Ketoconazole

Etki Mekanizması

Ketoconazole works through multiple pathways relevant to hair loss. As an azole antifungal, it inhibits the enzyme lanosterol 14-alpha-demethylase, disrupting ergosterol synthesis and killing Malassezia fungi that colonize the scalp and contribute to inflammation and seborrheic dermatitis. This anti-inflammatory effect reduces the chronic follicular inflammation associated with androgenetic alopecia. Independently, ketoconazole has demonstrated topical anti-androgenic activity by disrupting the binding of dihydrotestosterone (DHT) and other androgens to receptors at the hair follicle. Some evidence also suggests it may interfere with local androgen synthesis pathways. Unlike systemic anti-androgens such as finasteride, ketoconazole shampoo exerts these effects locally at the scalp without meaningful systemic hormonal changes, making it a well-tolerated complement to oral DHT-blocking therapies.