You can usually use ketoconazole cream again if it worked well before and as long as the infection is mild and has not spread. Pityriasis versicolor There are no adequate and well-controlled studies in pregnant or lactating women. Data on a limited number of exposed pregnancies indicate no adverse effects of topical ketoconazole on pregnancy or on the health of the foetus/newborn child. Animal studies have shown reproductive toxicity at doses that are not relevant to the topical administration of ketoconazole No effects on the breastfed newborn/infant are anticipated. See Pharmacokinetic properties, section 5.2. Dr. Ben Barankin, a Toronto based board-certified dermatologist at the Toronto Dermatology Centre, recommends it’s usage when he told us, “For mild-moderate dandruff, my preferred over the counter dandruff ingredients include: zinc pyrithione, selenium sulfide, ketoconazole, tar and salicylic acid“. For dandruff, use the shampoo twice weekly for 2-4 weeks. Wet your hair well before you apply the shampoo. Applythe 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. To use a dandruff shampoo, or any shampoo for that matter, shampoo, you should always follow the instructions on the label.

EMC. (2015). Pinewood Healthcare: Ketoconazole 2% w/w Shampoo. [Accessed: 28/2/17] www.medicines.org.ukDr. Matthew Zirwas, a board-certified dermatologist and founder of Bexley Dermatology in Bexley, Ohio recommended trying a shampoo for, “at least a month because if your old shampoo had ingredients that were causing a dandruff-like rash of their own, it will take 4-8 weeks for that ingredient to work its way out of your body after you start the new stuff.” Adult: 200 mg once daily; may increase to 400 mg once daily if clinical response is insufficient. Continue treatment until symptoms have cleared and cultures have become negative. To keep your scalp clear and to prevent dandruff returning, use Nizoral Dandruff Shampoo once every 1 – 2 weeks. If you stop using Nizoral Dandruff Shampoo altogether, your symptoms may become a problem again. Ketoconazole shampoos have been shown to be effective against a range of fungus and yeast species. These are known to cause several scalp conditions, and so your doctor may prescribe ketoconazole shampoo if your symptoms are consistent with an underlying fungal infection – without needing to send a sample for microbiological testing. Common species susceptible to ketoconazole are summarized below [5]: Fungus

Allergic reactions to ketoconazole shampoo are extremely rare, but should be taken seriously. Seek immediate medical attention if you have signs of an allergic reaction like: Massage the shampoo into the hair like normal shampoo, but leave it on for three to five minutes before rinsing.

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.