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Ketoconazole shampoo

Dandrazol, Nizoral

For dandruff, use the shampoo twice-weekly for 2-4 weeks. To help prevent dandruff from returning, continue to use the shampoo every 1-2 weeks.

For pityriasis versicolor, apply the shampoo directly to the skin patches once each day for up to five days. Leave it on the skin for 3-5 minutes before washing it off.

At a glance

  • Ketoconazole shampoo is an antifungal medicine used to treat severe dandruff and pityriasis versicolor.

  • It works by killing the yeast-like germs that cause these conditions.

  • For dandruff, use it twice weekly for 2-4 weeks, then once every 1-2 weeks to prevent recurrence.

  • For pityriasis versicolor, apply it daily for up to five days.

  • Speak to a doctor or pharmacist if you are pregnant, breastfeeding, or taking other medicines.

  • If dandruff symptoms do not improve after four weeks, consult a doctor or pharmacist.

Continue reading below

About ketoconazole shampoo

Type of medicine

An antifungal medicine

Used for

Severe forms of dandruff; pityriasis versicolor

Also called

Dandrazol®, Nizoral®

Available as

Shampoo

Ketoconazole shampoo is helpful for persistent or more severe forms of dandruff. It contains an antifungal agent which kills the yeast-like germs (a type of fungus) which cause the flaking of the scalp.

Ketoconazole shampoo is also prescribed for a skin condition called pityriasis versicolor. Pityriasis versicolor is a skin rash which is also caused by a yeast-like germ. Although small numbers of this germ commonly live on the skin and do no harm, some people are prone to it multiplying on their skin more than usual, which leads to small pale or brown patches of skin developing. In some people, hot, sunny or humid weather seems to trigger the germ to multiply on the skin.

Ketoconazole shampoo is available on prescription, and you can also buy some brands without a prescription at pharmacies and other retail outlets. It can be used by adults and children over 12 years of age.

To make sure this is the right treatment for you, before you start using ketoconazole shampoo it is important that you speak with a doctor or pharmacist if:

  • You have ever had an allergic reaction to a medicine.

  • You are pregnant or breastfeeding. This is because, while you are expecting or feeding a baby, you should only use medicines on the recommendation of a doctor.

  • You are taking any other medicines or using any other medicated skin products. This includes any medicines you are taking which are available to buy without a prescription, as well as herbal and complementary medicines.

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  • Before you use the shampoo, read the manufacturer's printed information leaflet from the pack. It will give you more information about ketoconazole shampoo and will provide you with a full list of the side-effects which you could experience from using it.

  • For dandruff, use the shampoo twice weekly for 2-4 weeks. Wet your hair well before you apply the shampoo. Apply the same amount of shampoo as you would usually use to wash your hair with. Massage the lather over your scalp and then leave it for about 3-5 minutes before you rinse it off. To help prevent the dandruff from returning, you can continue to use the shampoo once every 1-2 weeks.

  • For pityriasis versicolor, apply the shampoo to the skin patches once each day, for up to five days. Leave it on the skin for 3-5 minutes and then wash it off. For people who develop the rash after being out in the sun, the shampoo can subsequently be used as a way of preventing the rash from developing when planning to sunbathe. When used like this, it can be used for up to three days, in the same way as before.

  • Try not to get any of the shampoo into your eyes but if this happens, rinse it out with water as soon as possible.

  • If you are using the shampoo for dandruff and your symptoms are showing no signs of getting better after four weeks of using the shampoo, please speak with a doctor or pharmacist for further advice.

Continue reading below

Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the ones associated with ketoconazole shampoo. You will find a full list in the manufacturer's information leaflet supplied with your medicine. The unwanted effects often improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following continue or become troublesome.

Ketoconazole shampoo side-effects (these affect fewer than 1 in 100 people)

What can I do if I experience this?

Mild irritation, dryness, changes to how your hair feels

If it continues or becomes troublesome, speak with a doctor or pharmacist for further advice

If you experience any other symptoms which you think may be due to the shampoo, speak with your doctor or pharmacist for further advice.

  • Keep all medicines out of the reach and sight of children.

  • Store in a cool, dry place, away from direct heat and light.

Important information about all medicines

This preparation is for external use only. If you suspect that someone might have swallowed some of it by accident, go to the accident and emergency department of your local hospital. Take the container with you, even if it is empty.

The shampoo is for you. Do not give it to other people even if their condition appears to be the same as yours.

If you are having an operation or dental treatment, please remember to tell the person carrying out the treatment which medicines you are taking/using.

Do not keep out-of-date or unwanted medicines. Take them to your local pharmacy which will dispose of them for you.

If you have any questions about the treatment, please speak with your pharmacist.

Report side effects to a medicine or vaccine

If you experience side effects, you can report them online through the Yellow Card website.

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Frequently asked questions

What is the main ingredient in ketoconazole shampoo and what does it do?

Ketoconazole shampoo contains an antifungal agent. This agent works by killing the yeast-like germs, which are a type of fungus, responsible for causing severe dandruff and the skin rash known as pityriasis versicolor.

Where can I get ketoconazole shampoo?

Ketoconazole shampoo is available on prescription from a doctor. You can also purchase some brands of the shampoo without a prescription from pharmacies and other retail stores.

Does ketoconazole shampoo help with pityriasis versicolor even if it doesn't always show up on my skin?

Yes, if you develop pityriasis versicolor after being in the sun, you can use ketoconazole shampoo preventatively. It can be used for up to three days in the same way as for treatment when you plan to sunbathe, to help stop the rash from developing.

How long should I leave the shampoo on my scalp or skin?

Whether you are using it for dandruff or pityriasis versicolor, you should generally leave the shampoo on your scalp or skin for about 3-5 minutes before rinsing it off.

What should I do if any ketoconazole shampoo gets into my eyes?

If you accidentally get any ketoconazole shampoo in your eyes, you should rinse it out with water as soon as possible.

Are there any serious side effects I should be aware of?

Most people do not experience serious side effects. Possible side effects, affecting fewer than 1 in 100 people, include mild irritation, dryness, or changes to how your hair feels. If these persist or become bothersome, or if you experience any other unusual symptoms, you should speak with a doctor or pharmacist for advice. For a full list of side effects, consult the manufacturer's leaflet provided with the shampoo.

Can children use ketoconazole shampoo?

Ketoconazole shampoo is suitable for use by adults and children who are over 12 years of age.

Further reading and references

Continue reading below

About the authorView full bio

Author image

Michael Stewart, MRPharmS

Medicine Leaflet Review Manager – Contractor, Pharmacist

BPharm (Hons), MRPharmS

Michael is a community pharmacist practicing in the Midlands and South Yorkshire with more than 20 years’ experience advising on medicines and medical conditions. He has a strong background in healthcare training, having produced and delivered training courses for pharmacy teams and staff of residential care settings, including nurses. He has also contributed to pharmacy advisory boards for the management of low acuity conditions in the community.

About the reviewer

Author image

Sid Dajani

Sultan Dajani qualified at the London School of Pharmacy in 1994 and became the youngest elected member of the Royal Pharmaceutical Society council since its founding in 1842.

Article history

The information on this page is written and peer reviewed by qualified clinicians.

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