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Ketoconazole is an antifungal medicine. In the EU, the shampoo, cream and gel forms are authorised for dandruff, seborrhoeic dermatitis and a fungal skin condition called pityriasis versicolor. Using it for hair loss is off-label, and the evidence behind that use is weak.
Ketoconazole has no EU marketing authorisation for hair loss. No doctor in the EU — including ours — can prescribe it for this use.

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Can I get it?

Not for hair loss. We don’t prescribe ketoconazole for this today, but our doctors can review your case and propose an equivalent hair-growth treatment with EU authorisation.
What can I take instead? Minoxidil is approved in the EU, has published peer-reviewed trial results, and can be prescribed today if a doctor decides it suits you. See the minoxidil page.

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What it is

Ketoconazole is an antifungal that stops yeasts and fungi on the skin from making ergosterol, a substance they need to build their outer wall, so they cannot grow. Some people use ketoconazole shampoo hoping it will also help pattern hair loss, but that use is off-label.

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What the studies reported

Every trial behind ketoconazole for hair loss is listed here with how many people took part and whether the results are peer-reviewed.
The main evidence is a 2020 systematic review (Dermatologic Therapy, “Topical ketoconazole for androgenetic alopecia”). Its own conclusion is that randomised controlled trials are still needed: the included human studies were small, used different formulations and schedules, and no reliable effect size for hair growth can be quoted. Hair growth is not an authorised use of ketoconazole in the EU.

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What has been reported

The Spanish product information for topical ketoconazole 20 mg/g gel lists:
On 25 July 2013 the EMA’s CHMP recommended EU-wide suspension of the marketing authorisations for oral ketoconazole, because the risk of liver injury outweighed the benefit in fungal infection. The European Commission decision followed on 11 October 2013. Topical forms were not suspended, because very little ketoconazole is absorbed from them.

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Available hair-growth treatments

A licensed doctor decides case by case. We never prescribe without evaluation.

Oral finasteride

A 5-alpha-reductase inhibitor taken daily. A doctor may prescribe it after reviewing your history and ruling out contraindications.

Oral minoxidil

Low-dose oral minoxidil, used off-label by some dermatologists. Requires close medical supervision for potential cardiovascular effects.

Topical minoxidil

Solution or foam applied directly to the scalp. Can be combined with other actives in a compounded formulation.

Dutasteride 0.5mg

A more potent 5-alpha-reductase inhibitor. Reserved for specific cases, always under medical evaluation.

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How Hi-Doctor handles it

A licensed doctor reviews your hair-growth questionnaire and proposes one of the EU-authorised options above if it fits your case. See how the consultation works and how we handle safety and eligibility. Pricing is on the pricing page.

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Common questions

Ketoconazole is an antifungal medicine. In the EU the shampoo, cream and gel forms are authorised for dandruff, seborrhoeic dermatitis and a fungal skin condition called pityriasis versicolor. It works by stopping yeasts and fungi from making ergosterol, a substance they need to build their outer wall.
Not for hair loss. Ketoconazole has no EU marketing authorisation for hair loss, so no doctor in the EU can prescribe it for this use.
On 25 July 2013 the EMA’s CHMP recommended EU-wide suspension of the marketing authorisations for oral ketoconazole because the risk of liver injury outweighed the benefit. The European Commission decision followed on 11 October 2013. Topical forms were not suspended because very little ketoconazole is absorbed from them.
A 2020 systematic review in Dermatologic Therapy concluded that randomised controlled trials are still needed. The included human studies were small, used different formulations and schedules, and no reliable effect size for hair growth can be quoted. Hair growth is not an authorised use of ketoconazole in the EU.
The Spanish product information lists local burning sensation, itching and contact dermatitis. Oily or dry hair and discolouration of chemically damaged or grey hair are rare.
Minoxidil is EU-authorised with published peer-reviewed trial results. Finasteride, dutasteride and compounded formulations are also options a doctor may consider after reviewing your case.

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Start a consultation

Hair-growth consultation

Answer the hair-growth questionnaire and a registered doctor reviews it. They decide whether treatment is appropriate, which one, and at what dose — and declining is a normal outcome. See what it costs and how the review works.
This page is reference information, not medical advice and not a prescription. Whether a medicine is appropriate for you is decided by a registered doctor after reviewing your consultation.