Ketoconazole shampoos treat fungal infections that occur on or around the scalp. In some cases, a healthcare professional may recommend using ketoconazole for other off-label purposes.
In this article, we discuss what ketoconazole shampoo is, who can use it, and its potential side effects.
Ketoconazole shampoo is a red-orange liquid that a person can use to treat fungal infections on the scalp. It contains ketoconazole, which is a synthetic antifungal agent.
The Food and Drug Administration (FDA) approved ketoconazole in the form of a 2% solution to treat certain conditions, such as dandruff, seborrheic dermatitis, and tinea versicolor, which is a noncontagious fungal infection of the skin.
It is available in both over-the-counter (OTC) and prescription strengths.
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.
A person should follow all the instructions on the label or those that the doctor gives them.
In most cases, the person will need to work up a lather with the shampoo and apply it directly to the hair, ensuring that it reaches the scalp. They should leave the shampoo on their scalp for about 5 minutes before rinsing it off thoroughly.
People aged 12 years old and over should apply the shampoo to the scalp every 3–4 days for up to 8 weeks. After that, the product is only necessary if the person needs to control dandruff.
Anyone who is allergic to the active ingredient, ketoconazole, should not use the shampoo.
According to 2019 research, ketoconazole is safe to use topically, and people should be able to use ketoconazole shampoo for its intended purpose safely. However, the researchers note that in some cases, contact dermatitis may occur.
People who experience an allergic reaction when they use ketoconazole should discontinue its use.
If the reaction is severe, they should seek immediate medical attention.
Pregnancy or 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.
There does not appear to be much research on the use of ketoconazole shampoo during pregnancy. 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.
Ketoconazole shampoo generally has limited side effects.
According to the FDA, some reported side effects include:
- odd color and feel of the hair
- burning sensation
- dry skin
- irritated skin
If a person experiences a severe allergic reaction, which is called anaphylaxis, they should seek emergency medical help.
The symptoms of anaphylaxis include:
- passing out
- tight chest
- hoarse voice
- difficulty swallowing
- a feeling of impending doom
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.
If a reaction does occur, a person should talk to their doctor as soon as possible. It is possible that an alternative shampoo or medication may work without interactions.
If a person swallows ketoconazole shampoo, they should seek emergency medical treatment as soon as possible or contact Poison Control on 1-800-222-1222.
A person should talk to their doctor if they have tried using an OTC ketoconazole shampoo and still have symptoms of the condition that they are trying to treat.
A person should also see a doctor if they experience any of the following symptoms on using the shampoo:
- shortness of breath
- angioedema, which is a swelling that occurs under the skin
- skin reactions
Ketoconazole shampoo comes in both prescription and OTC strengths.
A person may be able to use ketoconazole shampoo to help with seborrheic dermatitis and dandruff, as well as fungal infections, including tinea versicolor.
A person should discontinue the use of ketoconazole shampoo if they have an allergic reaction to it. Women who are pregnant or breastfeeding should talk to their doctor before using the shampoo.