Korin Miller is a health and lifestyle journalist who has been published in The Washington Post, Prevention, SELF, Women's Health, The Bump, and Yahoo, among other outlets.
Hair loss is a concern for millions of people in the U.S. But could anti-dandruff shampoo be a hack to prevent it? Hair Growth Laser
Across TikTok, dermatologists and other creators say anti-dandruff shampoos that contain the active ingredient ketoconazole may be able to help slow hair loss.
“Anti-dandruff shampoo—no, it’s not just good for dandruff. It’s also great for hair loss,” Shereene Idriss, MD, a board-certified dermatologist and founder of Idriss Dermatology, said on TikTok. Her video, posted on March 9, has since been viewed over 3.1 million times.
The hack is one that TikToker Anushya Vijayaraghevan, PharmD, said she “[refuses] to gatekeep as a pharmacist.” In her video caption, she endorsed ketoconazole shampoo as a way to fight hair loss when used alongside other treatments.
Certain anti-dandruff shampoos contain ketoconazole, which is used primarily to fight fungal infections on the skin—in addition to working against scalp infections, it can also be found in creams used to treat athlete’s foot or sweat rash. Ketoconazole shampoos are widely available at stores over-the-counter and by prescription.
But can these anti-dandruff shampoos really help stave off hair loss? Here’s what dermatologists had to say about the hack and the best ways to protect your hair.
Though the medication isn’t approved by the Food and Drug Administration (FDA) to prevent hair loss, there is some evidence that the ketoconazole in anti-dandruff shampoos may be helpful, Idriss told Health.
In particular, the hack may be effective against androgenetic alopecia—also known as male pattern baldness or female pattern hair loss—which is the most common cause of hair loss.
Ketoconazole has anti-androgenic properties, meaning it works against the sex hormones that can lead to androgenetic alopecia. Specifically, it can reduce levels of dihydrotestosterone (DHT), a hormone that’s linked to hair loss at high levels, and potentially even stimulate hair regrowth, Idriss explained.
“DHT can lead to the miniaturization of hair follicles—the hallmark of androgenetic alopecia—and eventual shedding of these hairs,” Susan Massick, MD, clinical associate professor of dermatology at The Ohio State University Wexner Medical Center, told Health.
Ketoconazole works against this, increasing the number of hairs you have and making hair feel thicker, Massick said.
It’s important to point out that, while there’s data that show the anti-androgenic effects of taking ketoconazole orally, there’s less evidence outlining its effects when it’s used on the skin or scalp.
“There are only a few research studies studying a low number of participants that have looked at topical ketoconazole as a potential treatment option for hair loss,” said Massick.
That doesn’t mean using a ketoconazole shampoo can’t work—one meta-analysis called it a “promising” treatment for hair loss— but more research is needed to support the hack.
Beyond ketoconazole and its connection to androgenetic alopecia, there are a few other reasons why anti-dandruff shampoos, in general, may be able to help people avoid hair loss.
For one, the treatment may be able to tamp down inflammation on your scalp, protecting against hair loss, said Ife J. Rodney, MD, founding director of Eternal Dermatology + Aesthetics and professor of dermatology at the George Washington University School of Medicine and Health Sciences.
“That inflammation can cause the hair follicle to be damaged, and scratching can rip those hairs out,” Rodney told Health.
Using anti-dandruff shampoo regularly can also help promote good scalp health by removing excess oil, debris, and dead skin cells, Oma N. Agbai, MD, assistant clinical professor of dermatology at UC Davis Health, told Health.
“A clean and healthy scalp environment is critical for promoting healthy hair growth and minimizing factors that can contribute to hair loss,” she added.
If someone does have male pattern baldness or female pattern hair loss, they may want to give ketoconazole shampoo a try.
Prescription strength anti-dandruff shampoo usually has 2% ketoconazole, “but it’s also available over-the-counter in 1% ketoconazole, which is helpful, too,” Rodney said.
The actual logistics of the treatment will look different depending on the type of anti-dandruff shampoo you buy and the way your body reacts to it.
Nizoral—a popular brand of anti-dandruff shampoo that contains ketoconazole—instructs people to wash their hair with the shampoo about twice a week for eight weeks. Idriss suggests using the product as directed.
However, people may be able to use the product for longer than just two months, Rodney said.
“As long as you are not experiencing any adverse effects such as itching, burning, skin rashes, or excessive dryness of the hair, you can apply ketoconazole shampoo indefinitely,” Agbai agreed.
To use the shampoo, it’s best to lather it onto your hair near the scalp, let it sit for about two minutes, and then rinse it out, she said.
Since ketoconazole shampoos can be drying, people may want to use moisturizing hair products after rinsing out the anti-dandruff shampoo, Rodney suggested.
Though ketoconazole anti-dandruff shampoo may be helpful for people with androgenetic alopecia, it won’t help prevent all types of hair loss and may not work for everyone. The effectiveness “primarily depends on the underlying cause of the hair loss,” said Agbai.
However, this hack isn’t the only strategy available to help those with hair loss.
People with androgenetic alopecia may be prescribed topical treatments such as minoxidil, oral medications, light therapies, or more. Treatments for other types of hair loss may look slightly different—hair loss from alopecia areata, an autoimmune condition, may be treated with topical steroids, while hair loss from tinea capitis may require oral antifungal drugs, for example.
Lifestyle changes may also be helpful in preventing hair loss, Agbai said. Exercising regularly and eating a balanced diet that includes protein, iron, zinc, vitamin D, and biotin can keep hair healthy. Additionally, people can try regular scalp massages to improve blood circulation to the hair follicles, and should avoid harsh hair care practices such as excessive heat styling or tight hairstyles, she recommended.
If you do start to notice hair loss, it’s best to consult with a dermatologist sooner rather than later, said Rodney.
“With hair loss, time is of the essence,” she said. “It’s much easier to save the hairs you do have than to bring back ones that you’ve lost.”
National Library of Medicine: MedlinePlus. Androgenetic alopecia.
National Library of Medicine: MedlinePlus. Ketoconazole topical.
Fields JR, Vonu PM, Monir RL, Schoch JJ. Topical ketoconazole for the treatment of androgenetic alopecia: A systematic review. Dermatol Ther. 2020;33(1):e13202. doi:10.1111/dth.13202
Brazilian Hair Growth Products Nestor MS, Ablon G, Gade A, Han H, Fischer DL. Treatment options for androgenetic alopecia: efficacy, side effects, compliance, financial considerations, and ethics. J Cosmet Dermatol. 2021;20(12):3759-3781. doi:10.1111/jocd.14537