Ketoconazole Shampoo – Why only antifungal shampoo can truly control your dandruff?

Want to fix your flaky scalp forever? Then you may need to use antifungal shampoo for this purpose.

It may come as a surprise to you that dandruff is considered to be a fungal issue according to dermatologists. It causes the presence of yeast called Malassezia that acts as the primary element in the irritation that eventually leads to itching and continuous flaking on the scalp.

Knocking down this fungal infection and restoring your healthy scalp promoting growth to the hair, entails a proven antifungal treatment or a prescribed antifungal shampoo.

So what antifungal shampoos are all about, what do we call them, and how can they help in combating itchy scalp and unpleasant flaky symptoms.

Today in the post, we are covering the symptoms that are connected with fungal infections. Read on to ease your fears and find out which antifungal shampoo is the right pick for you.

Ketoconazole Shampoo – What should you know about it?

Ketoconazole is one of the most effective and receptive ingredients available in the market that works efficiently for seborrheic dermatitis victims. But how ketoconazole shampoo affects your scalp depends on the conditions of your fungal infection. Plus, no ingredient would help until you know our symptoms, but considering an active ingredient is the first-line treatment in both Europe and USA for the scalp infections.

Despite the importance and the effectiveness of the ingredient, only 4% of the shampoos contain Ketoconazole. Other than Ketoconazole, selenium sulfide is also an established antidandruff and antifungal ingredient.

If you’re suffering from seborrheic dermatitis or a dandruff infection, your doctor may suggest you a shampoo to monitor the reactions and conditions of your scalp after its use. Moreover, only 2% of the shampoo is available at the pharmacies to cure the potential infection or yeast causing dandruff in the UK.

A dermatologist based in Toronto, Dr. Ben Barakin, at the Toronto Dermatology Centre, recommended that from mild to moderate dandruff issues, zinc pyrithione, Ketoconazole, selenium sulfide, tar, and salicylic acids are some preferred over the counter dandruff fighting ingredients.

An interesting thing about ketoconazole is that it does not absorb in the bloodstream when it is used as an antifungal shampoo ingredient. It works to inhibit necessary enzymes to fight against fungus by synthesizing steroids into the cell membrane. Due to the fungal infection, the cells become leaky, they lose the ability to regulate electrolytes correctly and causing them to break down.

Who invented Ketoconazole?

Ketoconazole is originally formulated in Belgium by Janssen Pharmaceutical – a company that is also well-known for many other drugs like Daktarin and Imodium.

Ketoconazole was initially applied orally when it was discovered in 1976. But soon it was replaced by many other relatively less harmful ingredients that contain near to zero drawbacks. Some of the side effects witnessed initially included:

  • It couldn’t absorb completely by the brain or the scalp that leads to more serious infections.
  • The absorption of the substance was not uniform.
  • It also leads to liver toxicity and gastrointestinal issues.
  • The interactions of plenty of other drugs were discovered.

Because of the severe symptoms and organ toxicity, Medical and Healthcare Products Regulatory agencies (MHRA) recommended suspending the license for consuming Ketoconazole orally and suggested doctors prescribe other alternatives to the product.

The recommendation was made after the side effects of orally consuming the ingredient, however, it excluded the use of other formulations like creams and shampoo – not absorbing in the bloodstream while using orally may be the reason behind the recommendation.

Ketoconazole has been always effective towards the infections resulting from yeast species and fungus. These species and fungus are responsible to cause numerous scalp conditions, and for this reason, your doctor may prescribe you to use the antifungal shampoo containing ketoconazole without sending the scalp samples to a microbiological testing lab if you continue to underlie the fungal infections.

There can be many fungus and yeast species that can create fuss onto your scalp. Some of them include:


  • mentagrophytes
  • rubrum
  • tonsurans
  • audouni
  • gypseum
  • canis
  • floccosum


  • Orbiculare
  • ovale (Malassezia)
  • tropicalis
  • Albicans

Can ketoconazole be used in treating dandruff?

When treating sub-derm, ketoconazole has proved effective results and that is why it is listed in some of the few ingredients that are useful in the treatment of the fungal scalp. In the USA and the UK, it also an official anti-dandruff ingredient that is recommended to use to treat dandruff and scalp infections.

Another board dermatologist in Roswell, GA, and the founder of Live Oak dermatology added that it works behind seborrheic dermatitis as part of the mechanism which is considered to be an inflammatory immune reaction that results in flaking, itching, and redness of the scalp.

Antifungal shampoos having ketoconazole diminish the yeast population on the scalp that triggers skin inflammation. Generally, ketoconazole helps people to reduce scalp inflammation problems and is greatly covered by most insurance plans.

Many individuals also realize that the presence of anti-androgenic effects in ketoconazole might be the reason behind reducing sebum production when it is used as an antifungal shampoo.

Uses of Ketoconazole

Products that contain ketoconazole are freely advertised for dandruff treatments along with other OTC drug brands such as Nizoral that is available online and in the supermarkets to purchase. Every itching condition is not seborrheic dermatitis; however, it may be your dry scalp as well. You must figure out what your conditions are by consulting a dermatologist for your symptoms.

Seborrheic Dermatitis

It is a common skin disease that usually appears on the scalp of your head causing flaky scales and an itchy rash scalp. It is the reason for causing redness on fair skin and light patches on a darker tone of the skin. Generally, it is known as seborrhea, cradle scalp, dandruff, seborrheic psoriasis, and seborrheic eczema.

You might have heard about appearing the symptoms of dandruff or seborrheic dermatitis on your scalp, but it can appear anywhere on your body. Experts in this area are still trying to find the reason behind its occurrence, but it appears likely due to the mix of things like:

  • Genes
  • Stress
  • Consumption of certain medicines and medical conditions
  • The probable kind of yeast that lives on to your skin
  • Dry or cold weather
  • Or after an immune system response

It does not come from being unclean or from any ingredient that you may have been using on your scalp.

Risk Factors for Seborrheic dermatitis

Adults within the range of thirty to sixty are more prone to getting seborrheic dermatitis. It commonly appears in people having oily skin either men or women. Seborrheic dermatitis has the potential to raise the risks for:

  • Alcoholism
  • AIDS
  • Acne
  • Epilepsy
  • Depression
  • Eating disorders
  • Heart strokes
  • Rosacea
  • Parkinson’s disease
  • Psoriasis


Psoriasis is another skin inflammatory disease that causes redness, skin plague, and itchy skin for which ketoconazole works effectively. In this disease, yeast-like elements begin to infect n these skin patches and plagues. For psoriasis affairs, you also need ketoconazole treatments.

  • Tinea infections

Ketoconazole antifungal shampoo can also cure Tinea infections, capitis, and Versicolor. Tinea capitis appears as a ringworm-like infection affecting the scalp, whereas tinea versicolor is a result of skin infection which occurs due to the overgrowth of natural yeast.

  • Hair loss

Whereas Ketoconazole is mainly used to treat fungal infections or the symptoms that appear after seborrheic dermatitis and Tinea infection, it is also believed to be useful for promoting hair growth. A study performed on 15 people suffering alopecia, stated that applying ketoconazole for a month, it improves hair growth and promotes regrowth.

Types of Ketoconazole shampoo

You can get several types of OTC ketoconazole shampoo that are available and can be obtained by prescription from a medical healthcare provider.

The most commonly available and used OTC ketoconazole brand is Nizoral, most of the antifungal shampoo contains 1 percent or less amount of ketoconazole. You can use even 2 percent or more of the substance according to your conditions and prescription from your doctor.

Brands that are commonly prescribed include:

  • Ket Med
  • Nizoral
  • Ketozal
  • Ketozolin
  • Regenpure DR
  • Boost 2%

The best Ketoconazole containing shampoos

  • Nizoral

Nizoral is designed specifically to treat Seborrheic dermatitis. It supposedly on the top of the list of antifungal shampoos that are available in the market to control dandruff resulting from sub-derm. It is technically a prescribed medicine that is officially approved to make healthcare claims to treat dandruff and prevent connecting issues.

It is comprised of 2% ketoconazole which is tied with fragrance-free 11 ingredient formula. Studies have shown effective results in just a 30-day application period. If you suffer from severe dandruff and scalp fungal infections, Nizoral is a must-try

  • Ketozal 2% antifungal shampoo

The antidandruff antifungal shampoo is also intended to cure Seborrheic dermatitis disease. It is an effective product to treat the symptoms of severe dandruff and seb derm issues. General doctors prescribe 2% ketoconazole antifungal shampoo, where 2% ketozal is much cheaper and certainly cost-effective than the ones with big names available in the market. It comes as a caveat to all the general and expensive mediation available.

  • Regenpure DR Dandruff Shampoo

Regenpure hair and scalp treatment contain 1% ketoconazole formulated antifungal shampoo which is combined with salicylic acids. Regenpure company has been smartly advertised the product as a gentler alternative to the most commonly used antifungal shampoo Nizoral.

The inspired combination of Salicylic acid and ketoconazole is also a reason for its popularity that the company has received yet.

  • Ketozolin 2% antifungal shampoo

To opt for Ketozolin 2% for severe dandruff issues caused as a result of Seborrheic dermatitis would be one the smartest decision you could ever make. The product has the maximum EU recommended dose of ketoconazole. It is recommended due to the efficacy they deliver against the overgrowth of Malassezia yeast which is observed as a result of seb derm and dandruff infections.

You can even witness the improvements within only a week’s application. It also prevents dandruff from reoccurrence. Moreover, if you have a relatively sensitive scalp, you must ask your dermatologist before using the product as it contains some harsh chemicals like SLS and formaldehyde.

  • Ket Med Ketoconazole Shampoo

This should be the perfect option to combat your severe complications of dandruff and eczemas resulting because of seborrheic dermatitis.  The product contains 2% ketoconazole antifungal shampoo that is suggested by a pharmacist and many times prescribed by doctors as well.

Ket Med shampoo is also prescribed as an alternative to OTC in many countries to treat the same issues. The 2% formula falls perfect for infections and fungal treatments. However, if your scalp is prone to allergies you must use it after your doctor’s prescription.

  • Boost 2% Ketoconazole antifungal shampoo

Boost 2% antifungal shampoo is a UK pharmacist product that is much similar to the Walgreens product in the USA. Boost and Walgreens are actually the strategic partners of the pharm. Boost has developed a much cheaper alternative compare to Nizoral with 2% ketoconazole.

Although, the product does contain several harsh ingredients that you should look for if you have a sensitive scalp. But if you are seeking effective and cheaper ingredients for the treatment of your sufferings that you should give the product a try.

  • Sebizole 2% Ketoconazole antifungal shampoo

The product Sebizole 2% ketoconazole is available in New Zealand and Australia for now. The product contains ingredients such as Cocamide DEA, PEG – 150 disintegrate, hydrochloric acid, Sodium Laureth Sulfate, Sodium Lauryl sarcosinate, German II (preservatives), erythrosine sodium, Herb Flower fragrance, and purified water.

Where I can buy the Ketoconazole containing antifungal shampoo?

 The antifungal shampoo containing 1 % ketoconazole is available over the counter in the form of products such as Nizoral. You can only get the stronger solution of the shampoo with 2% ketoconazole from the prescription by a medical healthcare provider in the United States.

Although, it can be easily obtained from OTC in the countries like Europe, Australia, and New Zealand.

How often you should use ketoconazole containing antifungal shampoo?

To use any shampoo on your scalp, whether it is used for treating dandruff, scalp issues, or just for everyday use, you must follow the instructions written on the label.

Nizoral instructions, in this case, are extremely explicit.

  • Start with making your hair wet completely with cold water, apply a small amount of Nizoral dandruff shampoo onto your hair, and massage nicely to make leather.
  • Keep massaging and leave the leather on your hair for almost 5-7 minutes and then rinse thoroughly.
  • Use the shampoo every third or fourth day of the week for about two to four weeks.
  • If you still feel that your scalp is not clear enough after the use of the product for a month, you should contact your doctor or ask the pharmacist about the condition.
  • After that you may need to use the antifungal shampoo every second day for two weeks, it will also help preventing your dandruff from returning and dandruff or any infection would not be your issue again.

Unluckily, not all the antifungal shampoos and dandruff treating products are as prescriptive as Nizoral.

What are the risks of using ketoconazole?

When used as an antifungal shampoo ingredient, ketoconazole becomes mild and tolerated to some extent and does not appear to be associated with harmful; effects. Clinical trials were taken on 288 participants, where no contrast effects were seen except for one percent with prone skin. The most common reaction that was indicated include:

  • Rash
  • Dry skin / oily skin
  • Abnormal Hair texture
  • Irritation

In case of accidental contact with the eyes, the shampoo can cause irritation. One percent of victims who suffered mentioned adverse effects possibly due to any of these added ingredients, zinc pyrithione, ciclopirox olamine, salicylic acid, selenium sulfide, tea tree, piroctane olamine, or any other active ingredients of the shampoo that are known to prevent dandruff related issues.

Other than the particular product, ketoconazole may involve other negative effects as well that you must remain aware beforehand. One of the severe complications that people may expose to, is pimple-like bumps which are caused by irritation or inflammation on the spots where ketoconazole has been used.

In some individuals, it also has been seen that the use of ketoconazole has brought up an abnormal texture to the scalp like the dry skin changes to an oilier one and vice versa. Along with the abnormal texture, the consumption also caused discoloration, hair loss, and caused the permed hair to lose its curls as well.

Other considerations

The effects of ketoconazole on other individuals like breastfeeding mothers or pregnant women haven’t been studied well yet. In case you are expecting and worried about antifungal shampoo or treatment, consult your doctor prior to use the version of OTC antifungal shampoo.

The use of ketoconazole and the side effects of the application on children also haven’t been studied as well. It’s recommended that you should not apply harsh chemicals on children under 12 y/o until it is prescribed by the pediatrician.

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