Ketoconazole shampoo is a medicated treatment primarily used for fungal infections affecting the scalp and skin. It contains ketoconazole, a synthetic antifungal agent that inhibits the growth of fungi. This article explores the various uses of ketoconazole shampoo, its benefits, potential side effects, and important precautions to consider before use.
Ketoconazole shampoo is a red-orange liquid formulated to address fungal infections on the scalp and skin. The Food and Drug Administration (FDA) has approved ketoconazole in a 2% solution for treating specific conditions like dandruff, seborrheic dermatitis, and tinea versicolor, a noncontagious fungal infection of the skin. It is available in both over-the-counter (OTC) and prescription strengths.
Ketoconazole shampoo is effective in treating a range of conditions, including:
Seborrheic Dermatitis: Ketoconazole shampoo is commonly used as a dandruff treatment. Seborrheic dermatitis may be associated with an overgrowth of Malassezia, a yeast-like fungus naturally present on the skin. Ketoconazole helps treat dandruff by reducing the fungus and decreasing inflammation.
Dandruff: Ketoconazole shampoo is commonly advertised as a dandruff treatment, with OTC brands like Nizoral available for purchase in supermarkets or online.
Read also: Benefits of Keratin Treatments
Psoriasis: Ketoconazole is a common treatment for psoriasis, an inflammatory skin disease that causes skin flaking, skin plaques, and redness or other skin discoloration. Yeast-like fungus often infects these skin plaques. Prescription ketoconazole may be necessary to treat psoriasis flares.
Tinea Infections: Ketoconazole shampoo can also treat tinea capitis and tinea versicolor. Tinea capitis is a superficial, ringworm-like fungus infection that can affect the scalp. Tinea versicolor is a skin infection caused by overgrowth of a type of yeast that naturally lives on your skin. Prescription ketoconazole shampoo is used to treat tinea versicolor.
Ringworm: Topical ketoconazole is used to treat fungal skin conditions, such as ringworm.
Candidiasis: Topical ketoconazole is used to treat cutaneous candidiasis, a yeast infection of the skin.
Hair Loss: While ketoconazole is most often used for its antifungal properties to treat infections or conditions such as seborrheic dermatitis, some evidence suggests that it may also help promote hair growth or reduce hair loss. However, more research is necessary to investigate this possibility.
Read also: Uses of Nizoral Shampoo
Topical ketoconazole is an antifungal medicine that stops the growth of the fungus causing the infection. It works by slowing the growth of fungi that cause infection.
Multiple types of ketoconazole shampoos are available OTC and by prescription from a healthcare professional.
Over-the-Counter (OTC): OTC ketoconazole shampoos contain 1% or less of ketoconazole. The most commonly known OTC brand is Nizoral, which is available in most supermarkets and online. Over-the-counter ketoconazole shampoo is used to control flaking, scaling, and itching of the scalp caused by dandruff.
Prescription: You can get shampoos that contain 2% or more of ketoconazole with a prescription from your doctor. Brands available by prescription include Ketozal, Ketozolin, Ket Med. Prescription ketoconazole comes as a cream and a shampoo to apply to the skin. Prescription ketoconazole shampoo is usually applied one time to treat the infection.
Ketoconazole is also available as a tablet that is swallowed. Topical ketoconazole comes in a cream, foam, and shampoo.
Read also: Application of Ketoconazole Shampoo
A person should follow all the instructions on the label or those that the doctor gives them. A person should talk to their doctor if they suspect that they have a fungal infection. A doctor can provide more advice on effective treatments for their condition.
How often and how long you’ll use the shampoo will depend on several factors, such as: the strength of the shampoo (1% for the OTC version or 2% for the prescription version), the condition you’re using it to treat, the severity of your current symptoms. Based on these factors, your doctor might ask you to use the shampoo anywhere from every other day to once per week. Use ketoconazole shampoo exactly as your doctor recommends. Do not use it more or less frequently than your doctor tells you to.
Wet your hair thoroughly. Apply the shampoo to your hair. Use your fingers to rub the shampoo until it forms a lather. Rinse all of the shampoo out of your hair with plenty of water. Repeat steps 2 to 5.
Ketoconazole cream is usually applied once a day for 2 to 6 weeks. Over-the-counter ketoconazole shampoo is usually used every 3 to 4 days for up to 8 weeks, and then used as needed to control dandruff. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use ketoconazole exactly as directed. Do not use more or less of it or use it more often than prescribed by your doctor.
Anyone who is allergic to the active ingredient, ketoconazole, should not use the shampoo.
Allergies: People who are allergic to any of the following should not use topical ketoconazole: Ketoconazole, Extina, Ketodan, Ketozole, Kuric, Nizoral, Xolegel, Any of the ingredients in the specific product dispensed. Your pharmacist can tell you all of the ingredients in the specific topical ketoconazole products they stock.
Pregnancy and Breastfeeding: It is safe to use ketoconazole shampoo when breastfeeding. According to a 2018 article, the use of ketoconazole shampoo does not pose a risk to the infant. However, breastfeeding women should avoid applying it to the breasts or the nipples due to the chance of the infant ingesting it. According to the FDA, a person should not use ketoconazole during pregnancy unless the benefit outweighs any potential risks to the fetus. However, more recent 2017 research suggests that ketoconazole is likely safe but that if a pregnant woman uses it, she should only do so on limited areas for short periods. There are not enough studies to indicate whether the ingredients could be harmful to the developing baby. Tell your doctor if you are pregnant, plan on getting pregnant, or are breast-feeding. If you become pregnant while using ketoconazole, call your doctor. Tell your healthcare provider if you are breastfeeding or plan to breastfeed. Your healthcare provider will advise you if you should use topical ketoconazole while breastfeeding.
Children: Children under the age of 2 years should also avoid using the shampoo unless a doctor recommends it. The safety of ketoconazole shampoo on children remains unclear. It’s best not to use ketoconazole shampoo on children under 12 years of age unless instructed to do so by their pediatrician.
Drug Interactions: A person should talk to their doctor about any medications that they are taking. A doctor can advise whether certain medications will interfere with, or react to, ketoconazole. There are no known interactions between topical ketoconazole and other medicines. Always tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.
General Advice: If topical ketoconazole was prescribed to you by a healthcare provider, use it as prescribed. If you are using over-the-counter topical ketoconazole, follow the instructions that come with the product. Do not share topical ketoconazole that was prescribed for you by a healthcare provider with other people, even if they have the same condition as you. It may harm them. Do not apply topical ketoconazole near the mouth, lips, eyes, or vagina. There are several forms of topical ketoconazole. Each may need to be used differently. Follow the instructions on the specific topical ketoconazole product you have. Ask your healthcare provider if you are not sure how to apply it.
Sunlight Sensitivity: Topical ketoconazole foam can make your skin more sensitive to light from the sun, sunlamps, and tanning beds. This is called photosensitivity. Exposure to this light can cause severe sunburns, blisters, and swelling. If you need to be in sunlight, wear sunscreen, a hat, and clothing that covers your skin.
Other medical conditions: Tell your doctor if you have or have ever had any medical condition. If you will be using the cream, tell your doctor if you have or have ever had asthma.
Ketoconazole shampoo generally has limited side effects. According to the FDA, some reported side effects include:
In rare cases, ketoconazole shampoo can result in hair loss.
If a person experiences a severe allergic reaction, which is called anaphylaxis, they should seek emergency medical help. The symptoms of anaphylaxis include: wheezing, passing out, tight chest, hoarse voice, hives, diarrhea, difficulty swallowing, a feeling of impending doom.
If a reaction does occur, a person should talk to their doctor as soon as possible. A person should also see a doctor if they experience any of the following symptoms on using the shampoo: rash, shortness of breath, angioedema, which is a swelling that occurs under the skin, skin reactions.
Good Health Habits: Good health habits are also required for patients using the cream form of this medicine to help clear up your infection completely and to help make sure it does not return.
Athlete's Foot: For patients using the cream for athlete's foot (tinea pedis; ringworm of the foot), the following instructions will help keep the feet cool and dry: avoid wearing socks made from wool or synthetic materials (e.g., rayon or nylon). Instead, wear clean, cotton socks and change them daily or more often if your feet sweat a lot. Wear sandals or well-ventilated shoes (e.g., shoes with holes). Use a bland, absorbent powder (e.g., talcum powder) or an antifungal powder between the toes, on the feet, and in socks and shoes one or two times a day. It is best to use the powder between the times you use the cream. If you have any questions about these instructions, check with your doctor.
Jock Itch: For patients using the cream for ringworm of the groin (tinea cruris; jock itch), the following instructions will help reduce chafing and irritation and will also help keep the groin area cool and dry: avoid wearing underwear that is tight-fitting or made from synthetic materials (e.g., rayon or nylon). Instead, wear loose-fitting, cotton underwear. Use a bland, absorbent powder (e.g., talcum powder) or an antifungal powder on the skin. It is best to use the powder between the times you use ketoconazole cream. If you have any questions about these instructions, check with your doctor.
Foam Flammability: Topical ketoconazole foam is flammable. Keep it away from open flames.
Hair Texture Changes: If your hair is permed, ketoconazole may cause your hair to lose its curl. Ketoconazole shampoo may remove the curl from hair that has been permanently waved ('permed').
Check Progress: It is very important that your doctor check your progress at regular visits. This will allow your doctor to see if the medicine is working properly and check you for any problems or unwanted effects that may be caused by this medicine. Do not use this medicine for a skin problem that has not been checked by your doctor. If your skin problem does not improve within 2 weeks for cutaneous candidiasis, pityriasis versicolor, tinea corporis, or tinea cruris; or 4 weeks for seborrheic dermatitis; or 4 to 6 weeks for tinea pedis, or if it becomes worse, check with your doctor.
Apply the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not apply a double dose to make up for a missed one. If you miss a dose, use it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Use your next dose at the regular time.
Topical ketoconazole should be stored at room temperature, between 68 F to 77 F (20 C to 25 C). It can be exposed to temperatures between 59 F to 86 F (15 C to 30 C), for shorter periods of time, such as when transporting it. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Protect the medication from light and do not allow it to freeze. Different brands/strengths of this medication may have different storage requirements. Read the package labeling or ask your pharmacist for the storage requirements for the product you are using.
Dispose of unneeded medications in a way so that pets, children, and other people cannot take them. Do not flush this medication down the toilet. Use a medicine take-back program. Talk to your pharmacist about take-back programs in your community. Always lock safety caps. Place the medication in a safe location - one that is up and away and out of their sight and reach.
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