Nizoral Shampoo and Hair Loss: An In-Depth Guide

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.

Nizoral is a popular option for the treatment of many scalp conditions, but what about hair loss?

In this 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.

This will include a look at its mechanisms, possible side effects, costs, and more.

Let’s get started!

What is Nizoral Shampoo?

Nizoral shampoo is an over-the-counter product that is used in the treatment of dandruff, fungal infections, seborrheic dermatitis and related hair loss, thinning hair, and receding hairlines (1, 2).

This product is produced by numerous companies, each of which are fairly similar to one another.

A woman pouring nizoral shampoo into her palm

The active ingredient of Nizoral shampoo, known as ketoconazole, is an anti-fungal medication.

HAIRGUARD

GROWBRUSH

Play with the slider below to see before and after.

Nizoral shampoo is shown to be an effective method for treating dandruff and seborrheic dermatitis (3).

(Learn more about seborrheic dermatitis here.)

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 (4).

This may make it a treatment option for men and women with Androgenetic Alopecia (AGA) (5).

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

How Does Nizoral Work?

Nizoral shampoo contains an active ingredient known as ketoconazole, which is a broad spectrum synthetic anti-fungal agent effective for treating the underlying skin conditions that cause dandruff (6).

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 (7). It also inhibits the growth of dermatophytes and yeasts by reducing the permeability of the cell membrane in these organisms (8).

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

Ketoconazole is also indicated for the inhibition of 5-alpha-reductase, an enzyme which converts testosterone to DHT (9). When testosterone is converted to DHT this leads to damage of the hair follicle in individuals with AGA, which ultimately kills the 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 the 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.

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 the Treatment of Dandruff and Seborrheic Dermatitis

In a study published by the British Medical Journal of Clinical Evidence, the effectiveness of a ketoconazole scalp preparation was compared to a placebo (10). The results 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.

A 2010 study published in the journal of Pharmacy & Therapeutics states that the most effective method of treating seborrheic dermatitis is to address the colonization of yeast and fungus on the skin and reduce the resulting skin inflammation (11).

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.

In the Treatment of Hair Loss

Research that has been published more recently on ketoconazole suggests that it may also play a role in the treatment of androgenetic alopecia.

A 2014 study compared three solutions for the treatment of hair loss in mice (12). They were: minoxidil, ketoconazole, and minoxidil with tretinoin.

The dorsal areas of the mice were clipped and dyed, and the treatments were applied to each group once daily for three weeks.

The group to show the greatest hair growth was the minoxidil-only group.

However, the other two groups including ketoconazole also saw significant growth over the three week period.

And while this study was performed on mice, there is evidence to suggest that the use of ketoconazole would be effective in human subjects as well.

One such study was published in 2011 (13).

This study consisted of 15 male patients, all of who received a topical combination of finasteride, dutasteride, and minoxidil. However, the men were also able to choose additional treatments, one of which was ketoconazole shampoo.

Ten of the 15 patients incorporated ketoconazole shampoo into their routine, with one out of 15 using just ketoconazole alongside the above-mentioned topical combination.

As reported by researchers:

“Patients who did not have signs or symptoms of seborrheic dermatitis also reported subjective improvement [of hair growth] with use of 2% ketoconazole shampoo.”

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.

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.

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 and 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.

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 ounces 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.

Possible Side Effects

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

  • Skin irritation; itching, stinging, burning
  • Dryness or oiliness of the hair and scalp
  • Headaches

According to the Mayo Clinic, the skin irritation is likely to dissipate after multiple uses (14). 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.

Those 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
  • Individuals 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

Ketoconazole has been shown to be less irritating than similar treatments, though there is a risk of hepatotoxicity (15).

Is Nizoral Shampoo Right for You?

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 on the most appropriate method of addressing your scalp condition.

Do you have questions about Nizoral? Leave a comment down below.

Last Updated On

Categories Shampoo

32 thoughts on “Nizoral Shampoo and Hair Loss: An In-Depth Guide”

  1. Really informative post! Now I know to check out the products I buy and see if SLS is a part of it. My boyfriend uses Art Naturals Organic Moroccan Argan-Oil shampoo and conditioner, but I use something else. After I finished your article, I’ve decided that I’m going to just finish off my bottles of shampoo and conditioner and use the same one as him. =) I always find a lot of my hair just getting pulled out when I brush it, so I’m wondering if it is mostly caused by the products I use or if it’s just me.

  2. Exactly, it’s good to just experiment with the obvious potential causes before spending too much money on hair loss solutions (because trust me, it adds up!) And for us women, hair loss has so many different causes, both internal and external, it’s easier to start with the external stuff that goes on our heads every day before we go get bloodwork or see a nutritionist! thanks for the comment 🙂

  3. Very useful information on the ingredients that cause baldness. It’s one thing I’ve been trying to prevent for a long time and I’m glad to have found some kind of answer. I think those shampoos you’ve mentioned are a great alternative that don’t contain sodium lauryl sulfate. Thanks for the advice!

  4. Wow, I never thought that using my regular shampoo might damage my hair. I checked my shampoo now and it says that it contains Sodium Laureth Sulfate, is it the same SLS? Would you suggest I start using a different shampoo?
    Thanks,
    Paulina

  5. Thanks for the question! Sodium Lauryl Sulfate and Sodium Laureth Sulfate are very similar shampoo additives, that do the same thing (promote lather). However, Sodium Laureth Sulfate is even a bit worse, as it also contains a known carcinogen, 1,4 dioxane. I would highly suggest using and supporting shampoos and beauty products that don’t involve these additives.

  6. Great article! It makes me so mad that we are being poisoned by all these chemicals in everything we use. Grr. And Sodium lauryl sulphate is no exception. In fact I went through my bathroom cabinet one and found it in everything. Fortunately, I work in a Herbal Apothecary now where I have learnt so much about these chemicals, everything we sell is organic so as you can imagine my bathroom cabinet looks very different now…and so does my skin 🙂 And, it’s really great you’ve given us a list of good shampoos to buy. Thanks

  7. Thanks for the great comment. Yeah – it IS frustrating that some greedy people agreed that it would be ok for all of us to be slowly poisoned by harmless-seeming stuff that we use every day. This is just one more bugaboo to look out for, particularly for those of us trying hard to protect and regrow our hair. glad you have access to tons of herbal alternatives!

  8. OMG, the things you are not aware of is really sad and scary. I have never heard of SLS nor have I ever been warned about the uses of it. I read my food labels but now I have to read my hair and cleaning labels. This is a great article and I am glad I have run into this today because for one I am a mother who is responsible for my children. You may have brought my attention to what has been causing my husband’s scalp irritation also. So I truly thank you for opening my eyes to something as important as this. I have some labels to read. 😀

  9. Thanks for sharing your feedback – I agree, it’s sad and surprising that we’re surrounded by so many chemicals in what should be safe, every day ingredients. Good luck in your label vigilance! you may need to do a purge of cleaners and beauty products, and replace with all-natural alternatives.

  10. Hi Penelope
    Thank you for the explanation of Sodium Lauryl Sulfate – I had never heard of it before. I don’t use soaps due to eczema and the way they dry out my skin instead using water and non-scented moisturisers to shower. However, I do use shampoo and will be looking at the contents a lot more carefully now as my scalp is quite dry at the moment – which could be just from eczema or it could be from Sodium Lauryl Sulfate. Again thank you for pointing this out to me.
    regards,
    Megan

  11. Thanks for reading and sharing your thoughts on this dastardly ingredient that somehow sneaks its way into all our products! Glad you’re warned and on the lookout now! 🙂

  12. Great information! I have also learned that Sodium Lauryl Sulfate causes colored hair to lose the color quickly. This makes sense since it is such a damaging substance.

  13. Thank you for sharing your thoughts! I agree that SLS drains color, and since we usually pay an arm and a leg for that color, it makes total sense to avoid it just on those grounds.

  14. This is an eye-opener: High concentrations of Sodium Lauryl Sulfate in products can cause severe irritation and even corrosion of the skin and you’re telling me it also can be found in toothpaste, bubble bath, and shaving creams? We have been poisoning ourselves without knowing. This has to stop!
    This kind of information is important for people to read and I am glad you wrote about it. Keep up the good work!

  15. I have heard of SLS but I didn’t know it had so many side effects….I’m a bit worried as I went reading your article I realized that…well it might be the cause of my problem right now. I pretty much have all of the negative effect of it and I didn’t realize till now…I will make sure to change my shampoo Asap!! Thank you for the info I really really appreciate it!

  16. Thank you for the comments, and yes! We are surrounded by poisons in everyday products, it’s insidious, unfair, and absurd that our government gives these product makers a pass to utilize such damaging ingredients. The burden is, sadly, on ourselves to keep ourselves safe and in the clear.

  17. 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

  18. 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.

  19. 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.

  20. Thanks for reading! A commonly available product line is OGX – they’re in drugstores and department stores – and I mention it because they’re inexpensive and all sulfate free. They also have a terrific hair loss formulation you can read more about.

    .

  21. 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.

  22. 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!)

    Regards,
    Nick

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

  23. 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.

  24. Hi Will,

    Can you tell me how many times you should wash your hair (with or without natural shampoo) per week? I read many of your posts but I couldn’t find this info.

    Thanks!

    • Hi Jake, basically it depends. Overwashing can strip away too many natural oils that protect the scalp and can actually cause the scalp to start producing more sebum than it should. If your hair gets oily very quickly this is more an issue of your diet. Removing processed foods and any kind of fried foods or foods with vegetable oils is a must. Generally cleaning up your diet and detoxing will help your hair stay in good condition for longer without having to shampoo. As a rule of thumb though I would say 1-2 times per week.

  25. Hi
    How are you?
    I need your help please.
    I had two month with hear loss (a lot) the most around my forehead. I am a woman. I am desperate I do not how to stop my hear loss. I got some blood test and they are normal. After a surgery I had been little bit stressed and I lost 13 pound on two month.
    Please give me some information to do to stop my hair lost.
    Thank you
    I will appreciate it.

Leave a comment

This site uses Akismet to reduce spam. Learn how your comment data is processed.