From the FDA Drug Label
Seborrheic dermatitis: Ketoconazole Cream 2% should be applied to the affected area twice daily for four weeks or until clinical clearing. Mode of Action:In vitro studies suggest that ketoconazole impairs the synthesis of ergosterol, which is a vital component of fungal cell membranes. It is postulated that the therapeutic effect of ketoconazole in seborrheic dermatitis is due to the reduction of M. ovale, but this has not yet been proven.
Ketoconazole (Nizoral) may be effective for treating seborrheic dermatitis of the facial hair, characterized by flaky or dry skin, as it is postulated to reduce M. ovale, a yeast that may be involved in the condition. The recommended treatment is to apply Ketoconazole Cream 2% to the affected area twice daily for four weeks or until clinical clearing 1. However, it is essential to note that the therapeutic effect of ketoconazole in seborrheic dermatitis has not yet been proven 1.
From the Research
Ketoconazole (Nizoral) is an effective treatment for seborrheic dermatitis of the facial hair, characterized by flaky or dry skin, as it inhibits fungal growth that contributes to flaking and inflammation. According to the most recent and highest quality study 2, seborrheic dermatitis is a common chronic inflammatory skin disorder that mostly affects young adults in areas rich in sebaceous glands, and treatment is aimed at modulating sebum production, reducing skin colonization by Malassezia spp., and controlling inflammation.
Treatment Options
- Topical antifungals such as ketoconazole are recommended for mild-to-moderate scalp and facial seborrheic dermatitis 2
- Ketoconazole gel 2% has been shown to be effective in the treatment of moderate to severe seborrheic dermatitis, with a significant proportion of subjects considered effectively treated compared to a vehicle gel 3
- The use of ketoconazole shampoo 1% or 2% formulation can be applied to the affected area, leaving it on for 3-5 minutes, then rinsing thoroughly, 2-3 times weekly for 2-4 weeks, then reducing to once weekly for maintenance if effective
Important Considerations
- If symptoms persist after 2-3 weeks of treatment, or if irritation occurs, discontinue use and consult a healthcare provider as the condition may require different treatment 2
- Moisturizing beard oils or conditioners may be more appropriate if facial hair dryness is simply due to dehydration rather than fungal issues 2
- Ketoconazole works by inhibiting fungal growth that contributes to flaking and inflammation, making it a viable alternative to topical corticosteroids and other treatments 4