This is where there appears to be some amount of controversy within the scientific and medical communities.  There is one school of thought that believes the efficacy to be directly proportionate to its anti-inflammatory properties.  Since the hair follicle is inflamed, damaged and destroyed as a result of Dihydrotestosterone, some specialists believe that by reducing the inflammation the follicle is kept alive.  On the other side, there is the theory that Ketoconazole disrupts the production of DHT which is the ultimate cause of genetic hair loss.  This is, by far, the theory that has the greatest amount of support from medical professionals.

While there is a 1% solution available at most pharmacies which can be purchased OTC without a prescription, it is doubtful that Ketoconazole in such a weak solution will be of significant benefit.  The prescription 2% strength does, however, require a visit to the doctor which can be cost prohibitive to some consumers.  Unfortunately, without an accurate diagnosis it is difficult to discern which type of treatment to use.  Ketoconazole has shown considerable results as a treatment for Androgenetic Alopecia, but it is doubtful as to whether or not it can be effective in treating other types of hair loss.

Since there are various types of hair loss it is always recommended to get an accurate diagnosis prior to using any treatments.  The treatment of choice is dependent on the diagnosis which only a qualified physician can make.

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