Nizoral (Ketoconazole) Shampoo Review: One of the Big 3 Treatments?

Are you frustrated with the slow yet noticeable process of your hair gradually thinning or disappearing? We understand completely, and we want you to be happy with your hair.

​Enter Nizoral shampoo, also known as ketoconazole.

Nizoral shampoo is a name-brand product used to treat dandruff, flaking, itchy scalp, and hair loss. The FDA approved this drug as an antifungal agent. However, this product can help reduce inflammation associated with dandruff.

Researchers also found out that Nizoral may help someone with hair loss.

Read on to discover everything you need to know about Nizoral shampoo. Examine the ingredients found in the shampoo, including ketoconazole, how they affect you and what this product does for hair loss.​

Another up and coming contender are laser combs. Be sure to know what they can do.


Nizoral (Ketoconazole 1%) Shampoo

nizoral ad shampoo hair loss review


  • Fights dandruff
  • Positive results from studies done on hair loss
  • Cheap


What is Ketoconazole?

Ketoconazole is a medication prescribed by physicians to fight infections caused by various types of fungi. This drug can be taken orally and has other uses as well.

When people take this drug by mouth, it can cause serious side effects. A prominent side effect is liver damage. However, individuals who use ketoconazole as a topical medicine for dandruff show negligible side effects associated with liver damage whatsoever, according to the U.S. Food and Drug Administration.

Ketoconazole is the generic name of the name-brand product known as Nizoral.

What is Nizoral?

Nizoral, as an ingredient of anti-dandruff shampoo, is a drug that prevents the growth of fungus on your skin. The most serious side effect of Nizoral anti-dandruff shampoo is an allergic reaction to the medicine or any of the shampoo's ingredients.

Nizoral may affect some medical conditions, including pregnancy, alcoholism, liver problems, and allergies. However, medical science notes that since small amounts of Nizoral enters the bloodstream through shampoo, the chances of serious interactions are tiny.

If you have concerns about Nizoral shampoo and your health, always speak to your doctor or a licensed medical professional.

What ingredients are in Nizoral shampoo?

Nizoral shampoo has an active ingredient of a 1-percent concentration of ketoconazole. This drug is labeled to help control flaking, scaling, and itching associated with dandruff.

The 1-percent solution is available without a prescription, but the 2-percent solution requires a doctor's permission to use. We will discuss the differences between these percentages later in this review.

Inactive ingredients in Nizoral shampoo include:

  • ​Acrylic acid polymer (Carbomer 1342)
  • Butylated hydroxytoluene
  • Cocamide MEA
  • FD&C Blue #1
  • Fragrance
  • Glycol distearate

Acrylic acid polymer, or Carbomer 1342, works as a thickening agent that helps keep ingredients dissolved in the liquid solution. This ingredient acts the main substance of Nizoral shampoo that holds everything together. This ingredient is safe for use on your scalp.

Butylated hydroxytoluene is an antioxidant that may prevent virus from replicating. It can be added to foods as a preservative or used as a medicine. This ingredient is usually safe, although there is little information about its medical uses.

Cocamide MEA is an ingredient synthesized from coconuts, coconut oils and ethanolamine (a derivative of alcohol). This serves as an emulsifier, which means it helps disperse the ingredients in Nizoral shampoo evenly throughout the product.

FD&C Blue #1 is a synthetic dye made from petroleum. It is used as a hair dye in more concentrated forms. In the case of Nizoral shampoo, it simply adds color to the product.

Fragrance refers to any class of substances that add an aroma to a product.

Glycol distearate comes from stearic acid, a naturally occurring fatty acid. This ingredient is a skin conditioning agent that also helps keep the shampoo in a liquid form.

These are safe ingredients in the Nizoral shampoo and they have very few side effects. Using Nizoral shampoo is very easy, and your symptoms of dandruff may improve over time if you use this substance correctly.

How do you use Nizoral shampoo?

  1. Wet hair thoroughly before using this shampoo.
  2. After wetting hair, apply shampoo. Consider a quarter-sized amount at first, depending on how much hair you have on your head.
  3. Generously lather the shampoo into your hair, leave it on the scalp for three to five minutes, and then rinse thoroughly.
  4. Use this shampoo once every three to four days for up to eight weeks. These instructions may change based on your doctor's instructions. That means your doctor might tell you to use this shampoo more times or fewer times.
  5. During your treatment regimen with this shampoo, your dandruff and scalp itchiness may subside. Furthermore, Nizoral shampoo could also reduce hair loss on your scalp.

Does Nizoral work for hair loss?

Nizoral is designed as an anti-dandruff shampoo. Some medical studies report that Nizoral shampoo may work as a shampoo that helps prevent hair loss.

One of the First Studies

In 1998, research attempted to find out if ketoconazole applied to the scalp can help improve androgenetic alopecia, also known as pattern baldness. Researchers wanted to know if hair loss might be associated with some microbial infection.

One group of individuals used a 2-percent concentration of ketoconazole on the scalp combined with a 2-percent solution of minoxidil. Other groups of people in this study used minoxidil without the ketoconazole, while others simply used topical ketoconazole with unmedicated shampoo.

The people who used minoxidil or ketoconazole both saw similar results when it came to hair density and size. Researchers recommended further study regarding ketoconazole and hair.

Combination Therapy

A study in 2002 went further than the original study from 1998. Over the course of one year, researchers observed 100 men divided into four groups. One group used oral finasteride, or Propecia, as a way to treat hair loss. Another group combined finasteride with topical minoxidil. The third group of men just used minoxidil. The fourth group took finasteride and used topical ketoconazole.

Every group of men saw more hair growth at the end of one year. The group that saw the best results used a combination of finasteride and minoxidil. The second-best group was the one that used ketoconazole. This second study backed up the first in that ketoconazole, or Nizoral is an effective treatment for hair loss.

Updated Study

Research published in 2011 provided some very encouraging results for people using Nizoral shampoo for hair loss. Although this study only followed 15 men, the authors noted that a 2-percent solution of Nizoral, when left on the scalp for 10 minutes, produced significant hair regrowth and better growth of existing hair.

This study combined Nizoral with other treatments, such as NuHair, to check the efficacy of various products. This pilot study noted anecdotal evidence that Nizoral works to improve hair loss.

Researchers in this pilot study note that the FDA only approves Nizoral for antidandruff properties and not for hair loss. Therefore, consumers in the United States won't see labels that say anything about Nizoral's effects on hair loss.

Each study pointed out that the side effects of Nizoral shampoo were minimal or non-existent.

What are the side effects of Nizoral shampoo?

Common side effects of Nizoral shampoo include rash, hives and a reaction on the site where you apply the shampoo. These might indicate allergic reactions to the product.

Other side effects are:

  • Dry skin
  • Mild irritation
  • Abnormal hair texture
  • Scalp pustules
  • Abnormal oiliness or dryness of the hair and scalp​

If you experience any of these side effects, discuss them with your doctor immediately. Your doctor can determine if there is an underlying cause to these side effects.

Even with these side effects, doctors still may recommend Nizoral for hair loss. The shampoo comes in solutions of 1 percent or 2 percent.

Difference between 1% and 2%?

The main difference between Nizoral shampoo at 1% and 2% is that the lower concentration is available over-the-counter. The higher strength requires a doctor's prescription.

The percentages refer to the concentrations of ketoconazole in the shampoo. A 2-percent solution contains twice as much as a 1-percent solution - the reason why you need a doctor's prescription.

The percentages refer to the ratio of the drug compared to the rest of the ingredients. A 1-percent concentration means just one part in 100 contains ketoconazole. A 2-percent concentration refers to two parts in 100 in the entire product.

Because of possible side effects, the higher concentration requires a prescription. However, the 1-percent shampoo is available for purchase without a doctor's permission.

Where can you buy Nizoral shampoo?

The easiest place to buy Nizoral shampoo is through With just a few clicks, you can get this product delivered to your door in just a few days.

You can also buy Nizoral at several national retailers in the pharmacy section. However, you may spend less money on Amazon depending on price, sales tax and how far you need to travel to get to the store.

Another benefit of looking at Amazon includes the tips and tricks supplied by buyers as they answer questions about the product.

What are some other tips and tricks?

Users recommend using a conditioner on your hair if Nizoral dries out your hair and scalp. Conditioners add moisture back into your hair. They can also help your scalp.

Another thing to remember is that you aren't supposed to use this shampoo all of the time. Just use it up to two times per week. Some studies found that men who use it for a year saw few if any, side effects when following the package directions.

One way to help with a hair loss problem might be to use Nizoral in combination with other treatments. Discuss this with your doctor in case there are any complications against certain medical conditions.


Overall, Nizoral shampoo is regarded as safe. As with any hair products, you must use it according to the instructions. Keep this product out of your eyes, and never ingest it. If you have any problems, consult with your doctor.

If you talk to your doctor about hair loss problems, mention Nizoral or Ketoconazole as a possible treatment method. Your physician can then discuss this medicated shampoo as a possible treatment regimen for your hair loss.

The bottom line with Nizoral shampoo and hair loss is that you should find out what works best for you. Keep in mind, the FDA only approves Nizoral to be labeled as an anti-dandruff shampoo rather than a medication for hair loss. That's why you should discuss this option with your doctor since only a physician can write a prescription for the 2-percent concentration.

It never hurts to try something if you are worried about hair loss. Just keep in mind the side effects of Nizoral shampoo, and talk to your doctor if you notice any abnormal changes in your hair or skin after using this product.


  • Few, if any, side effects
  • Works against dandruff
  • Studies show it helps hair loss, especially when combined with other treatments


  • May dry out hair
  • Might complicate with some medical conditions


This article is for informational purposes only and should not be construed as medical advice. If you have any questions about using this product, consult with a physician.

The FDA has not evaluated Nizoral shampoo for hair loss. However, the shampoo may be used for conditions other than what is described on the label based on a doctor's instructions.​

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