Nizoral Cream (ketoconazole) is an antifungal medication applied topically to fungal infections on the skin. Like most topical antifungals, results are usually noticeable within the first few days of use and serious side effects are extremely rare.

Conditions most commonly treated with Nizoral Cream include:

• Athlete's foot
• Jock itch
• Ringworm
• Tinea versicolor
• Seborrheic dermatitis
• External thrush
• Certain yeast infections

On average, a fungal infection treated with Nizoral Cream will be completely cleared up in two to four weeks.

Effective Use of Nizoral Cream

While for the most part use of Nizoral Cream is self-explanatory, there are some things to keep in mind to ensure treatment is trouble-free:

• Nizoral Cream should be applied twice a day to the affected skin, extending a short ways onto surrounding healthy skin.
• It should never be applied to mucous membranes, open wounds, or skin with a bacterial, viral, or unknown infection.
• The application site should not be covered with airtight dressings or clothing.

In most cases the recommended treatment is two weeks, even if all symptoms vanish before then (as they often do). There may be lingering fungus in amounts too small to cause noticeable symptoms but in sufficient quantities to cause a resurgence of the infection if treatment is stopped early. Similar to antibiotics, stopping treatment too early can contribute to resistant fungus.

Some infections are tougher than others, and it may take up to four weeks of twice-daily application for symptoms to be completely eradicated. This is particularly true of seborrheic dermatitis; four weeks of treatment is the norm rather than the exception.

Treatment may be repeated as-needed if the infection recurs in the future, assuming the medication produced good results the first time.

If the infection is not cleared up in two to four weeks, treatment may continue longer, but having the infection checked out by a doctor is highly recommended. Likewise if the condition worsens during treatment. Depending on the type of fungus involved, alternative medications may be more effective.

On Safety

As mentioned above, Nizoral Cream, and other topical antifungal medications, are very unlikely to produce serious adverse effects if used properly. Persistent improper use, which includes applying the medication to open wounds, non-fungal infections, or mucous membranes, or covering the application site with an airtight dressing, can produce potentially serious adverse reactions over time.

The greatest concern with Nizoral Cream is ingestion; if pets or children accidentally eat the cream, emergency medical attention should be sought.

Applied properly Nizoral Cream does not penetrate the skin to be absorbed into the bloodstream, which provides additional advantages over oral administration:

• It is considered safe for use in pregnant or breast-feeding women. If applying the cream to breasts to treat thrush, be sure the medication is washed off before feeding.
• It is safe for use in individuals with liver damage or other preexisting conditions which prevent use of oral antifungals.
• It will not interact with other medications, supplements or foods.

In short, if Nizoral Cream is used properly, there is virtually no risk of serious or dangerous adverse effects.

Side Effects

Since the medication does not enter the bloodstream, side effects are typically restricted to the application site. The one exception is if there is an extreme allergic reaction to treatment, which is exceedingly rare, but which may cause life-threatening swelling of the face and throat, difficulty breathing, heartbeat changes and confusion or unconsciousness.

The most commonly experienced side effects include:

• Mild burning, stinging, or tingling sensation during application
• Dry skin at or around application site
• Other mild irritation at or around application site

Less commonly more serious side effects may develop at the application site, including:

• Blistering or bleeding
• Redness, swelling or pain
• Rash, itching or hives

While very unlikely to be dangerous, if the above symptoms do develop discontinue use of Nizoral Cream until speaking with a doctor.

Presentation: Shampoo 1% 100ml, 2% 100ml.

Active Ingredients: Ketoconazole.

Approved Indications: Dandruff or seborrhoeic dermatitis of the scalp.

Contraindications: Hypersensitivity to any ingredient.

Precautions: Pregnancy, lactation. For external use only.

Adverse Effects: Rarely, scalp irritation, itching, oiliness or dryness of the scalp.

Directions: Wet hair, massage into scalp for 3-5 minutes then rinse. Use twice weekly for 2-4 weeks, then as required

Nizoral shampoo (ketoconazole) is an antifungal treatment used to eliminate tinea versicolor or the itching, flaking and scaling associated with dandruff.

The product is available in two strengths; a 1% solution and a 2% solution. It is not suitable for use while pregnant or breastfeeding unless explicitly instructed by a doctor.

A Safer Solution for the Scalp

While antifungal lotions, creams, powders and sprays may technically work on the scalp, these products are typically less-than-ideal for use there, especially if hair is present. Oral tablets can also clear up fungal infections of the scalp, but carry risk of potentially serious side effects, and often take considerably longer to produce results than topical applications.

Nizoral shampoo is ideal for use on the scalp, has minimal risk of side effects, and is also often less costly and easier to acquire than other treatments---shampoos, unlike tablets and creams, are widely available without a prescription.

Topical antifungal treatments are generally preferred over oral tablets due to the reduced risk of side effects. This is because very little, if any, of the topical solution is absorbed into the bloodstream. However, absorption can happen---as well as irritation---if the shampoo gets in the eyes, mouth or other mucous membranes. Likewise, the product should not be used on open wounds.

For best results, as with any infection, the condition should be diagnosed by a doctor before initiating treatment. Nizoral shampoo should not be used to treat viral or bacterial infections.

Directions for Use

Use of Nizoral Shampoo depends on the strength of the product as well as the area on which it is being used; the shampoo is effective at treating tinea versicolor on the trunk or other parts of the body.

If using the 2% shampoo, one treatment is often all that's needed. On the scalp, lather into damp hair as with any other shampoo. Let stand for 5 minutes and rinse off.

On the skin, the 2% shampoo should be lathered onto the affected area and a short ways onto surrounding healthy skin. Let stand for 5 minutes and rinse off. Treatment may be repeated on both scalp and skin in the future if the condition returns.

The 1% Nizoral shampoo requires more treatments than the 2% version, but is less likely to produce side effects and is safer for more frequent use.

On the scalp, the 1% shampoo is used similarly; lather and let stand for 5 minutes. Repeat once per day for 3 to 5 days. Individuals who experience frequent fungal scalp infections may want to use Nizoral 1% shampoo once per month as a preventive treatment.

On the skin, treatment is also similar; lather onto the affected area and let stand for 5 minutes before rinsing off. Repeat once daily for 3 to 5 days; in some cases treatment may need to be extended a few days longer.

If improvements are not noticed within a few days of starting treatment, alternative options should be considered.

Precautions & Adverse Reactions

As mentioned above, side effects from topical antifungal treatments are rare. Those side effects that are experience from Nizoral shampoo tend to be mild and only occur at the application site, including:

• Mild itching
• Dry skin or scalp
• Mild stinging, burning or other irritation

Rarely some individuals experience more severe reactions. Discontinue use immediately if experiencing:

• Severe itching or burning
• Hair loss
• Pain
• Redness
• Oozing or blistering skin

Nizoral shampoo should not be used while pregnant or breast feeding unless explicitly instructed to do so by a doctor.