There have been a few crappy studies. Nothing conclusive can be drawn.
Ketoconazole Shampoo: Effect of Long-Term Use in Androgenic Alopecia
Dermatology 1998;196:474–477
C. Piérard-Franchimont a P. De Donckerb G. Cauwenbergh c G.E. Piérarda
Department of Dermatopathology, University of Liège, and b Janssen Research Foundation, Beerse, Belgium; c Johnson and Johnson Research and
Development, Skillman, N.J., USA
I always use
http://scholar.google.com.au/ at an education institution because they buy the rights to view the whole document.
Here’s another one.
Ketocazole as an adjunct to finasteride in the treatment of androgenetic alopecia in men
B.S. Hugo Perez
Ketoconazole
Ketoconazole is an imidazole broad-spectrum anti- fungal and steroid biosynthesis inhibitor [20,21]. Ketoconazole in high doses (400 mg TID) blocks both testicular and adrenal androgen biosynthesis [22–24]
Although the effects of ketoconazole on 5a-R have been documented, the authors of the study concluded that the benefits were attributed to its effects on fungal scalp infections in genetically predisposed individuals. They argued that Androgenetic Alopecia has a multifactorial pathogenesis with an inflammatory reaction caused by a Malassezia fungal infection. It was concluded that ketoconazole was therapeutic by reducing inflammation through its anti-inflammatory properties and by clearing the adjacent fungal infection.
Discussion
Clinical trials are needed to evaluate the effectiveness of ketoconazole shampoo in the treatment of Androgenetic Alopecia. These trials should attempt to elucidate the method of action responsible for the results. Both the inflammation and the DHT path-way need to be addressed.