Ketoconazole shampoo

Ketoconazole is an antifungal shampoo that kills yeasts and fungi. It reduces irritation, such as flakes and an itchy, scaly scalp. Ketoconazole shampoo is also suitable for use in children.

Fungi and yeasts naturally live in and on all parts of the body, including the scalp. An overgrowth of them can lead to health problems and discomfort. The active ingredient in Ketoconazole shampoo kills fungi and yeasts on the scalp by causing holes to appear in their cell membranes, preventing the fungi or yeasts from multiplying. It usually takes a few weeks for the infection to clear up.

Ketoconazole shampoo is mainly used to treat seborrheic dermatitis, which is related to a yeast on the scalp. Dandruff and cradle cap (in infants) are mild forms of seborrheic dermatitis. More severe forms are characterised by symptoms such as itching, skin redness and yellow, greasy scales. The condition can also involve temporary hair loss if located on the scalp.

Seborrheic dermatitis can also appear around the mouth, between the eyebrows, and on the body where there are a lot of sebaceous glands like the nose and scalp. Ketoconazole shampoo is only intended for use on the scalp.

Use Ketoconazole shampoo as advised by the doctor or according to the instructions on the package leaflet. The shampoo should be used as follows:

• Wash hair with regular shampoo first, and rinse well;
• Apply a small amount of Ketoconazole shampoo to wet hair, and massage in gently;
• Leave it on for three to five minutes before rinsing;
• Avoid contact with the eyes. If the shampoo does get in the eyes, rinse immediately with plenty of water;
• Do not wash your hair between treatments. If you need to wash your hair, use a normal shampoo and then wash it with Ketoconazole shampoo directly after;
• Do not stop using the Ketoconazole shampoo until the scalp has cleared up. This generally takes around four weeks. Stopping early could cause the yeasts and fungi to linger and the symptoms to return.

Seborrheic dermatitis is a chronic form of eczema. The condition is characterised by spontaneous remissions and exacerbations (flare-ups). You should avoid triggers to prevent a flare-up. Do not wash your hair often and always use a mild shampoo. Do not wear caps or hats. Avoid stress, as this is a common trigger for seborrheic dermatitis. For more information about use, see the package leaflet.

Ketoconazole shampoo contains 20 mg ketoconazole per gram of shampoo. A doctor must determine how often you should use the shampoo. The general guideline for both children and adults is to wash with Ketoconazole shampoo twice a week for four weeks. For more information on the dosage of Ketoconazole shampoo, see the package leaflet.

Although Ketoconazole shampoo is generally well tolerated, some of the following side effects may occur in rare cases:

• Skin reactions such as itching, redness and/or a burning sensation on the treated areas;
• Acne;
• Change in how the hair feels (greasy or dry);
• Hair discolouration;
• Brittle hair;
• Hair loss (alopecia);
• Infected hair follicles;
• Eye irritation, watery eyes;
• Taste disturbances.

For a complete list of side effects, see the package leaflet. Side effects should be reported to a doctor or pharmacist, particularly if they are severe or persistent.

Do not use Ketoconazole shampoo if you are allergic to the active ingredient ketoconazole or any other ingredient in this shampoo. Talk to your doctor or pharmacist if you are allergic to other imidazole antifungals, such as miconazole or isoconazole. Consult a doctor before using Ketoconazole shampoo if you are pregnant. Ketoconazole shampoo is safe for use by breastfeeding women.

Some medicines may interfere with the effectiveness of others. Ketoconazole shampoo is known to interact with corticosteroid-based skin treatments, and skin irritation may occur with concomitant use. Consult a doctor if you wish to combine the use of corticosteroids and Ketoconazole shampoo. For more information on this subject, see the package leaflet.

Ketoconazole shampoo is available at pharmacies and online pharmacies.

A doctor’s prescription is required to obtain Ketoconazole shampoo.

College ter Beoordeling van Geneesmiddelen (Dutch Drug Evaluation Committee). (n.d.). Ketoconazol Teva 20 mg/g, shampoo | Geneesmiddeleninformatiebank. Consulted on 22 May 2020 on https://www.geneesmiddeleninformatiebank.nl/ords/f? p=111:3::SEARCH:NO::P0_DOMAIN,P0_LANG,P3_RVG1:H,NL,30871

KNMP (Royal Dutch Pharmaceutical Society). (2019, 31 December). Ketoconazol voor op de hoofdhuid (Ketoconazole for use on the scalp) – Apotheek.nl. Consulted on 22 May 2020 on https://www.apotheek.nl/medicijnen/ketoconazol-voor-op-de- hoofdhuid?product=ketoconazol-shampoo#!

Nederlandse Vereniging voor Dermatologie en Venereologie (Dutch Society for Dermatology and Venereology). (n.d.). Seborrhoïsch eczeem (Seborrheic dermatitis). Consulted on 22 May 2020 on https://nvdv.nl/patienten/dermatologie/zoek- een-huidaandoening/seborrhoisch-eczeem

Zorginstituut Nederland (Dutch National Health Care Institute). (2020, 13 May). Ketoconazol (cutaan) (Ketoconazole for cutaneous use) – FarmacotherapeutischKompas. Consulted on 22 May 2020 on https://www.farmacotherapeutischkompas.nl/bladeren/preparaatteksten/k/ketoconazolcutaan_#interacties