From the FDA Drug Label
Ketoconazole Cream 2% is indicated for the topical treatment of ... tinea (pityriasis) versicolor caused by Malassezia furfur Cutaneous candidiasis, tinea corporis, tinea cruris, tinea pedis and tinea (pityriasis) versicolor: It is recommended that Ketoconazole Cream 2% be applied once daily to cover the affected and immediate surrounding area Patients with tinea versicolor usually require two weeks of treatment.
Ketoconazole cream is suitable for treating suspected pityriasis versicolor. The recommended treatment duration for tinea versicolor is two weeks, not 30 days. It is advised to follow the recommended treatment duration to ensure effective treatment and reduce the possibility of recurrence. 1 1
From the Research
Ketoconazole cream is a suitable treatment option for suspected pityriasis versicolor, but the most recent and highest quality study suggests that oral fluconazole may be a more effective treatment with fewer relapses. The patient's symptoms of red bumps and white spots that turn red with sun exposure are consistent with pityriasis versicolor, a common fungal skin infection caused by the Malassezia yeast.
Treatment Options
- Apply ketoconazole 2% cream to the affected areas once or twice daily for 2-4 weeks, as this has been shown to be effective in treating pityriasis versicolor 2.
- Alternatively, consider oral fluconazole, which has been shown to have a higher clinical and mycological cure rate with fewer relapses compared to ketoconazole 3.
- For widespread infection, ketoconazole shampoo as a body wash or oral antifungal medication may be recommended by a doctor.
Important Considerations
- The cream should be massaged gently into the skin until absorbed, and treatment should continue for the full recommended duration even if symptoms improve earlier.
- Skin color may take several months to normalize completely after successful treatment.
- If symptoms persist after 4 weeks of treatment, consult a healthcare provider as alternative treatment options may be necessary.
Study Comparison
- A study comparing oral and topical ketoconazole therapy found that both treatments were effective, but oral ketoconazole had a higher cure rate 2.
- Another study found that single-dose oral fluconazole had the best clinical and mycological cure rate with no relapses during a 12-month follow-up period 3.