What it is used for
- Dandruff and seborrhoeic dermatitis (shampoo)
- Fungal skin infections such as ringworm and athlete's foot (cream)
- Pityriasis versicolor
- Selected serious systemic fungal infections (oral form, restricted use)
How it works
Ketoconazole blocks an enzyme fungi need to build their cell membrane, weakening and killing the fungal cells. On the skin and scalp it also reduces the yeast that contributes to dandruff and seborrhoeic dermatitis.
How it is taken
Most commonly used as a medicated shampoo and a skin cream; an oral tablet form exists but its use is now restricted to certain serious infections under specialist supervision because of liver risks. Use the shampoo or cream exactly as your doctor, pharmacist, or label directs, applying to the affected area for the recommended time.
No doses here on purpose. The right strength and schedule depend on you — only a doctor or pharmacist should set them. Always follow your prescription and the label.
Common side effects
- With shampoo or cream: skin irritation, itching, dryness, or a burning feeling
- Change in hair texture (shampoo)
- With tablets: nausea, stomach upset, headache
Serious effects — get help
- With oral tablets: signs of liver damage (yellow skin or eyes, dark urine, severe tiredness), which can be serious
- Severe allergic or skin reaction
- Adrenal or hormone-related effects with the oral form
- Heart-rhythm changes with the oral form
If a reaction is severe — for example trouble breathing, swelling of the face or throat, or collapse — go to the nearest emergency room now or call your local emergency number. Do not wait for an online consultation.
Interactions to watch
- Oral ketoconazole interacts with many medicines, including some statins, sedatives, and heart medicines
- Topical forms have minimal interactions
- Tell your clinician about all medicines, especially before any oral course
Who should take care
- Oral ketoconazole is avoided in people with liver problems and needs liver monitoring
- Avoid getting the shampoo or cream in the eyes
- Use in pregnancy or breastfeeding only on clinical advice
- Tell your doctor about any previous antifungal allergy