#1 Big Reason I Will Never Use Nizoral Shampoo For Hair Loss

I’m sure you’ll agree that stopping hair loss is no easy task. Now maybe you’re wondering if Nizoral shampoo could be the answer to your hair loss prayers.

In this in-depth article I’m going to review the good and the bad of Nizoral shampoo so you can make an informed decision about whether you should be using it.

Fair warning! I don’t personally use Nizoral.

The reason?


Yes that’s right. I personally believe that using chemicals on your hair and scalp will hurt its long term health and ultimately lead to even more damaged hair follicles that need repairing.

“So how do you wash your hair” I hear you asking.

Well I make my own (all-natural) shampoo – and it works AMAZING.

In fact, at the end of this article I’m going to share the amazing homemade recipe I use to wash my hair with…

And it’s 100% NATURAL and AMAZING for hair growth.

Every single ingredient has been specifically chosen to maximise scalp circulation, boost nutrients and minerals to the hair follicles, block DHT topically and clean the scalp gently.

However, I still want to fairly review Nizoral shampoo and look at all the evidence impartially so that you can make the best decision about if you want to use it for your self.

So I recommend reading this article carefully before jumping to conclusions.

With that out the way, let’s begin…

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Why Nizoral?

Commonly touted for the ability to manage a variety of scalp issues, Nizoral shampoo may be used for its capacity to address dandruff, fungal infections, seborrheic dermatitis and related hair loss, thinning hair, and receding hairlines.

The active ingredient in Nizoral shampoo is ketoconazole, and the shampoo is available as an over the counter product with two percent ketoconazole or there are prescriptions available with higher percentage concentrations.

While this product is available over the counter, it can be helpful to address these conditions in consultation with a medical professional to determine whether or not the use of Nizoral shampoo is appropriate.

The use of Nizoral shampoo is indicated for numerous issues related to hair loss, typically treating the underlying condition that is causing hair loss.

There is also limited evidence to suggest that the active ingredient, ketoconazole may promote hair growth where hair loss has occurred due to fungal infection.

Nizoral shampoo should not replace the regular use of shampoo to wash hair, and should only be used intermittently to treat dandruff or seborrheic dermatitis and to prevent the relapse of these conditions.

What is Nizoral Shampoo?

Nizoral shampoo is an over the counter product available at numerous stores and is sold on the internet as well. This product is produced by numerous companies, each of which are fairly similar to one another.

A woman pouring nizoral shampoo into her palm

There are many factors to consider when determining whether the use of Nizoral shampoo is correct for you, and anyone considering its use should be aware of the indicated uses, the counter indications of use, and the potential for side effects from use.

One of the active ingredients of Nizoral shampoo, known as ketoconazole which is an anti-fungal medication, is the main chemical that makes Nizoral shampoo effective.

Nizoral shampoo is not a registered name brand and is produced by a variety of manufacturers, many of which are similar to one another.

Nizoral shampoo is shown to be an effective method for treating dandruff and seborrheic dermatitis, and may have potential in the treatment of androgenic alopecia as well.

Furthermore, there is limited research to suggest that the active ingredient in Nizoral shampoo may help prevent the body from producing DHT which is another underlying cause for hair loss and thinning hair.

Nizoral shampoo is not intended to be a daily use shampoo, and should only be used as directed. T

ypically, the initial period of treatment requires using Nizoral shampoo twice a week for one month which is to be reduced to only a single use every other week if the issue remains chronic.

There are a variety of potential side effects associated with the use of Nizoral shampoo, however these are rare and may only last for a short period of time when beginning to use the product.

Ingredients of Nizoral Shampoo

A pair of hands filled with soap suds

Ketoconazole, coco diethanolamide, disodium laureth sulfosucciante, hydrochloric acid, imidurea, peg 120 methyl glucose dioleate, sodium chloride, sodium hydroxide, sodium laureth 3 sulfate. (Source.)

That’s a lot of chemicals going on to your scalp – not good for the long term health of your hair.

Does Nizoral Shampoo Really Work?

The effectiveness of Nizoral shampoo depends on the severity of the condition being addressed, as well as whether or not it is the appropriate treatment for an individual.

In general, Nizoral shampoo works in the majority of cases for individuals who are experiencing dandruff or less severe instances of seborrheic dermatitis.

There are numerous studies published dedicated to the study of the active ingredient in Nizoral shampoo, however much of the research is inconclusive and more research is necessary to fully understand the effectiveness of Nizoral shampoo.

In a study published by the British Medical Journal of Clinical Evidence, the effectiveness of a ketoconazole scalp preparation as comparted to a placebo showed a statistically significant difference in the reduction of scalp symptoms such as itching, redness, and dandruff over four weeks for people with seborrheic dermatitis.

The use of products that include ketoconazole can be effective in the clearance of dandruff and the longer term maintenance of scalp and hair health.

This study recommends that the product be used twice a week for four weeks while clearing the condition, which is to be reduced to once a week or every other week in order to prevent a relapse of the condition.

The journal Pharmacy & Therapeutics states in an article on seborrheic dermatitis that the most effective method of treating the condition is to address the colonization of yeast and fungus on the skin and reducing the resulting skin inflammation.

Ketoconazole is one of the most well studied treatments, having undergone many randomized trials that have demonstrated its effectiveness as a treatment for scalp dermatitis.

The article also suggests that intermittent use of ketoconazole is effective in preventing remission of the condition when used consistently.

One study published by ISRN Dermatology suggests that the use of products containing ketoconazole, such as Nizoral shampoo, may be effective in treating conditions of androgenic alopecia.

The use of ketoconazole containing solutions has been shown to improve the density, size, and proportion of hair follicles in individuals with a diagnosis of androgenic alopecia.

In general, ketoconazole will prevent the hair loss that is associated with the inflammation of the scalp caused by fungus.

According to a study available from the US National Library of Medicine topical solutions containing ketoconazole have shown to have a therapeutic effect on conditions of androgenic alopecia.

Long term use of topical agents such as Nizoral shampoo may also help prevent the onset of androgenic alopecia, and may even be useful in instances not related to the typical use of ketoconazole such as dandruff and seborrheic dermatitis.

Ketoconazole can prevent hair follicle miniaturization that leads to hair loss.

In a study of the use of ketoconazole containing solutions on rodents, there was significant hair growth after only three weeks of treatment. The health of the skin in the rodent was shown to have improved and there was significant difference in the diameter of the hair follicle.

The authors of the study suggest that the use of topical ketoconazole could stimulate hair growth significantly.

The Journal of Dermatology has also begun to research the potential of ketoconazole to promote hair growth beyond its capacity to manage fungal infections, dandruff, and seborrheic dermatitis.

The study repeated the study of hair growth on rodents, comparing the experimental group to a control group, and found that the application of a ketoconazole solution had significant stimulatory effects on the growth of the hair.

The authors of the study confirmed that there is efficacy to the use of ketoconazole in the stimulation of hair growth, however discuss the lack of understanding of the mode of action through which this occurs.

Further research is required to determine the role of ketoconazole in the process of hair growth, beyond its role in promoting skin and hair follicle health in cases of seborrheic dermatitis and other scalp irritations.

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Numerous studies, from the National Center for Biotechnology (2) compare the effectiveness of ketoconazole treatments with other common treatments for dandruff and seborrheic dermatitis.

These studies found that there is generally less irritation from the treatments of ketoconazole, and that the results were typically similar in outcome.

Ketoconazole has also been found to have similar effects and outcomes as some lower strength prescription options, which is useful due to the general availability of Nizoral shampoos and ketoconazole topical solutions.

The effectiveness of Nizoral shampoo depends on the severity of the condition as well as the length of time the scalp has been subject to the harm of the condition.

The available research suggests that hair loss, thinning hair, and receding hairlines may be reversible in some cases depending on the damage that has been caused to the hair follicle and the ability of the systems that support hair growth to recover.

There is also limited research to suggest that in some cases, ketoconazole can promote hair growth depending on the initial cause of the hair loss.

How Does Nizoral Work?

Nizoral shampoo contains an active ingredient known as ketoconazole, which is an anti-fungal agent effective for treating the underlying skin conditions that cause dandruff.

Ketoconzaole has also been shown to inhibit one of the steps in the production of DHT, which is indicated in hair loss due to damage to the hair follicle.

Using Nizoral shampoo two times a week will reduce the proliferation of fungal agents that are causing dandruff or seborrheic dermatitis. Once the noticeable irritation of the skin and presence of dandruff has dissipated, using Nizoral shampoo on a bi weekly basis will help prevent the recurrence of these conditions.

Nizoral shampoo should not replace the regular use of a shampoo to wash hair, and should only be used as directed to avoid overuse and the increased potential for side effects.

What is Ketoconazole?

Ketoconazole is a broad spectrum synthetic anti-fungal agent, typically used to treat a variety of skin conditions. The mode of action of ketoconazole impairs the body’s ability to synthesize ergosterol which is a vital component of the cell membranes of fungus.

As an anti-fungal agent, ketoconazole inhibits the growth of dermatophytes and yeasts by reducing the permeability of the cell membrane in these organisms.

While these organisms are normally present on the scalp, the significant proliferation of them can be prevented by the use of ketoconazole.

Ketoconazole is also indicated for the inhibition of 5 AR, an enzyme which converts testosterone to DHT. When testosterone is converted to DHT this leads to damage of the hair follicle which ultimately kills the follicle.

The use of ketoconazole may help reduce the likelihood that testosterone is converted to DHT which will ultimately promote the overall health of the scalp and the hair follicles.

Seborrheic Dermatitis

The Oxford Journals of Medical Mycology define seborrheic dermatitis as a chronic and widespread skin condition that is influenced by the activities of a variety of yeasts and fungi of the species Malassezia.

The occurrence of seborrheic dermatitis can depend on a variety of factors including age, gender, and the health of the individuals’ immune system.

The buildup of white sebum on the scalp can be a sign of an unhealthy scalp and possible future hair thinning

The main clinical characteristics of seborrheic dermatitis include inflammation and redness, as well as scaling of the skin. This condition occurs on areas of the body which have high numbers of sebaceous glands, including the scalp, face, and chest.

Due to the role of the immune system in preventing seborrheic dermatitis, this condition is commonly seen in patients with HIV/AIDS and other immunosuppressive conditions.

Individuals who experience cases of seborrheic dermatitis are likely to have intermittent periods of relapse of the course of years.

Early treatment of the condition with a variety of products including shampoo containing ketoconazole, such as Nizoral shampoo, is likely to reduce the likelihood that a case becomes severe enough to lead to hair loss or damaged hair.

If addressed early enough, some hair loss that may have occurred due to these conditions has been shown to be reversible.

Reviews of Nizoral Shampoo

There are many reviews available for Nizoral shampoos, the majority of which offer an overall positive rating for the product.

Numerous consumers agree that Nizoral shampoo is effective in treating the majority of cases of dandruff or low level seborrheic dermatitis, and are less harsh than other treatments typically used to address such issues.

Reviewers commonly comment on the gentle tingling sensation associated with the use of Nizoral shampoo, stating that it is an enjoyable and fresh feeling that suggests the product is actually working.

Other common comments include the fact that the shampoo has a fresh, clean scent and leaves hair with a pleasant smell. Many users also enjoy the significant amount of lather the shampoo generates while washing hair.

There are some negative reviews associated with Nizoral shampoo, mainly associated with the potential side effects of using this type of shampoo.

Depending on the severity of the case of seborrheic dermatitis the use of Nizoral shampoo may not sufficiently address the condition, as stronger treatments may be required.

Many users also complain about the cost of the product which can be expensive when compared to other products on the market that are designed to address similar issues.

There are a variety of factors to consider when determining whether or not Nizoral shampoo is the correct product for the treatment of your dandruff, scalp fungal infection, or seborrheic dermatitis.

These factors include the severity of your condition, your body’s predisposition for experiencing side effects, and health conditions you might have.

In cases of minor dandruff or if the use of Nizoral shampoo has been successful in the past you may wish to utilize this product as it is easily available over the counter.

Otherwise you may wish to consult with a physician or medical professional on the most appropriate method of addressing your dandruff, fungal infection, seborrheic dermatitis as it relates to any hair loss, thinning hair, or receding of the hairline that you might be experiencing.

See my review of Revivogen products and shampoos here.

Cost of Nizoral Shampoo

The cost of Nizoral shampoo will depend on the strength and concentration of ketoconazole. Over the counter options typically cost somewhere in the range of $15 USD for approximately 8 oz. of product.

Prescription strength ketoconazole shampoo will cost more than the name brand Nizoral product. The amount of product needed may vary from one individual to another, as well as the frequency of use.

Typically, this product is used only a couple times per week initially, which will be reduced once the issue has been addressed in order to prevent a recurrence of the condition.

In comparison to other products with a similar treatment, Nizoral shampoo is one of the less expensive options available.

There are many products on the market that are designed to address similar conditions as Nizoral shampoo, as well as a variety of prescription strength products.

In comparison to the prescription strength products, Nizoral shampoo has been shown to be equally effective in many cases and can be the cheaper option depending on the potential coverage by insurance.

Due to the suggested intermittent use of Nizoral shampoo, the product will generally last for a reasonable period of time particularly once it is only being used bi-weekly as a maintenance option versus the direct treatment of the condition.

Possible Side Effects

There are many potential side effects associated with the topical use of the active ingredient in Nizoral shampoo, ketoconazole.

According to the Mayo Clinic, the most common side effect of skin irritation is likely to dissipate after multiple uses. Should any side effects beyond the irritation of the skin in the areas of use, it is important to seek medical attention and discuss these issues with a physician.

Often, many of the less severe side effects can be managed in consultation with a physician. However, if you experience any of the more serious side effects it is important to discontinue use immediately and seek medical attention.

Common Side Effects of Nizoral Shampoo

  • skin irritation; itching, stinging, burning
  • dryness or oiliness of the hair and scalp
  • headaches

Individuals with the following conditions should consult a physician prior to using Nizoral shampoo;

  • women who are pregnant or are planning to become pregnant
  • women who are actively breastfeeding
  • people with asthma or chronic obstructive pulmonary disease
  • individuals who have some form of cardiac condition
  • individuals who are, or may be, allergic to the ingredients of Nizoral shampoo

How To Make Your Own Hair Loss Shampoo Instead

Like I said in the introduction, I don’t use Nizoral shampoo, and I don’t recommend it to anyone either.

I try and make sure I don’t use any chemicals on my hair, because the long term effect is damage to the scalp and to the hair follicles.

Why would you anyway when there are wonderful natural products that can gently clean your hair without the chemicals?

Start with a teaspoon of baking soda and add this to a tablespoon of apple cider vinegar in a glass. Top up the glass with luke warm water. Stir until it has stopped fizzing.

Apple cider vinegar shampoos gently cleanse the scalp

When you are in the shower you can now pour the mixture over your hair slowly, massaging into the scalp as your go. Massage the mixture gently into your scalp for around 30 seconds and then wash through with luke-warm water.

Now for stage 2…

Take half a teaspoon of bentonite clay and mix thoroughly with luke-warm water in another glass. Inside the shower, after you’ve washed your hair with the baking soda (not baking powder FYI) and apple cider vinegar mixture, pour the bentonite clay and water mixture on to your scalp.

Pour slowly and massage as your go. When you’ve poured the entire contents of the glass over your hair continue massaging for 30 more seconds and then rinse thoroughly with luke-warm water.

Thoroughly rinse out the shower after.

In my hair loss course, Hair Equilibrium, I’ll show you some of the variations of this homemade shampoo recipe that I use that work even better.

And I’ll show you a few special ingredients that I add which help block DHT, boost circulation and feed the hair follicles.


As you’ve read, there are cases when Nizoral has been proven to work well and it is a popular product to help with dandruff and hair loss.

However, that still doesn’t mean I will use it personally.

If you have a lot of dandruff, this has a lot more to do with your diet and lifestyle than choosing the wrong shampoo.

The problem is, chemicals will always damage, age and dry your skin over time so they can only make the problem worse.

Using this kind of shampoo only covers up the symptoms of the problem, which stems from your diet.

On Hair Loss Revolution, and inside my popular course, Hair Equilibrium, I’ll show you the exact diet changes you need to make so stop dandruff completely (from the inside out.)

I’ll show you how to completely renew the health of your scalp so that it doesn’t itch, or feel tight. I’ll show you how to make it the perfect environment for strong healthy hair growth.

I’ll show you how to boost your hair growing nutrition so much that your hair is practically forced to grow thick and strong due to the complete abundance of nutrients and minerals.

I’ll show you how to clean your body in a way that makes dandruff and scalp sebum a thing of the past.

Then you won’t even need to consider using Nizoral shampoo at all.

Inside Hair Equilibrium I’ll also show you some of my other homemade shampoo recipes that kick-butt at growing back hair whilst also protecting your fragile hairs around the hairline and at the same time invigorating the scalp.

11 thoughts on “#1 Big Reason I Will Never Use Nizoral Shampoo For Hair Loss

  1. I do agree that chemicals are bad but nizoral does block dht and help with itching and dandruff which can indirectly accelerate hairloss. My main concern is that nizoral is an antiandrogen so it will not only block dht but testosterone as well since some of the drug can be absorbed through your scalp

  2. Has anyone tried Stemm shampoo by Deciem. It’s pretty pricey and has had mixed reviews online, but it seems to follow Will’s ethos of only natural stuff. Biotin, caffeine, fluvic acid, amino acids etc – nothing nasty to make it lather. I’m using it now, too early to see any noticeable results.

  3. Hi Will. My hair started thinning because I wasn’t washing enough, then I overcompensated by washing everyday and it kept thinning. I switched to Purador brand shampoo and conditioner for hair regrowth and I’ve been using it every other day. (there are no sulfates or parabens, but the ingredients are a huge list of chemicals) Lately though, my hair has been really dry and itchy on the days when I do not wash. Whenever I touch my head, a hair floats down, sometimes with a yellow blob on the end of it. My scalp has felt tight for nearly a year, and it has recently started to feel like there’s dried up skin gunk on my scalp. Just to look at me though, I still look normal. I’m hoping to change my habits to prevent further loss and regrow what fell out. What what habits do I need to drop and what ones should I start? Specifically, how often should I wash?

    • Firstly, stop using any kind of shampoo, just use apple cider vinegar (a couple of tablespoons) diluted in water and massaged into the scalp for 1 minute. Just do this once per week and no more. Then focus on changing your diet, removing processed foods, fried foods, dairy, gluten etc. Also, consider doing a detox. That should help.

  4. You realize that literally everything is chemicals, right? Even the “natural” alternatives you are suggesting ARE chemicals. Apple Cider Vinegar contains chemical acetic acid which can burn your skin and erode the enamel of your teeth. But it’s good because it’s “natural”, right?

    • This is an interesting point. The thing with what I define as chemicals is, you wouldn’t want them inside your body. Would you mind drinking a teaspoon of sodium lauryl sulphate? Probably not a good idea! Would you mind a teaspoon of apple cider vinegar? Well I have a teaspoon of ACV in my herbal tea before I go to bed every night, so I certainly wouldn’t have a problem with that.

      The main issue is that people see the skin as impermeable, so if they put something like SLS on their skin in the form of a shampoo, that it won’t go through into their body and start affecting it in unforeseen and probably negative ways. But since the skin isn’t like that, and chemicals do go into the body it makes sense that you would use ‘chemical free’ products.

  5. Hi Will,

    You go into detail about what Nizoral is, how it works, etc., but you don’t do so for your natural solution. Plse could you guide me to the page where you do?

    Many thanks in advance. Enjoyed this post (the whole of the internet raves about Nizoral; you don’t: good!)


    • Thanks Nick, for more info on the natural solutions, I would recommend checking out our Hair Equilibrium program.

  6. I am very curious on this. I eat healthy. Never had pseriosis ever until 2yrs ago and I don’t do anything diff

    • I agree there is no real definition of what a chemical is. However I think about it with a simple test: would you happily ingest it?
      For example, would you put baking soda and apple cider vinegar in your body?
      Yes, and it would actually be considered healthy. I often take a teaspoon of ACV before a meal since it has shown to reduce blood sugar levels.
      However, would you take a teaspoon of any of the ingredients from Nizoral and put that in your mouth? No way!
      People don’t realise that whatever goes on your skin also goes into your body. It’s the same reason I don’t use ‘chemical’ based deodorants, body washes, shampoos and topicals.

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