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Nizoral is a form of medicated shampoo intended to treat fungal infections of the scalp. This medication uses the active ingredient ketoconazole to address issues such as psoriasis and particularly stubborn dandruff.

What is Nizoral?

Nizoral is a well-tolerated medicated shampoo used for the treatment of various fungal conditions that affect the scalp. It is also available in its generic form, without the brand name “Nizoral”. Nizoral medicated shampoo is available over the counter in many EU countries, or via a prescription provided by a consultant or doctor. Shampoos similar to Nizoral are commonly- used treatments.

Nizoral contains the active ingredient ketoconazole, which is a form of medicine that belongs to the antifungal family and is responsible for killing yeasts and fungi by causing small holes to appear in the cell membranes of the fungus which kill the fungi and yeast by causing them to leak out. The most common yeast treated with Nizoral is pityrosporum. Like other shampoos, Nizoral will also include ingredients that will clean your hair. Nizoral is suitable for both adolescents and adults, but is not recommended in women who are breastfeeding or pregnant, and not intended for children under the age of 12.

When is Nizoral used?

Nizoral is a medicated shampoo often prescribed or suggested by consultants when other dandruff treatments have been unsuccessful. This substance is excellent for treating conditions that are caused by an overgrowth of yeast on the skin.

Nizoral shampoo can address very severe forms of dandruff that cause flaking of the skin and itching of the scalp.

In some cases, you may be prescribed Nizoral for a skin condition known as pityriasis versicolor, caused by a germ that is similar to a type of yeast. Pityriasis versicolor can commonly live on the skin in small numbers without causing harm.

However, some people are more prone to the substance multiplying on the skin than others. Eventually, small patches of brown or pale skin may develop as a result. For some people, humid, hot or sunny weather can trigger an increase in symptoms.

How do you use Nizoral?

Before taking any new medication including medicated shampoos such as Nizoral, it is important to speak to your consultant and read through the patient leaflet provided. For a shampoo, you may need to read the back of the shampoo bottle for more information about how to use it properly.

Nizoral can be used just like any other shampoo, to wash your hair and treat the affected areas of skin on your scalp at the same time. As with other shampoos, you should lather the substance into the hair and rinse thoroughly after use. Try to avoid getting Nizoral shampoo into your eyes. If you do, rinse them thoroughly with water.

When using Nizoral shampoo for dandruff and similar conditions, you will need to wash your hair and the affected area of skin with the substance twice per week for a period of around four weeks. It is important to give the Nizoral shampoo medication time to soak into the skin, so you will need to leave it on your hair or other parts of the body for five minutes before you rinse it away with plenty of water. Once your condition has cleared up, you may be able to reduce the chances of it coming back by continuing to use Nizoral or a similar shampoo every one or two weeks.

If you are taking Nizoral shampoo for pityriasis versicolor, you will need to wash the affected areas of skin once a day for a period of no more than five days. Leave the Nizoral shampoo on your skin for at least three to five minutes before rinsing it away. Remember that this condition can get worse during the hotter spring and summer months. You can prevent the condition from getting worse by using this shampoo once a day for at least three days before you expose your skin to the sun.

The cream version of Nizoral may come with slightly different instructions from the shampoo for how to use it. It is important to read through the instructions provided carefully. Usually when applying Nizoral cream, you will not rinse the substance off after using it as it will need to be fully absorbed into your skin. Make sure that you wash your hands after using Nizoral cream, however, to avoid getting it into your eyes. Do not cover the skin where you have applied Nizoral cream with a bandage.

What dosages are there?

Nizoral is available in both cream and shampoo forms. Your consultant or pharmacist will tell you how much you should use, but a small amount – similar to the regular amount of shampoo you use with this medication – should be more than enough. Nizoral should be taken only for as long as recommended on the packaging for your specific condition. If you are treating pityriasis versicolor with this shampoo, then you should not use the medication for any longer than five days without speaking to a doctor. If your conditions worsen or persist when you are taking this medication, seek help from a medical professional.

What are the side effects of Nizoral?

Nizoral is a very specific form of ketoconazole that is delivered in cream or shampoo form. The fact that you are using this medication topically means that the risk of side effects is very low, as little of the substance will be absorbed into your bloodstream. If you are taking a pill form of ketoconazole, then your chances of side effects may be slightly heightened.

As a well-tolerated treatment for fungal conditions, Nizoral shampoo and Nizoral cream rarely cause any severe side effects. However, your reaction to this medication will depend on your background, medical history and how you respond to certain ingredients. It is important to make sure that you are aware of the potential side effects before using Nizoral. Remember, many of the common side effects associated with this medicated shampoo will go away by themselves. Most of the time, you will find that your side effects diminish as your skin gets used the substance and you continue your treatment.

There are no common side effects for Nizoral shampoo or Nizoral cream, however some people may suffer from inflammation around the hair follicles, hair loss, thinning or changes in how it feels to the touch, drier than usual skin particularly around the application site, rash or itching, and skin reactions such as redness, irritation, itching or burning when you apply Nizoral to your hair.

In very rare circumstances, Nizoral shampoo and Nizoral cream can sometimes cause skin blistering or peeling. It has also been known for this substance to cause acne in very few cases. Although an allergic reaction to this medication is very rare, it is important to contact a medical professional if you notice signs of a reaction. Get help if you notice a rash or swelling at the application site, problems with your breathing, or dizziness. Do not continue to use this medication if you think that you could be allergic to it, or if you believe that your condition is getting worse. This is not a complete list of the possible side effects that could be caused by Nizoral shampoo or Nizoral cream.

When should you not use Nizoral?

Before using either Nizoral cream or Nizoral shampoo, it is important to note that not everyone will react well to this medication. Some people will be predisposed to having side effects when using this medication. Speaking to your consultant about your medical history will help to ensure that this is the right treatment for you.

Make sure that you do not use Nizoral shampoo or Nizoral cream if you are allergic to the active ingredient ketoconazole, or if you have ever had a reaction to tablets that include that medication. You should also avoid Nizoral shampoo and Nizoral cream if you are allergic to similar azole antifungal medications such as miconazole or econazole. Telling your consultant about any allergies you have to other ingredients is also advised when taking Nizoral. This medication can include active ingredients which can cause allergic reactions in their own right.

Before you begin using Nizoral shampoo or Nizoral cream, make sure that you let your consultant know if you are pregnant or planning on getting pregnant, as Nizoral may also pass into breastmilk.

Does Nizoral interact with any other medications?

Medications can sometimes react poorly with other substances that you are using. Because very small amounts of Nizoral shampoo and Nizoral cream are absorbed into the blood stream, there is a very low chance that you will experience any interactions. However, it is still a good idea to tell your consultant if you are using any other medications alongside Nizoral, including over-the-counter medications and herbal supplements. Your consultant will be aware of any possible reactions that you need to avoid. If you have been using a form of corticosteroid to topically treat your scalp or skin condition, you may need to gradually begin using that treatment less often when you are using Nizoral.

Where can you buy Nizoral?

Nizoral is available to purchase over the counter and from collaborating pharmacies. We can arrange for a consultation with an EU professional for you, and then have an order for Nizoral sent to a corresponding pharmacy in your location.

Can you get Nizoral shampoo or Nizoral cream without a prescription?

Nizoral is available in some locations without a prescription – depending on the kind of treatment you need. While you may be able to get the shampoo over the counter, you will need a prescription for the cream treatment.


Drug.scom, online, 2019, “Ketoconazole shampoo 2%”, [accessed 20 November 2019] available on: online, 2019 “Nizoral 2% shampoo” [accessed 20 November 2019] available on:

RXList, online 2019, “Nizoral shampoo” [accessed 20 November 2019] available on:

Reviewed by:

Dr Imran Malik, General practitioner Registrationnumber: GMC: 4741365 Last checked: 21-11-2023 | Still valid

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