2% Ketoconazole shampoo
Ketoconazole is an antifungal medication thought to help promote hair growth through its anti-inflammatory and antifungal effects against Malassezia, a type of scalp fungus believed to be involved in certain types of hair loss by causing oxidative damage that compromises hair quality and growth. Fungal species Malassezia metabolize the oils produced by the sebaceous glands in the scalp. The byproducts of this metabolism cause inflammatory and oxidative damage that negatively affects the follicle’s ability to grow healthy hair. Malassezia is part of your normal skin flora, and certain skin conditions, including seborrheic dermatitis, are associated with the overgrowth of this fungus. Reducing the Malassezia population by using ketoconazole-based shampoos will decrease the oxidative damage caused by the fungus and allow for healthier hair and scalp. A retrospective review study found that ketoconazole-based shampoos can result in increased hair shaft diameter giving the appearance of more density.
Ketoconazole shampoos are often used in combination with minoxidil and finasteride for synergistic effects. Like minoxidil, ketoconazole can cause dryness, irritation, and redness in individuals with sensitive scalps.
There are no shampoos that are proven to regrow hair, and they do not work to treat male pattern baldness. Ketoconazole does not block the effects of DHT, but it can improve the scalp condition to promote an environment that allows existing hair to grow healthier.