Ketoconazole

What is Ketoconazole?

Ketoconazole is used to treat and prevent fungal infections on the skin and nails. Ketoconazole shampoo may be used for seborrhoeic dermatitis, dandruff (pityriasis capitis), and pityriasis versicolor caused by the fungus Pityrosporum (or Malassezia).

Pityriasis versicolor, also known as tinea versicolor or sun fungus, is a common and harmless fungal infection of the skin. It causes light or dark patches with fine scales, usually on your torso, neck and arms. The Malassezia fungus that causes this condition is normally present on your skin, so the condition is not contagious.^[1]
You might also find it comforting to know that tinea versicolor is a purely cosmetic condition. It’s not painful and doesn’t affect your overall health.

How does Ketoconazole work?

Ketoconazole belongs to a group of antifungal medicines called imidazoles (or simply azoles). Its mechanism of action involves reducing the fungi’s ability to synthesise ergosterol, a vital component of their membranes. By disrupting the production of ergosterol, the fungal cell membranes become weak and unstable, leading to a breakdown of essential cellular processes and eventually causing the fungus to die off.^[2]

Ketoconazole, along with other azole drugs like miconazole and clotrimazole, is a fungistatic, meaning it slows down fungal growth. It doesn’t kill the fungi straight away. Instead, it relies on the natural shedding of your skin, a process called epidermal turnover, to remove the fungus that’s still alive on your skin surface.^[3]

How to use Ketoconazole for tinea versicolor

When using Ketoconazole shampoo or any other medicine, always listen to your clinician’s instructions. Here’s a simple guide to help you out:

1. Rinse the affected area of your skin or hair with water.
2. Give the shampoo bottle a little shake, then squeeze a small amount onto the affected area.
3. If you’re treating your scalp, massage the shampoo in until it lathers up.
4. Let the shampoo sit for 3 to 5 minutes.
5. Rinse it off with water.

If your symptoms don’t go away or if you have any questions, don’t hesitate to message our clinicians for further advice.

Are there different forms of Ketoconazole?

Ketoconazole comes in different forms: tablets, cream or shampoo. For tinea versicolor, you may be prescribed Ketoconazole 2% Shampoo. It’s a clear pink liquid, and each gram of it has 20mg of ketoconazole.

Our clinicians will give you instructions on how to use Ketoconazole shampoo based on your symptoms. Typically, you’ll be instructed to use it once a day for up to five days.

And if you notice more patches of pityriasis versicolor when exposed to the sun, you can use Ketoconazole 2% shampoo once daily for up to three days before being in the sun.