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FDA-approved · Off-label use

Ketoconazole shampoo: uses, dosing, side effects and where to get it

An antifungal shampoo that some providers add to finasteride or minoxidil. The evidence for hair loss is small.

Amber dropper bottle beside a pale wooden comb on warm limestone

By the RxLineup editorial team · Fact-checked against provider sites and FDA labels · Updated

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Active ingredient
Ketoconazole
Made by
Generic manufacturers
Form
2% prescription shampoo (1% sold over the counter)
Price online
From $25 a bottle at Strut Health and $33 per delivery at Keeps, as of October 2026.

Safety

Applied to the scalp, ketoconazole shampoo can cause irritation and changes in hair texture. Systemic risk is low.

Talk to a licensed clinician about your health history and every medication you take before you start.

Prescription only; FDA-approved. FDA-approved as an antifungal shampoo and low risk; its use for hair loss is an off-label add-on.

What ketoconazole shampoo is

Approved as an antifungal shampoo; using it for hair loss is an off-label add-on to finasteride or minoxidil.

FDA-approved for

  • 2% shampoo: tinea (pityriasis) versicolor, a skin yeast infection
  • 1% shampoo: dandruff, without a prescription

Dosing

2% prescription shampoo (1% sold over the counter), a few times a week, as directed. Lather, leave on the scalp for a few minutes and rinse; your prescriber sets how often.

How well it works

Evidence is small. A 1998 study found 2% ketoconazole shampoo improved hair density and the share of growing follicles about as much as 2% minoxidil, and called for larger controlled trials. Individual results vary.

Ketoconazole shampoo cost

From $25 a bottle at Strut Health and $33 per delivery at Keeps, as of October 2026. For a full breakdown, read How much does minoxidil cost?. For the steps, read How to get a finasteride prescription online.

Questions, answered

How much does ketoconazole shampoo cost online?
From $25 a bottle at Strut Health and $33 per delivery at Keeps, as of October 2026.

Is ketoconazole shampoo FDA-approved?
Yes. Ketoconazole shampoo is FDA-approved for 2% shampoo: tinea (pityriasis) versicolor, a skin yeast infection; 1% shampoo: dandruff, without a prescription. Providers may prescribe it off-label for other uses.

How do you take ketoconazole shampoo?
2% prescription shampoo (1% sold over the counter), a few times a week, as directed. Lather, leave on the scalp for a few minutes and rinse; your prescriber sets how often.

What are the risks of ketoconazole shampoo?
Applied to the scalp, ketoconazole shampoo can cause irritation and changes in hair texture. Systemic risk is low.

Can I get ketoconazole shampoo online?
A licensed clinician can prescribe ketoconazole shampoo after an online or in-person visit.

Sources

  1. Ketoconazole shampoo 2% label, DailyMed (effective Jan 29, 2026)
  2. Piérard-Franchimont et al., ketoconazole shampoo in androgenic alopecia, Dermatology 1998