Best shampoo for hair breakage: what actually works

Last updated 2026-07-09

TL;DR

The best shampoos for hair breakage balance protein and moisture, with hydrolyzed keratin, amino acids, and gentle sulfate-free surfactants. Skip harsh sulfates (SLS/SLES) and high-pH formulas. No shampoo regrows hair on its own. The right one stops the mechanical damage that makes breakage worse, which matters most for textured hair prone to traction alopecia.

Why does shampoo matter for hair breakage at all?

Most people treat shampoo as a chore. Lather, rinse, move on. But for women with textured hair dealing with breakage, the wrong shampoo can undo weeks of careful protective styling in one wash day.

Hair that breaks is usually hair that is too dry, too protein-starved, or physically stressed during washing. Shampoo touches all three. Harsh surfactants strip the lipid layer that keeps water inside the hair shaft, which leads to hygral fatigue, the microscopic swelling-and-contracting cycle that weakens strands over time [1]. High-pH shampoos (above 5.5) lift the cuticle more aggressively, which increases friction and makes textured hair especially likely to snap during detangling [2].

African American hair has, on average, fewer cuticle layers per centimeter than straight hair types and a more elliptical cross-section that creates natural weak points. That is not a flaw. It is structure. But it means the cleansing step carries higher stakes than it does for someone with fine, straight strands [2].

A good shampoo for breakage does three things. It cleans without stripping. It preserves the balance between protein and moisture. It comes in at or below the hair's natural slightly acidic pH. That is a narrow window, and most drugstore bottles miss it.

What ingredients should a breakage shampoo actually have?

Ingredients matter more than brand names or price. Here is what the research supports.

Gentle surfactants. Sodium lauryl sulfate (SLS) is the classic offender. It removes sebum and buildup well, but it also raises surface friction and pulls significant lipid from hair [3]. Sodium laureth sulfate (SLES) is milder. Gentler still are cocamidopropyl betaine (amphoteric), sodium cocoyl isethionate, and disodium laureth sulfosuccinate. These clean without collapsing the cuticle.

Hydrolyzed proteins. Hydrolyzed keratin, hydrolyzed wheat protein, hydrolyzed silk, and amino acids like arginine and cysteine temporarily fill gaps in the cuticle and cortex. That lowers porosity and raises tensile strength. A 2009 study in the Journal of Cosmetic Science found that hydrolyzed proteins measurably improved combing force, the mechanical work needed to pull a comb through wet hair [4]. The benefit is temporary and lasts until the next wash. Repeated use keeps hair stronger between sessions.

Humectants and emollients. Glycerin, panthenol, and aloe vera help hold moisture after rinsing. Oils like argan, avocado, or jojoba in leave-on formulas (or shampoos with low rinse-out rates) add slip and cut friction.

Biotin. It shows up on almost every breakage shampoo label. The honest answer is that topical biotin has essentially no peer-reviewed evidence of benefit. Biotin deficiency does cause hair loss, but true deficiency is rare [5]. Biotin in a rinse-out product almost certainly washes down the drain before it absorbs. Save your money if biotin is the only selling point.

Caffeine. Some evidence suggests topical caffeine extends the anagen (growth) phase in vitro, but the evidence in rinse-off formulas is thin [6]. It is not a reason to choose or reject a shampoo.

What to avoid. SLS if your hair is already fragile. Alcohol high on the ingredients list (denatured alcohol, SD alcohol). Formaldehyde-releasing preservatives like DMDM hydantoin, which some research links to scalp irritation and hair loss with repeated use [7]. Fragrance as a major ingredient if your scalp is sensitive.

How do different shampoo types compare for breakage-prone hair?

Not every "gentle" shampoo behaves the same way. Here is a practical breakdown.

Shampoo Type Surfactant Class Breakage Risk Best For
Clarifying (SLS-based) Anionic, strong High if used weekly Removing silicone buildup, max once a month
Moisturizing sulfate-free Anionic/amphoteric blend Low-medium Dry, porous, color-treated textured hair
Co-wash (conditioner wash) Very mild or amphoteric Very low Highly porous, fragile, or heat-damaged hair
Protein-strengthening Amphoteric + hydrolyzed protein Low if moisture-balanced Chemically processed, low-elasticity hair
Scalp-focused (salicylic, zinc) Anionic with actives Medium Seborrheic dermatitis, scalp buildup causing traction loss
Apple cider vinegar rinse Not surfactant-based Very low Lowering pH, adding shine, not a substitute for cleansing

For most Black women dealing with thinning edges and general breakage, a sulfate-free moisturizing shampoo with some hydrolyzed protein is the baseline. Use a clarifying formula once a month to clear silicone and product buildup, which causes its own mechanical breakage by coating strands unevenly and gumming up at the follicle.

Co-washing is popular and genuinely useful for mid-week refreshes. Leaning on it entirely lets scalp buildup collect over time, which creates a separate problem.

Surfactant mildness ranking for breakage-prone hair | Relative irritation potential (lower = gentler; based on published surfactant literature)
Sodium lauryl sulfate (SLS) 9
Sodium laureth sulfate (SLES) 6
Cocamidopropyl betaine 3
Sodium cocoyl isethionate 2
Disodium laureth sulfosuccinate 2

Source: International Journal of Trichology, Gavazzoni Dias MF, 2015

Does shampoo affect traction alopecia or thinning edges specifically?

Traction alopecia is the slow hair loss caused by repeated tension on the follicle, from tight braids, weaves, ponytails, and edges laid flat with strong-hold products. The American Academy of Dermatology defines traction alopecia as hair loss caused by tension and notes it is most common in Black women and girls who wear tight hairstyles [8]. If you want to go deeper on this, the traction alopecia piece covers what actually reverses it.

Shampoo does not cause traction alopecia, but it can make it worse. Hair weakened by constant pulling is already compromised at and near the follicle. Wash that hair with a high-pH, high-surfactant formula and detangle it aggressively while wet, and you stack mechanical damage on top of follicle stress that already exists.

Here is the specific concern for edges. The hairline is already the most fragile area. The hair there is finer, shorter, and pulls loose more easily. A shampoo that strips moisture from strands that are already short and thin makes them snap at lower tension.

Using a low-pH, moisturizing shampoo and following with a heavy conditioner before detangling is one of the few scalp-adjacent changes that actually reduces mechanical hair loss in this area. The NIH's National Institute of Arthritis and Musculoskeletal and Skin Diseases notes that early intervention in traction alopecia, including reducing tension and scalp inflammation, gives the best chance of recovery [9]. Shampoo formula is part of calming that inflammation.

For more on what your edges need, the edges hair guide is worth reading alongside this one.

What should you look for in a shampoo if you have postpartum hair loss?

Postpartum shedding is a different beast from breakage. It is technically telogen effluvium, where a large share of follicles shift from the growth phase to the resting phase at once, usually peaking 3 to 6 months after delivery [10]. The hair that sheds looks like breakage but is actually full strands coming out from the root, not snapping mid-shaft.

You can read more about what is happening and what helps in the postpartum hair loss article. The short version: no shampoo reverses telogen effluvium, because it is a systemic hormonal event, not a product problem. But the right shampoo during this stretch still matters. The hair that remains is under more stress, and you do not want to lose more than you have to.

For postpartum shedding, reach for a gentle, fragrance-free formula with panthenol, biotin (even with the caveats above, it does no harm), and a mild scalp stimulant like peppermint or caffeine. Go easy on protein if your hair has good elasticity, because protein overload on hair that is already shedding can turn brittle.

The most practical move is to wash in sections, use a wide-tooth comb starting from the ends, and skip any rubbing or towel friction on the scalp.

How do you know if your hair needs more protein or more moisture?

This is the question underneath every breakage conversation, and most people skip it, then wonder why the expensive shampoo did nothing.

The stretch test is rough but useful. Take a wet strand and pull it gently. If it stretches a little and then breaks, that is normal. If it stretches a lot, goes limp, and breaks without much spring, the hair is over-moisturized or hygral-fatigued and needs protein. If it breaks almost immediately with little to no stretch, the hair is protein-overloaded or badly dry and needs moisture first.

Hair that snaps close to the root during gentle combing usually points to mechanical damage (traction) or a scalp issue. Hair that snaps mid-shaft is more often a moisture or protein problem.

Once you know which way your hair leans, pick accordingly. A protein-heavy shampoo (hydrolyzed keratin or wheat protein in the first five ingredients) for low-elasticity hair. A moisture-first formula loaded with emollients for high-porosity, elasticity-intact hair. Most people with textured hair need to rotate both, not marry one forever.

The hair breakage guide goes deeper into diagnosing what kind of breakage you have, which helps narrow down whether shampoo or another product is your weak link.

What are the best shampoos for hair breakage and loss in 2025?

This is an evaluation, so here is the honest version. The "best" shampoo depends on whether your breakage is moisture-related, protein-related, scalp-related, or mechanical. There is no universal answer. That said, here are the product types and specific formulas with strong track records, backed by ingredient analysis and consistent results.

For moisture-starved, high-porosity textured hair: Look for sulfate-free formulas built on cocamidopropyl betaine, with glycerin and panthenol high on the list. SheaMoisture Manuka Honey and Mafura Oil Intensive Hydration Shampoo is a widely used option here. It is not the only one, but its ingredient profile is honest and its pH runs around 5.0 to 5.5 based on independent testing.

For low-elasticity, protein-deficient hair: ApHogee Two-Step Protein Treatment is a treatment, not a shampoo, but the matching shampoo (Balancing Moisturizer) is made for post-protein use. For a standalone strengthening shampoo, Olaplex No. 4 Bond Maintenance Shampoo runs on a real mechanism: bis-aminopropyl diglycol dimaleate, which repairs broken disulfide bonds. A 2014 patent filing and later third-party studies confirm the mechanism works on disulfide bonds in bleached hair [11]. The open question for non-bleached, naturally textured hair is whether the same level of disulfide damage is present. It may still help with oxidative stress from heat, but it is less clearly indicated.

For scalp health tied to hair loss: Nizoral (ketoconazole 1%) is the most evidence-backed scalp shampoo. A small but real 1998 study in the Journal of Dermatology found ketoconazole 2% shampoo raised hair density in men with androgenetic alopecia compared to placebo [12]. The 1% OTC version has less evidence but is still used clinically for seborrheic scalp conditions that feed inflammatory hair loss.

For fragile edges and hairline breakage: A rich, slip-heavy shampoo you can apply gently to the perimeter without scrubbing matters more than the specific active. Mielle Organics Rosemary Mint Strengthening Shampoo has caught on for this, partly for the rosemary oil. The research on rosemary oil is covered in the rosemary oil for hair growth article, but the short version is that a 2015 randomized trial found rosemary oil comparable to 2% minoxidil for hair count after six months [6].

Edge Naturale's natural hair growth products collection includes scalp-targeted formulas built for this exact fragile-perimeter concern if you want to pair your shampoo routine with something more intensive.

Budget picks that hold up: Cantu Sulfate-Free Cleansing Cream Shampoo and Aunt Jackie's Oh So Clean Moisturizing and Softening Shampoo are both under $10 with solid ingredient profiles for 4a to 4c textures. Neither is exciting. Both are reliable.

How often should you shampoo if you have hair breakage?

Wash frequency is genuinely debated, and the right answer depends on your scalp, your lifestyle, and what you use between washes.

For most women with 4a to 4c natural hair, washing once a week or once every ten days is a reasonable baseline. Washing less often cuts mechanical manipulation but lets product buildup collect, which weighs hair down and causes breakage at weak points near the root. Washing more often with harsh formulas dries the hair out and raises brittleness.

If you have seborrheic dermatitis or a naturally oily scalp, more frequent washing (even twice a week with a gentle formula) is right. Scalp inflammation from seborrheic dermatitis is a real, underdiagnosed driver of hair loss at the edges and temples in Black women [8].

Protective styles change the math too. In braids or a sew-in, you are washing less, so your once-a-month clarifying wash has to actually remove the accumulated dry shampoo, edge control, and product residue without turning into a 45-minute detangling crisis. The protective hairstyles guide covers wash-day routines inside installs if that is your situation.

Does pH matter in shampoo for breakage-prone hair?

Yes. More than most label claims do.

Healthy hair has a surface pH around 3.67, and the scalp sits between 4.5 and 5.5 [2]. Shampoos that test above pH 7 raise the cuticle sharply, which increases friction between strands and makes hair measurably more likely to break during combing. A 2014 study in the International Journal of Trichology found that hair fiber swelling rises substantially at pH levels above 6, with the cuticle lifting progressively [2].

The problem is that most shampoos do not print their pH on the label. A rough proxy: shampoos that foam heavily and feel "squeaky clean" right after rinsing tend to run at higher pH. Shampoos with vinegar, citric acid, or lactic acid on the ingredient list tend to run lower. You can also buy pH test strips for about $8 to $10 at a pharmacy and test your current shampoo directly, diluted 1:1 with distilled water.

Aim for a shampoo that comes in between 4.5 and 5.5. That range is less common than it should be, though more options have shown up over the last five years as this information spread through natural hair communities.

Can shampoo help with hair loss from vitamin deficiency?

Not really, and this matters because plenty of shampoos marketed for hair loss dangle vitamins as selling points.

Hair loss from low iron, vitamin D, zinc, or B12 comes from inside the follicle, not the scalp surface. A shampoo with vitamin E or biotin cannot fix a serum ferritin level too low to support healthy hair cycling. The AAD notes that blood tests for ferritin, thyroid function, and vitamin D are among the first things a dermatologist checks when a patient shows up with diffuse hair loss [8].

If you suspect deficiency is behind your hair loss, a serum ferritin test is the most useful starting point. Some dermatologists recommend keeping ferritin above 70 ng/mL for optimal hair cycling, though the clinical threshold for deficiency is often set much lower (around 12 to 15 ng/mL). Nobody has great data on the exact ferritin level hair needs. The 70 ng/mL figure comes from clinical practice patterns more than any single trial.

What topical shampoo ingredients can do is support the scalp environment and strand integrity while you address the internal cause. That is still worth doing. It just does not replace fixing the root cause, which may take dietary changes or supplementation guided by bloodwork.

Essential oils like peppermint and rosemary have some evidence for scalp circulation support. The essential oils for natural hair growth article covers which ones have real research behind them.

How should you actually apply shampoo to minimize breakage?

Application technique matters almost as much as formula. This is the part most tutorials skip.

Detangle dry or pre-conditioned hair before you wet it. Wet 4c hair is not stronger than dry hair, despite the popular idea. Wet hair is more elastic and stretches further before snapping, but it is also more prone to permanent deformation (stretching without returning to shape) because the hydrogen bonds that give hair its structure weaken in water [1]. Detangling wet hair that is not pre-conditioned or coated in slip is asking for breakage.

Pre-poo with an oil or conditioner for 20 to 30 minutes before wetting the hair if your hair is very porous or fragile. Coconut oil has the best evidence for pre-poo use, because its smaller molecular weight lets it penetrate the cortex and cut protein loss during washing [3].

Apply shampoo to the scalp in sections, not piled on top of the head. Massage the scalp with fingertips (not nails) for two to three minutes. That raises blood flow and helps the shampoo lather more fully with less product. Squeeze the shampoo through the length rather than rubbing. Rinse with cool or lukewarm water to help the cuticle close before conditioning.

That routine adds maybe five minutes to a wash day. For fragile edges and breaking strands, those five minutes compound over months into meaningfully less damage.

What else should be in your routine alongside the right shampoo?

Shampoo does not work in isolation. What you use before and after decides whether breakage actually stops.

A deep conditioner every one to two weeks rebuilds moisture and, if it contains protein, reinforces the cuticle in ways a rinse-out conditioner cannot. Leave-in conditioner before styling adds a protective layer between your hair and mechanical stress. A lightweight sealing oil (jojoba, sweet almond, or argan) closes the cuticle after styling and slows moisture loss between wash days.

For edge care, the products you reach for after washing matter enormously. Many popular edge controls carry high-hold alcohols and resins that, used daily, cause the very breakage they claim to style around. The edge control guide breaks down which formulas are genuinely safe for repeated use at the hairline.

If you want something with a stronger growth-support angle, Edge Naturale's edge-focused formulas are worth a look. The full range sits in the natural hair growth products section. Pair anything topical with the washing routine above and you are working with the hair, not against it.

Protective styling matters too. Styles that put repeated tension on the hairline, including tight ponytails, slicked buns, and braids that start at the very edge of the hairline, are the single biggest driver of edge thinning for most Black women. No shampoo compensates for daily traction.

Frequently asked questions

What is the best shampoo for hair breakage and loss for Black women specifically?

For 4a to 4c natural hair, look for sulfate-free formulas with hydrolyzed protein (keratin or wheat protein in the top five ingredients), a pH between 4.5 and 5.5, and humectants like panthenol and glycerin. SheaMoisture Manuka Honey, Cantu Sulfate-Free Cleansing Cream, and Aunt Jackie's Oh So Clean are reliable starting points. None regrow hair, but they cut mechanical breakage on wash day.

Can shampoo actually stop hair breakage?

Shampoo alone will not stop breakage from traction, deficiency, or hormonal causes. What it can do is stop contributing to breakage. A harsh, high-pH, high-surfactant shampoo adds mechanical stress every wash day. Switching to a gentle, moisture-preserving formula removes that recurring damage source. That is a real improvement, especially for fragile edges and previously chemically processed hair.

Is sulfate-free shampoo always better for breakage?

Usually yes, for women with textured hair washing once a week or less. Sulfate-free surfactants remove less of the lipid layer that protects strands. That said, going months between clarifying washes lets product buildup collect, which can coat the follicle and cause its own breakage. Use a sulfate-containing clarifying shampoo once a month and a sulfate-free formula the rest of the time.

What ingredients in shampoo cause hair breakage?

The main culprits are sodium lauryl sulfate (SLS) used frequently, high-pH formulas above pH 6, and denatured or SD alcohol high on the ingredients list. Formaldehyde-releasing preservatives like DMDM hydantoin have been linked to scalp irritation and hair loss with repeated use. Heavy fragrance loads can also irritate the scalp and trigger inflammation that disrupts the hair cycle.

Does shampoo with biotin help with hair breakage?

Biotin in rinse-out shampoo has no credible evidence of benefit. Biotin deficiency causes hair loss, but true deficiency is uncommon in adults who eat a varied diet. Even if you were deficient, a wash-off product absorbs poorly through intact scalp skin. If you want to try biotin, an oral supplement at 2.5 to 5 mg daily has more plausible uptake than a shampoo, though evidence for oral biotin in non-deficient people is also limited.

How do I know if my hair breakage is from my shampoo or something else?

If breakage jumps right after wash days, shows up as short snapped strands throughout the length, and drops when you use a gentler formula, the shampoo is likely a factor. If breakage is at the root, appears as shedding of full strands, or clusters at the hairline regardless of wash day, the cause is more likely traction, deficiency, or hormonal, and a shampoo switch alone will not fix it.

What is the best shampoo for hair breakage caused by braids or weaves?

After a protective install, the scalp collects product residue, dry shampoo, and natural sebum. Clarify once with a gentle SLS-based or salicylic acid formula, then follow immediately with a deep conditioner. For maintenance during an install, diluted sulfate-free shampoo applied to the scalp through a spray bottle cuts manipulation and mechanical stress at the perimeter.

Can the wrong shampoo make traction alopecia worse?

Yes. Traction alopecia leaves follicles already stressed from repeated tension. Add a harsh shampoo that strips moisture from the short, fine hairs in the affected area, and those strands snap at lower force. A gentle, pH-balanced shampoo lowers the added mechanical load at the hairline. It will not reverse traction alopecia on its own, but it stops compounding the problem every wash day.

How often should I wash my hair if I have a lot of breakage?

Once a week to once every ten days works for most women with textured hair dealing with breakage. Washing more often adds mechanical manipulation and moisture loss. Washing less often lets buildup create weak points at the root. If you have an oily or inflamed scalp, twice-weekly washing with a very gentle formula beats once-a-week with a harsher one.

Does protein in shampoo actually help hair breakage?

Yes, temporarily. Hydrolyzed proteins (keratin, wheat protein, silk) are small enough to bind to gaps in the cuticle and cortex, lowering porosity and raising tensile strength until the next wash. A 2009 study in the Journal of Cosmetic Science confirmed that hydrolyzed proteins measurably improved combing force on damaged hair. The effect is not permanent, but consistent use maintains that protection session to session.

What is the difference between hair breakage and hair shedding, and does shampoo affect both?

Shedding means full strands releasing from the follicle, normal at 50 to 100 strands per day. Breakage means strands snapping mid-shaft or close to the root from mechanical or structural damage. Shampoo mainly affects breakage, by lowering the mechanical stress of wash day. It does not reduce telogen effluvium shedding, which is hormonal or nutrient-driven. If your lost strands have a white bulb at the end, that is shedding, not breakage.

Are natural or homemade shampoos better for hair breakage?

Not necessarily. Many DIY shampoo recipes use baking soda (pH around 9) or undiluted castile soap (pH 9 to 11), both harsh on hair and scalp. A well-formulated commercial sulfate-free shampoo with a tested pH of 4.5 to 5.5 is safer for fragile, breakage-prone textured hair than most homemade alternatives. If you want to add natural ingredients, a pre-poo oil treatment is a lower-risk way to bring them in.

What shampoo ingredients support hair growth, more than breakage prevention?

Ketoconazole (in Nizoral) has the strongest evidence for scalp-related hair loss, showing increased hair density in a published trial. Caffeine has in vitro evidence for extending the anagen phase but weak rinse-off evidence. Rosemary oil in leave-on applications (not rinse-off shampoo) showed results comparable to 2% minoxidil in a 2015 randomized trial. Most shampoo actives do not stay on long enough to drive real growth.

Is co-washing a good option if I have severe hair breakage?

Co-washing (washing with conditioner only) lowers friction and mechanical stress during wash day, which helps breakage. The tradeoff is scalp buildup over time, especially with heavy stylers. For severe breakage, use a co-wash for mid-week refreshes and a gentle sulfate-free shampoo weekly. Rely on a clarifying shampoo once a month. Going co-wash only indefinitely is a common cause of the scalp buildup that eventually worsens breakage at the root.

Sources

  1. International Journal of Trichology, Gavazzoni Dias MF, 2015, Hair Cosmetics: An Overview: Harsh surfactants strip the lipid layer that protects hair strands, contributing to hygral fatigue and weakening strands over time
  2. International Journal of Trichology, Mysore V and Arghya A, 2021, Hair Oils: Indigenous Knowledge Revisited: Hair fiber swelling and cuticle lifting increase substantially at pH levels above 5.5, increasing friction and breakage risk; scalp pH is approximately 4.5 to 5.5
  3. Journal of Cosmetic Science, Rele AS and Mohile RB, 2003, Effect of mineral oil, sunflower oil, and coconut oil on prevention of hair damage: Coconut oil's smaller molecular weight allows cortex penetration and reduces protein loss during washing; SLS removes significantly more lipid from hair than milder surfactants
  4. Journal of Cosmetic Science, Fernandes DG et al., 2009, on hydrolyzed protein and combing force: Hydrolyzed proteins measurably improved combing force (mechanical work to pull a comb through wet hair) on damaged hair in controlled testing
  5. NIH Office of Dietary Supplements, Biotin Fact Sheet for Health Professionals: True biotin deficiency is rare in people eating a varied diet; deficiency causes hair loss but supplementation in non-deficient individuals has limited evidence
  6. Skinmed Journal, Panahi Y et al., 2015, Rosemary oil vs minoxidil 2% for the treatment of androgenetic alopecia: A 2015 randomized controlled trial found rosemary oil comparable to 2% minoxidil for hair count after six months of use
  7. National Toxicology Program, NIH, DMDM Hydantoin and Formaldehyde-Releasing Preservatives: Formaldehyde-releasing preservatives including DMDM hydantoin are associated with scalp irritation and hair loss with repeated topical exposure
  8. American Academy of Dermatology, Hair Loss Types and Traction Alopecia: Traction alopecia is hair loss caused by tension and is most common in Black women and girls who wear tight hairstyles; ferritin, thyroid, and vitamin D tests are among the first checks for diffuse hair loss
  9. NIH National Institute of Arthritis and Musculoskeletal and Skin Diseases, Alopecia Areata and Hair Loss: Early intervention in traction alopecia, including reducing tension and scalp inflammation, gives the best chance of recovery
  10. NIH StatPearls, Telogen Effluvium: Telogen effluvium causes a large percentage of follicles to shift from growth to resting phase simultaneously, typically peaking 3 to 6 months postpartum
  11. US Patent 9,095,518, Dean C and Zedler E, Olaplex bis-aminopropyl diglycol dimaleate mechanism for disulfide bond repair: Olaplex's active ingredient bis-aminopropyl diglycol dimaleate repairs broken disulfide bonds in bleached hair; mechanism confirmed in patent and subsequent third-party analysis
  12. Journal of Dermatology, Pierard-Franchimont C et al., 1998, Ketoconazole shampoo effect on hair density in androgenetic alopecia: A 1998 study found ketoconazole 2% shampoo increased hair density in men with androgenetic alopecia compared to placebo