Ketoconazole is an antifungal medication that stops fungi from growing, similar to other antifungals with ingredients like Tolnaftate. As an imidazole derivative antifungal agent, ketoconazole comes in creams, foams, gels, and even shampoos that you can apply directly to your skin.
Doctors prescribe ketoconazole cream 2% to treat a variety of skin conditions, including:
- dermatophytoses like tinea corporis (ringworm), tinea cruris (jock itch), and tinea pedis (athlete’s foot)
- cutaneous candidiasis
- pityriasis versicolor
- seborrheic dermatitis
This article will give you a complete overview of ketoconazole cream, including how to use it, what to watch out for, and other important information you’ll want to know.
What is ketoconazole cream used for?
Ketoconazole cream is a topical antifungal medication that treats a variety of skin infections.
Dermatophytoses
Dermatophytoses are fungal infections of the skin caused by fungi called dermatophytes. Ringworm, jock itch, and athlete’s foot are all dermatophytoses. Ketoconazole cream can treat these conditions:
- Tinea corporis (ringworm)
- Tinea cruris (jock itch)
- Tinea pedis (athlete’s foot)
Topical ketoconazole is often the first treatment doctors prescribe for tinea corporis and tinea cruris. If you have athlete’s foot with thick, crusty skin or a moccasin-type infection, you may need to take an oral antifungal medication.
Cutaneous Candidiasis
Cutaneous candidiasis is a fungal infection of the skin caused by Candida yeast species. It can cause redness, itching, and a burning sensation. Ketoconazole cream is effective in treating cutaneous candidiasis.
Pityriasis (Tinea) Versicolor
Pityriasis versicolor is a fungal infection that causes discolored patches on the skin. Ketoconazole 2% cream and shampoo are effective in treating pityriasis versicolor, but keep in mind that even after the infection is gone, the skin may not return to its normal color right away.
Seborrheic Dermatitis and Dandruff
Seborrheic dermatitis is a common skin condition that causes scaly patches, red skin, and stubborn dandruff. Ketoconazole 2% cream, foam, gel, and 1% and 2% shampoo can treat seborrheic dermatitis and dandruff.
How to use ketoconazole cream
General instructions
- Wash your hands before and after each application.
- Apply a thin layer of the cream to the affected area and the skin around it.
- Be careful not to get it in your eyes, mouth, or other mucous membranes.
Dosage for dermatophytoses
For skin infections caused by dermatophytes, apply ketoconazole 2% cream to the affected area once a day for two to four weeks.
Dosage for cutaneous candidiasis
For cutaneous candidiasis, a fungal infection of the skin, apply ketoconazole 2% cream once or twice a day for two to four weeks.
Dosage for pityriasis versicolor
For pityriasis versicolor, a common fungal infection that causes small, discolored patches of skin, apply ketoconazole 2% cream once a day for two weeks. Ketoconazole 2% shampoo can be used as a three-day treatment or as a single application.
Dosage for seborrheic dermatitis and dandruff
To treat seborrheic dermatitis and dandruff, you can use the following ketoconazole products:
- 2% Cream: Apply to affected areas once or twice a day for two to four weeks.
- 2% Foam: Apply to affected areas twice a day for up to four weeks.
- 2% Gel: Apply to affected areas once a day for two to four weeks.
- 1% Shampoo: Use twice a week for two to four weeks.
- 2% Shampoo: Use once every three to four days for up to eight weeks.
It’s important to follow your doctor’s instructions carefully. They may adjust your dosage or treatment plan based on your individual needs.
Cautions: Adverse effects, precautions, and contraindications
Like any medication, ketoconazole cream has potential side effects and contraindications, and understanding those, similar to understanding Fungisol side effects, is important. Here’s what you need to know:
Adverse effects
The most common side effects of topical ketoconazole are usually mild and temporary. You might experience, including a burning sensation:
- Irritation, itching, or stinging where you put the cream
- A burning sensation
Rarely, people experience more severe side effects, such as:
- Contact dermatitis (a type of skin rash)
- Severe allergic reactions
Precautions and contraindications
You should NOT use ketoconazole if you are allergic to it or any of the other ingredients in the cream or shampoo.
Also, be aware of the following:
- Ketoconazole foam is flammable, so keep it away from open flames.
- Some formulations of ketoconazole contain sodium sulfite, which can cause allergic reactions in some people.
Pregnancy and lactation
If you are pregnant or breastfeeding, talk to your doctor before using ketoconazole cream or shampoo. They can help you weigh the risks and benefits.
This information is not a substitute for professional medical advice. Always talk to your doctor or pharmacist if you have any questions or concerns about ketoconazole.
How Ketoconazole Cream 2% Works
Ketoconazole is an antifungal medication. It belongs to a class of drugs called imidazoles, which work by interfering with an enzyme called cytochrome P450. But what does that mean, exactly?
Well, fungi need a substance called ergosterol to build their cell membranes. Think of ergosterol as the special ingredient that holds the fungal cell together.
Ketoconazole blocks the fungus from making ergosterol, which weakens the cell membrane. Without a strong membrane, the fungal cell can’t survive, and the infection goes away.
So basically, ketoconazole attacks the fungus’s construction process, causing it to crumble and die. It’s like taking away their building blocks!
What types of infections does ketoconazole treat?
Ketoconazole is an antifungal medication that treats fungal infections. If your doctor has prescribed ketoconazole, you may wonder what kind of fungus it’s designed to fight off.
Ketoconazole is effective against these types of fungus:
- Dermatophytes, such as Trichophyton, Microsporum, and Epidermophyton
- Candida species
- Malassezia furfur (the fungus that causes pityriasis versicolor)
Can fungus become resistant to ketoconazole?
Yes, it can. Over time, fungus can develop resistance to ketoconazole, especially if you use it for a long time or repeatedly.
That’s why it’s important to follow your doctor’s instructions carefully and use the medication exactly as prescribed. Don’t use it more often or for longer than you’re supposed to. If you do, the fungus may become resistant to the medication, and it won’t work as well. It’s also important that you not share the medication with anyone else.
If your symptoms don’t improve after a few weeks of using ketoconazole, talk to your doctor. They may need to prescribe a different medication.
Pharmacokinetics
Pharmacokinetics is the study of how your body absorbs, distributes, metabolizes, and excretes a drug.
Absorption
When you use ketoconazole cream on your skin, very little of the medicine makes its way into your system.
For example, one study showed that 75 percent of people who used a 2 percent ketoconazole foam had less than 6 ng/mL of ketoconazole in their blood plasma.
Another study showed that people using a 2 percent ketoconazole gel had a mean peak plasma concentration of 1.35 ng/mL on day 7 and 0.8 ng/mL on day 14.
These studies help illustrate that ketoconazole cream is absorbed into the bloodstream in very small amounts, which is why the cream is used to treat infections of the skin.
What is ketoconazole cream made of?
Like all medications, ketoconazole cream is a chemical compound. Here are some things to know about the chemistry and stability of this drug.
Chemistry
Ketoconazole is part of a family of medicines called imidazole derivatives.
Stability
When you’re storing ketoconazole cream, keep it at room temperature, between 68°F and 77°F (20°C and 25°C). If you need to, it’s OK to store it at temperatures between 59°F and 86°F (15°C and 30°C) for a short time.
As with all medications, follow the directions on the label for proper storage.
Available Preparations
Ketoconazole topical treatments come in several forms and strengths:
- 2% Cream
- 2% Foam
- 2% Gel
- 1% Shampoo
- 2% Shampoo
You might recognize ketoconazole by brand names like Extina or Nizoral. The strength of the ketoconazole will vary depending on the product.
Ketoconazole cream, foam, and gel are typically supplied in tubes. The shampoo comes in a bottle.
It’s important to use these medications exactly as directed by your doctor. If you experience side effects, it’s important to report them. In the U.S., you can report side effects to the FDA at 800-FDA-1088. In Canada, the number is 866-234-2345.
If you think someone has swallowed ketoconazole cream, shampoo, or foam, contact Poison Control at 800-222-1222 immediately.
The Bottom Line
Ketoconazole cream is a topical antifungal medication that’s effective for treating a variety of skin conditions. It’s important to use it exactly as directed and to understand the possible side effects and things to watch out for.
Fungal infections can look similar to other skin conditions, so it’s important to talk with a healthcare professional if you think you have a fungal infection. They can diagnose your condition and recommend the best treatment for you.