Is ketoconazole useful to prevent hair loss?

Females usually detect hair loss faster than men, but baldness or alopecia is more common in males due to their hormonal profile. Testosterone has a significant role in male pattern baldness because this hormone is transformed into DHT in the hair follicle, and DHT causes destruction of this structure in the scalp. If you no longer have hair follicles because they are destroyed, you end up with alopecia, and your hair won’t grow back again. For those considering the use of finasteride and planning to start a family, a common question arises: should I use finasteride while trying to conceive?

That’s why alopecia is more common in males with bald parents, uncles, or grandparents. It has a genetic predisposition to it, but there’s something we can do to solve the problem. As you will see in this article, ketoconazole, an antifungal agent, is also useful for some cases of alopecia, especially androgenetic alopecia.

Androgenetic alopecia and ketoconazole

Androgenetic alopecia is the most common cause of hair loss in males. It causes a male pattern baldness, which affects the midfrontal and frontoparietal scalp. As it advances, it goes up to the superior portion of the scalp, and it is more common in older Caucasians. It is estimated that around 50% of Caucasian males will develop a form of androgenic alopecia when they reach 50 years old. However, even though genetics are essential, several environmental factors play an important role, including stress, smoking, and consumption of alcohol.

What happens is that circulating testosterone is converted into an active form called DHT or dihydrotestosterone. This hormone binds to their receptors in the scalp, and trigger a dysfunction and later destruction of the hair follicles.

So far, the only treatment approved by the FDA includes oral finasteride and topical minoxidil. This combination is useful to prevent the conversion into DHT and stimulate hair growth, respectively. However, it is not very useful for some patients, and others may develop adverse effects. That is why other therapies have been implemented, including laser light therapy, dutasteride, platelet-rich plasma, hair transplants, and topical ketoconazole.

Ketoconazole is an antifungal agent included in the group of imidazole substances. It inhibits the synthesis of ergosterol, a material that is found in the cell membrane of fungi. But besides its antifungal properties, it is also an anti-inflammatory that inhibits an enzyme called 5-lipooxygenase and blocks the synthesis of testosterone and the concentration of DHT. As such, ketoconazole is another potential treatment of androgenetic alopecia, and it has been studied in animals and humans with promising results.

Is ketoconazole useful to promote hair growth?

According to studies, ketoconazole can be useful in promoting hair growth in patients with androgenetic alopecia. For example, in one of them, the researchers used a ketoconazole lotion, which was meant to be used daily for one year. During the follow-ups, patients who used ketoconazole showed an improvement and significant hair regrowth. Still, according to this study, they needed to wait for a long time to start seeing results.

Other studies evaluated using a ketoconazole shampoo along with 1 mg oral finasteride. The control group included one with oral finasteride alone and another with oral finasteride and 2% minoxidil twice a day. In combination with finasteride, ketoconazole works even better, and the patients had a significant improvement in their condition. Combined treatment was more useful than finasteride alone, and no side effects were reported. However, there was no significant difference between ketoconazole and minoxidil as a side treatment. As such, it is considered a suitable alternative to minoxidil in these patients.

And one of the first studies of ketoconazole for hair loss showed that treating patients with ketoconazole shampoo can lead to potential hair regrowth after 6 months, which increases as the treatment continues and plateaus after one year and 3 months. In comparison, patients who used shampoo with no medication at all remained stable and sometimes experienced a significant increase in the severity of their condition.

Should you choose to use a shampoo with ketoconozale, we recommend Hair Restoration Laboratories’ Professional Strength Hair Restore Shampoo.  It contains 1% ketoconozale along with numerous other ingredients that have been clinically proven to help prevent hair loss and promote hair growth. 

The present and future of ketoconazole treatment for alopecia

Currently, androgenetic alopecia is a health problem with significant psycho social consequences, and there is a need of established and alternative therapies for these patients. The clinical studies and animal research about ketoconazole for the treatment of alopecia always support its use in some way. 

The application of this alternative can be useful in patients with androgenetic alopecia and concomitant seborrheic dermatitis, primarily because ketoconazole has been described as a useful therapy against Malassezia infections. It can also be a safe alternative for women with androgenetic alopecia who are unable to use finasteride treatment or display limited results with minoxidil.

Still, to study ketoconazole in the treatment of androgenic alopecia, we still need more large-scale prospective studies to figure out the exact mechanisms by which ketoconazole promotes hair regrowth. In any case, the absence of side effects of topical ketoconazole makes it a useful candidate to use as an adjunctive therapy to treat male and female patients with androgenetic alopecia, and well designed, and large-scale studies are still necessary to evaluate its efficacy on the long-term.

Sebastian

Sebastian was born and raised in the busy city of Abbottabad. As a journalist, Saad Mushtaq has contributed to many online publications including the PAK Today and the Huffing Post. In regards to academics, Saad Mushtaq earned a degree in business from the Abbottabad UST, Havelian. Saad Mushtaq follows the money and covers all aspects of emerging tech here at The Hear Up.Thanks