Shampoos and pills sit at opposite ends of the evidence scale. A medicated shampoo (such as ketoconazole) can support scalp health and may modestly help density, but rinse-off contact time is short and shampoos alone do not stop genetic hair loss. Oral pills — finasteride, and dutasteride where approved — directly lower DHT, the hormone driving pattern loss, and have the strongest evidence for halting and partly reversing it. Topical minoxidil sits in between. For real pattern loss, pills (for men) plus minoxidil do the heavy lifting, while a ketoconazole shampoo two to three times a week is a useful, low-risk add-on, especially with flaking. Don't expect a shampoo to replace a pill — but a good shampoo complements the regimen and keeps the scalp healthy. Match the tool to how much work you need done.

Sources: AGA review (CCID) ↗

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Not medical advice. General education only; it does not replace diagnosis or treatment by a licensed professional. Consult a board-certified dermatologist before starting, stopping or changing any treatment.

⚠️ When to see a doctor — don’t self-treat

Sudden patchy or circular bald spots
Redness, scaling, pus, pain or itch (possible scarring alopecia — treat urgently)
Broken hairs or rapid loss
Loss with body-wide signs (weight loss, fatigue, cycle changes, acne, extra hair)
Loss right after a new medication
Any hair loss in a child

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