Ketoconazole

About ketoconazole

Ketoconazole is an antifungal medicine. It's used to treat skin infections caused by a fungus (yeast). It can also prevent them coming back.

It treats different types of fungal infections including:

Ketoconazole is available as a cream or shampoo.

You can buy most ketoconazole creams and shampoos in pharmacies and supermarkets, or get them on prescription. For treating pityriasis versicolor, you will need a prescription.

Ketoconazole also comes as tablets but these usually only treat a rare condition called Cushing's syndrome. The tablets are available on prescription only, and they are not covered here.

Key facts

Who can and cannot use ketoconazole

Ketoconazole creams and shampoos can be used by most adults and children aged 12 years and over.

Ketoconazole is not suitable for everyone. To make sure it's safe for you, talk to your doctor or pharmacist before using it if you have ever had an allergic reaction to ketoconazole or any other medicine.

How and when to use ketoconazole

How often to use cream for athlete's foot, jock itch and sweat rash

Always follow the instructions that come with your medicine, or your doctor's advice.

How long you use ketoconazole for and how often depends on the type of skin problem you have.

Use the cream once or twice a day on the infected skin and surrounding area. For athlete's foot, you need to use it twice a day regularly.

Carry on using the cream for 3 days after your symptoms have cleared up, to stop the infection coming back.

How often to use shampoo or cream for seborrhoeic dermatitis

Use the shampoo twice a week for 2 to 4 weeks until your symptoms have cleared. Then use it once every 1 to 2 weeks, to stop them coming back.

Alternatively, you can use the cream once or twice a day, for 2 to 4 weeks, and then use the shampoo once every 1 to 2 weeks to stop your symptoms coming back.

How often to use shampoo for dandruff

Use the shampoo twice a week for 2 to 4 weeks, then once every 1 to 2 weeks to stop your dandruff coming back.

How often to use cream or shampoo for pityriasis versicolor

Use the shampoo once a day, for up to 5 days.

For treating small areas of skin, you can use the cream instead. Put the cream on once or twice a day for 2 to 3 weeks.

If your symptoms tend to return in sunlight, use the shampoo once a day for up to 3 days before going out in the sun.

How to use ketoconazole cream

  1. Wash and dry the infected area of skin. If you're treating your feet, make sure you dry between your toes.
  2. Use your own towel or flannel. This stops you passing the infection on to anyone else.
  3. Gently rub the cream into the infected area and surrounding skin. You'll usually need a small amount, depending on the size of the area you're treating. Be careful not to let the cream get into your eyes or mouth. If it does get into your eyes or mouth, rinse them with water.
  4. Wash your hands afterwards. This stops you spreading the infection to other parts of your body or other people.

If you're using any other creams, ointments or lotions on the same area of skin, do not put them on at the same time as ketoconazole cream. After putting on the ketoconazole cream, wait 30 minutes before you use different products on the same area. This gives the ketoconazole time to be absorbed into your skin.

How to use ketoconazole shampoo

  1. Rinse your hair or the infected area of skin with water.
  2. Shake the shampoo bottle, then squeeze a small amount onto the infected area.
  3. If you're treating your scalp, massage the shampoo into your scalp until it makes a lather.
  4. Leave the shampoo on for 3 to 5 minutes, then wash it off with water. Try not to get the shampoo into your eyes or mouth. If it gets into your eyes or mouth, rinse them with water.
  5. Wash your hands afterwards. This stops you spreading the infection to other parts of your body or other people.

What if I forget to use it?

If you forget to use your ketoconazole cream or shampoo, just skip the missed dose and then keep to your usual routine.

What if I use too much?

If you use too much ketoconazole shampoo or cream, or use it more often than you need to, it may make your skin irritated or red. If this happens, use less the next time.

Side effects of ketoconazole

Common side effects

Like all medicines, ketoconazole cream and shampoo can cause side effects, but not everyone gets them.

Most side effects are minor. You can try using a smaller amount of the cream or shampoo to see if that helps.

You're unlikely to have common side effects when using the right amount of ketoconazole shampoo.

With ketoconazole cream, common side effects happen in more than 1 in 100 people. They usually affect your skin where you've applied the cream.

Talk to a pharmacist or doctor if these side effects bother you or do not go away, or if they spread beyond the area of skin you've treated:

Serious allergic reaction

Serious allergic reactions (anaphylaxis) are rare but can happen with ketoconazole cream or shampoo.

These are not all the side effects of ketoconazole. For a full list, see the leaflet inside your medicine packet.

How to cope with side effects of ketoconazole

What to do about:

Pregnancy and breastfeeding

Ketoconazole and pregnancy

You can use ketoconazole cream or shampoo if you're pregnant. Only tiny amounts are absorbed into your body so it will not affect your baby.

Ketoconazole and breastfeeding

If you want to breastfeed and are using ketoconazole on your chest, wash any cream off your breasts and nipples and then wash your hands before feeding your baby.

Cautions with other medicines

Using ketoconazole with other skin treatments

Only tiny amounts of ketoconazole are absorbed into your body when you use it as a cream or shampoo. You can usually use ketoconazole skin treatments while taking most medicines.

If you're using a mild steroid cream (such as hydrocortisone) to help with swelling or inflammation caused by the skin infection, put the steroid cream on in the morning and the ketoconazole cream in the evening.

If you're using ketoconazole twice a day, make sure you wait at least 30 minutes after putting it on before using the steroid cream.

Mixing ketoconazole with herbal remedies and supplements

There's very little information about taking herbal remedies and supplements while using ketoconazole. They are not tested in the same way as other medicines.

Common questions about ketoconazole

How does ketoconazole work? How long does ketoconazole take to work? What if ketoconazole does not work? What do I do if the infection comes back after treatment? Are there other treatments for fungal infections? Can I drink alcohol? Is there any food or drink I need to avoid? Will it affect my fertility? Will ketoconazole affect my contraception? Can I drive or ride a bike? What else can I do to help fungal infections?