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Overview: Topical ketoconazole is used to treat fungal skin conditions, such as ringworm, tinea versicolor, candidiasis, and seborrheic dermatitis. It stops fungi from growing. Common side effects include irritation, burning, itching, or stinging when it is applied. Topical ketoconazole comes in a cream, foam, and shampoo.

Uses

What is topical ketoconazole used for?

Topical ketoconazole is commonly used for the following conditions.

Topical ketoconazole may not be appropriate for some of the infections listed above, depending on which germs are causing the infection. Fungi in some locations may have developed resistance to topical ketoconazole, which will make it not work as well.

Topical ketoconazole may also be used for other conditions as determined by your healthcare provider.

How does topical ketoconazole work (mechanism of action)?

Topical ketoconazole is an antifungal medicine that stops the growth of the fungus causing the infection.

How is topical ketoconazole supplied (dosage forms)?

Brand and other names

  • Extina
  • Ketodan
  • Ketozole
  • Kuric
  • Nizoral
  • Nizoral Anti-dandruff
  • Xolegel

Dosage forms and strengths

  • 2% topical foam
  • 2% topical cream
  • 2% shampoo

Ketoconazole is also available as a tablet that is swallowed. See Ketoconazole for more information.

How should I store topical ketoconazole?

Topical ketoconazole should be stored at room temperature, between 68 F to 77 F (20 C to 25 C). It can be exposed to temperatures between 59 F to 86 F (15 C to 30 C), for shorter periods of time, such as when transporting it. Topical ketoconazole foam is flammable. Keep it away from open flames. 

Side Effects

What are the most common side effects of topical ketoconazole?

The most common side effects of topical ketoconazole are listed below. Tell your healthcare provider if you have any of these side effects that bother you.

  • Burning, irritation, itching, or stinging where it is applied
  • Dryness
  • Redness

There may be other side effects of topical ketoconazole that are not listed here. Contact your healthcare provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of topical ketoconazole?

While less common, the most serious side effects of topical ketoconazole are described below, along with what to do if they happen.

Severe Allergic Reactions. Topical ketoconazole may cause allergic reactions, which can be serious. Stop using topical ketoconazole and get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Trouble swallowing or throat tightness
  • Itching, skin rash, or pale red bumps on the skin called hives
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain

Warnings & Precautions

Who should not use topical ketoconazole?

Allergies to Ingredients. People who are allergic to any of the following should not use topical ketoconazole.

  • Ketoconazole
  • Extina
  • Ketodan
  • Ketozole
  • Kuric
  • Nizoral
  • Xolegel
  • Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in the specific topical ketoconazole products they stock.

What should I know about topical ketoconazole before using it?

If topical ketoconazole was prescribed to you by a healthcare provider, use it as prescribed. If you are using over-the-counter topical ketoconazole, follow the instructions that come with the product.

Do not share topical ketoconazole that was prescribed for you by a healthcare provider with other people, even if they have the same condition as you. It may harm them.

Do not apply topical ketoconazole near the mouth, lips, eyes, or vagina.

There are several forms of topical ketoconazole. Each may need to be used differently. Follow the instructions on the specific topical ketoconazole product you have. Ask your healthcare provider if you are not sure how to apply it. 

Topical ketoconazole foam can make your skin more sensitive to light from the sun, sunlamps, and tanning beds. This is called photosensitivity. Exposure to this light can cause severe sunburns, blisters, and swelling. If you need to be in sunlight, wear sunscreen, a hat, and clothing that covers your skin.

What should I tell my healthcare provider before using topical ketoconazole?

Tell your healthcare provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if topical ketoconazole is right for you.

In particular, make sure that you discuss any of the following.

Pregnancy. It is not known if or how topical ketoconazole could affect pregnancy or harm an unborn baby. Tell your healthcare provider if you are or plan to become pregnant. Your healthcare provider will advise you if you should use topical ketoconazole while you are pregnant or trying to get pregnant.

Breastfeeding. It is not known if topical ketoconazole passes into breast milk. Tell your healthcare provider if you are breastfeeding or plan to breastfeed. Your healthcare provider will advise you if you should use topical ketoconazole while breastfeeding.

Interactions

Does topical ketoconazole interact with foods or drinks?

There are no known interactions between topical ketoconazole and foods or drinks.

It is unknown if drinking alcohol will affect topical ketoconazole.

Does topical ketoconazole interact with other medicines (drug interactions)?

There are no known interactions between topical ketoconazole and other medicines. Always tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

Does interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much topical ketoconazole?

If you or someone else has used too much topical ketoconazole, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of topical ketoconazole?

If you miss a dose, use it as soon as you remember. If it is almost time for your next dose, skip the missed dose and only use the next dose. Do not use double or extra doses.