** This content was written by a DS Laboratories writer and is not intended to be served as medical or treatment advice.

When trying to answer this question we have to briefly disambiguate some terms here. For some of you that may not know, DHT or dihydrotestosterone is a male steroid hormone which is responsible for developing male genitalia during pregnancy and in early life for developing male facial characteristics such as beard etc. Ironically enough, in adult life it is responsible for the loss of hair in both men and women. The hormone appears as a by-product of testosterone and attaches itself to follicles in the scalp. In men and women who are genetically susceptible to hair loss it causes the follicles to weaken, shrink and completely shut down. It is the main culprit in causing male pattern baldness and can eventually lead to complete hair loss on the scalp. The most effective way in stopping or preventing hair loss in such cases is to block the DHT hormone.

One of the ways of blocking the DHT hormone topically on the scalp is by using blocking shampoos. One of the most common ingredients in these shampoos that is used to block DHT is ketoconazole. Ketoconazole is primarily a medication that has antifungal properties and is used to treat conditions that affect the nails and skin such as seborrheic dermatitis, candidiasis and ringworm.

Scientific studies have shown a link between the use of ketoconazole and the prevention of hair loss and male pattern baldness. Even though scientists still can’t determine exactly how ketoconazole blocks DHT into measurable form, there have been many studies which show that the use of ketoconazole shampoos has greatly helped with hair loss and male pattern baldness. One such study from 1998 compared the effect of ketoconazole and minoxidil and the scientists have come to realize that the rate at which ketoconazole increased the size and proportion of anagen hair follicles is similar to the rate of the minoxidil spray. Many studies have also been conducted to animals, and the results have shown that with regular use of ketoconazole, there is a great improvement in hair growth, not only in affected follicles, but also in follicles that are immune to DHT and are located at the back of the head. In 2004 there was a scientific paper that hypothesized that ketoconazole can potentially block DHT and slow down the hair loss process by disrupting the DHT pathway. Find below some additional studies that have proven the positive effects of ketoconazole on hair thinning and DHT induced hair loss:

• 1. Aldhalimi et al, ISRN Pharmacology, 2014. We retrieved it from Hindawi International Scholarly Research Notices

• 2. Rafi and Katz, ISRN Dermatology, 2011. We retrieved it from US National Library of Medicine

• 3. Khandpur et al, Journal of Dermatology, 2002. We retrieved it from US National Library of Medicine

• 4. Pieard-Francimont et al, Journal of Dermatology, 1998. We retrieved it from US National Library of Medicine

Scientists believe that ketoconazole has proven effective against DHT as it is an androgen receptor antagonist. What does that mean for blocking DHT? This means that ketoconazole will actually try to bind with androgen receptors in the follicles of the hair, and in trying to do so, will battle DHT in order to bind to the receptors first. By doing so, it will prevent the DHT from binding to the receptors. In this way it will allow less DHT to bind with the follicles, and while DHT causes the follicle to shrink and stop producing hair, ketoconazole has no such effect. So, the only thing that ketoconazole does is fill in the place that would normally be taken by the DHT and so protect the follicle. While ketoconazole may not block DHT on a molecular level and is not a medication that will completely cure hair loss on its own, in the least it is a partial hair loss cure. Its effects are felt the most when it is used together with a DHT hair loss treatment, and should be used like this for optimal results.

Ketoconazole treatments may come in different forms, some of which include oral use of the medication. Nevertheless, the safest and the most accessible forms of ketoconazole treatments are topical shampoos. They come in different concentrations such as 1% and 2%. The 1% ketoconazole formula you can simply get over the counter, whereas the 2% formula requires a doctor’s prescription as it may be a bit too strong for people with a sensitive scalp. In these cases, people may experience skin irritation, some itching, burning, dryness or oiliness of the hair and scalp and in rare cases even headaches. If by any chance you feel you are sensitive to the 2% solution, make sure to consult your doctor and switch to the 1%. Another downside which is not so harmful, is that ketoconazole may leave your hair looking a bit flatter than before. This is why it is recommended that you use a volumizing conditioner alongside the ketoconazole shampoo.

As the numerous studies above suggest, ketoconazole has proven to be quite effective when it comes to treating androgenic alopecia in both men and women. Even though as a medication it is used to fight seborrheic dermatitis and dandruff which may lead people to believe that it boosts hair growth by eliminating these issues, studies have shown that long-term use of the 2% ketoconazole solution has proven to be effective against androgenic alopecia even in patients who weren’t suffering from seborrheic dermatitis or dandruff problems. As mentioned above, it is effective against DHT due to the fact that it possesses antiandrogenic properties. However, it is not only effective with DHT susceptible follicles but also on the androgen insensitive follicles as well. It increases hair follicle diameter and boosts hair growth.

If you are suffering from androgenic alopecia, and are undergoing treatment, feel free to go for a ketoconazole topical shampoo to boost the effect. Consult your doctor on which solution would be best for you to try in order to avoid any side effects due to scalp sensitivity, and incorporate it into your hair treatment routine.