Category Archives: Ketoconazole

Regenepure DR

I have mentioned Nizoral a few times on this blog and even have it listed as one of the recommended hair loss products on this blog. For one, it is personal. That Ketoconazole 1% containing shampoo has helped me more than any other product out there when it comes to combating my on-and-off itchy, dry, dandruff or dermatitis inflicted scalp. Since I do not get excessive dandruff too frequently these days, one 7-ounce bottle of Nizoral can last me for quite a few months. I use very little of the product each time I shampoo with it since it lathers well, and I rarely need to use it more than once every two weeks as of late. There was a time I used it twice a week as recommended, but sometimes I felt that my scalp was starting to become reliant/dependent on its regular usage and itching more than normal when I reduced usage frequency.

Besides its anti-fungal properties, a second reason for using a shampoo with Ketoconazole in it is due to the fact that there have been a few studies that suggest that the product also has anti-androgenic properties.

Regenepure DR Shampoo With Ketoconazole

However, this blog post is not about Nizoral. Rather, it is about a new potentially superior alternative called Regenepure DR. Until last year, I did not know that there was another shampoo product for sale in the US containing Ketoconazole 1%. Then I discovered Regenpure DR and recently had a chance to try it. My first impression after usage was that it seemed to result in slightly silkier and smoother hair in comparison to Nizoral.

Regenpure Ingredients

Upon checking the ingredients of this product, I was impressed to see that besides Ketoconazole, this product contains Saw Palmetto Extract, Emu Oil, Caffeine, Jojoba Oil, Zinc Oxide and various B Vitamins (B3, B5, B6).

Saw Palmetto has been known to counter DHT when ingested orally, and many people have tried to use it as a natural substitute to Finasteride (although it can ever be as effective, even at very large doses). I am not sure about the usefulness of topical Saw Palmetto on a wet scalp, but maybe it has mild anti-androgenic or anti-DHT properties?

Emu oil has anti-inflammatory properties based on various studies on PubMed, as does Jojoba oil to a lesser extent. For self-experimenters, note that Blue emu oil from Walmart is a popular less expensive version of imported emu oil. Overall, these ingredients are far more impressive and superior in comparison to the list of mostly harsh ingredients of Nizoral. Moreover, unlike Nizoral, Regenepure DR does not contain sulfate.

To purchase Regenepure shampoo and/or conditioner on Amazon, click on the below photos (make sure to read the reviews on there first):


While Nizoral is made by multinational behemoth Johnson & Johnson (via the McNeil Consumer Healthcare subsidiary), Regenepure is made by a small US-based company called Salonceuticals. This company specializes in a few hair loss and hair health related products and one nail related anti-fungal product. Although I am impressed with this product, I would be more at ease if I could verify the ingredients of Regenepure DR (especially the Ketoconazole 1% quantity in each 8-ounce bottle) at a lab or via some government testing agency report.

Johnson & Johnson, due to its size, cannot avoid any mistakes in the legitimacy of its product composition and risk losing huge amounts of revenues across the company’s product lines due to bad publicity from one bad product. I am a bit more wary about products made by smaller companies. Most likely, US government regulations are strict and this product gets tested frequently. I am, however, curious as to why more companies have not come up with a Ketoconazole containing shampoo when the market for it has to be very significant, yet has been dominated by one product (Nizoral)? Is it difficult to get access to Ketoconazole or difficult to add it to a shampoo? How did Salonceuticals succeed where others failed?

Nizoral is Back: 2018 Update

Update: As of 2018, there are clearly no Nizoral shampoo shortages. Moreover, in December 2017, Johnson & Johnson was contemplating a sale of anti-dandruff shampoo Nizoral. Analysts estimate the value of such a sale to be worth several hundred million dollars. Clearly, Nizoral is a highly respected brand that is very effective at reducing dandruff and scalp itching.

Nizoral Shampoo

Nizoral Shampoo
Nizoral Shampoo

Nizoral shampoo is one of the best reviewed everyday products that you can buy without a prescription to counter scalp itching and fungus. I rank it as one of the 10 best hair loss shampoos in the world. A small bottle of this product will last for many months.

Ketoconazole: the Active Ingredient in Nizoral

To date, only two drugs (each with very different mechanisms of action) have been approved by the US FDA to cure hair loss:  Finasteride (Propecia) and Minoxidil (Rogaine).

Nizoral Shampoo Ingredients
Nizoral Shampoo Ingredient List

There is, however, one drug that has significant beneficial properties in helping hair loss sufferers, yet never gets enough credit. This drug is Ketoconazole (the active ingredient in this bestselling shampoo) and will likely never be officially approved to treat hair loss because its manufacturer will not file for approval and go through all the clinical trials. Ketoconazole is a synthetic drug that is used to treat fungal infections. In particular, the drug flushes out Malassezia (formerly known as Pityrosporum) fungus, which has been implicated in problems such as dandruff and seborrheic dermatitis.

Ketoconazole was originally available in tablet form, but has since also been developed into topical forms such as creams, lotions and shampoos. While oral ingestion of Keto can lead to serious side effects such as liver damage in some patients, topical cream and ketoconazole shampoo usage has generally not been linked to such side effects.

My Experiences with Nizoral

A large proportion of hair loss sufferers seem to also get itchy and dry scalp conditions, including dandruff and seborrheic dermatitis. I am one of those, although the severity and frequency of my symptoms is moderate.

Some years ago, I started using Nizoral 1% anti dandruff shampoo for hair loss instead of other regular shampoos, and was absolutely amazed at its effectiveness at completely eliminating my scalp itching and dandruff for a day or two each time I used it. My hair itself also looked better and it seemed like my hair shedding rate declined too.

There is some evidence that Ketoconazole  blocks the synthesis of dihydrotestosterone in the scalp and acts as an antagonist of the androgen receptor (see list of studies at the bottom of this post). Nizoral sometimes also helps improve psoriasis symptoms.

Nizoral Shortage

In 2012 or so, it seemed like US drug stores and stopped carrying Nizoral shampoo, at least when it comes to the most popular blue bottle variety (see photo further below). At first, I thought this was because of the warnings related to side effects from taking oral Ketoconazole. Luckily, I had sufficient supplies to last me for a while, since you only need a small amount of Nizoral shampoo to make a big difference, and most people do not need to use Nizoral more than twice a week.

However, this shortage continued in 2013 and I had to pay a significant premium to buy it from a seller on ebay. A lot of people made great profits by selling their surplus Nizoral stock in 2012 and 2013. I later found out that the problems with availability were due to the shampoo’s manufacturer having production issues at its main plants rather than any issues related to side effects.

Good News: Nizoral Shampoo Back on Sale

As of 2014, Nizoral is now back on the market and the shortages are over. You can read numerous favorable reviews of the product on Amazon.

Ketoconazole and Hair Loss Studies

You can find a number of studies that conclude favorable outcomes for Ketoconazole shampoo use for hair loss. Below I list them in chronological order.