Ketoconazole Shampoo Usage Instructions
For scalp fungal infections including seborrheic dermatitis and dandruff, apply ketoconazole 2% shampoo twice weekly for 2-4 weeks during the treatment phase, then once weekly for maintenance prophylaxis to prevent recurrence. 1
Treatment Phase Application
- Apply ketoconazole 2% shampoo to wet scalp and hair twice weekly (e.g., every 3-4 days) for 2-4 weeks to achieve initial clearance of infection 1, 2
- Leave the shampoo on the scalp for 3-5 minutes before rinsing thoroughly to allow adequate contact time for antifungal activity 1
- This regimen produces an excellent response in approximately 88% of patients with moderate to severe seborrheic dermatitis and dandruff 1
- Clinical improvement typically becomes evident within the first 2-4 weeks of treatment 2
Maintenance/Prophylactic Phase
- After achieving clearance, continue with once-weekly application to prevent relapse 1
- Prophylactic once-weekly use reduces recurrence rates from 47% (placebo) to 19% (active treatment) over 6 months 1
- This maintenance approach is critical because fungal scalp infections have high recurrence rates without ongoing prophylaxis 3
Specific Application Technique
- Wet hair and scalp thoroughly with water first 1
- Apply sufficient shampoo to generate lather over the entire affected scalp area 2
- Massage gently into scalp, ensuring contact with all affected areas 2
- Leave in place for 3-5 minutes (do not rinse immediately) 1
- Rinse thoroughly with water 2
- May repeat application if desired for cosmetic cleansing purposes 2
Role in Tinea Capitis Management
Important caveat: While ketoconazole shampoo is useful as an adjunctive measure to reduce spore transmission in tinea capitis (scalp ringworm), it should not be used as monotherapy 4
- Ketoconazole 2% shampoo serves only to reduce transmission of fungal spores to others, not as primary treatment 4
- Oral antifungal therapy (such as griseofulvin or terbinafine) is required for actual eradication of tinea capitis 4
- Topical therapy alone, including ketoconazole shampoo, is not recommended for management of tinea capitis as it cannot penetrate the hair shaft adequately 4