my dermotologist just prescribed Nizoral Shampoo.  ( Ketoconazole )
for seborrheic dermatitis on my face, my skin has reacted quite badly
too it. Is this product supposed to be used on the face, shampoo
implies that its only for hair.

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Request for Question Clarification by pafalafa-ga on 08 Nov 2006 08:55 PST

It's an odd medical fact of life, that medicines for skin conditions
can sometimes aggravate those very conditions.

Ketoconazole is frequently applied to the skin, and is available in
cream/ointment form for that purpose.

I'm pretty sure the use of shampoo on the face as well as the scalp is
a pretty common practice among patients, and might be effective.

However, medical shampoos are not known for their gentle formulations,
and there could be something in the shampoo other than ketoconazole
that you're reacting to.

On the other hand, the ketoconazole itself can also be the culprit, in
which case, I doubt it makes much of a difference whether it's in
shampoo or cream format.  The flare up might also be termporary...an
initial reaction to the drug, that (hopefully) might be followed up by
an easing of symptoms.

Just let your doctor know what's going on, and he/she should be able
to provide some alternatives for you.

As for your question here, what sort of documentation are you looking
for by way of an answer?


pafalafa-ga

Hi anthonyplanet,

Thank you for your question.  Please note the Important Disclaimer at
the bottom of this page "Answers and comments provided on Google
Answers are general information, and are not intended to substitute
for informed professional medical,..."   Your doctor is the person who
can best manage your health, and should be informed of ANY adverse
effects.

With that said, I did find an answer to your question - "Is this
product supposed to be used on the face, shampoo implies that its only
for hair."

Here are my findings.

W.B. Saunders Harcourt Health Sciences
http://www.merckmedicus.com/ppdocs/us/hcp/content/white/chapters/white-ch-003-s006.htm

Gary M. White & Neil H. Cox 
Diseases of the Skin 
SEBORRHEIC DERMATITIS

Treatment

"One of the best shampoos is ketoconazole (Nizoral shampoo) which
contains an imidazole antifungal agent to kill Pityrosporum yeasts. It
is highly effective and more cosmetically acceptable to the patient?s
than more abrasive tar shampoos.?

[edit]

?When seborrheic dermatitis is present on the face, it is critical to
have the patient lather the face daily or every other day with the
medicated shampoo. A topical steroid (e.g. hydrocortisone 1% cream) is
usually recommended as well. An alternative approach for facial
seborrheic dermatitis is to use either topical ketoconazole cream or a
combined imidazole-hydrocortisone preparation daily.

For seborrheic dermatitis of the eyelids, daily gentle shampoo with
ketaconazole shampoo (or baby shampoo if irritation occurs) should be
tried. For seborrheic dermatitis of the ear, a low potency topical
steroid applied twice a day for the pinna and a corticosteroid otic
preparation for the ear are effective. Daily use of a medicated
shampoo is also recommended. Hydrocortisone 1% or a combined
imidazole-hydrocortisone cream can also be applied to the eyelids
carefully using a cotton wool bud, and is particularly effective for
seborrheic blepharitis.?

=========

(cached page)
http://66.102.7.104/search?q=cache:gQJVS0oJNSwJ:gateway.nlm.nih.gov/MeetingAbstracts/102212370.html+Nizoral+shampoo+ketoconazole+applied+to+face+seborrheic+dermatitis&hl=en&gl=us&ct=clnk&cd=9

Ketoconazole shampoo in the treatment of seborrhoeic dermatitis in
patients with HIV infection.

?STUDY OBJECTIVES: To assess the safety and efficacy of Ketoconazole
applied as a 2% shampoo in the treatment of seborrhoeic dermatitis in
patients with concomitant HIV infection. METHODOLOGY: 46 HIV positive
patients with moderate to severe facial and scalp seb. derm. applied
Ketoconazole as a 2% shampoo to the scalp massaging the lather over
the face and other affected areas leaving contact with the skin for
five minutes. Treatment was for three consecutive days then twice
weekly for four weeks.?

See SUMMARY OF RESULTS

=========

keyword search:
Nizoral shampoo ketoconazole applied to face seborrheic dermatitis

=========

Best regards,
tlspiegel

thanks, that was useful.

Hi!!

I am not sure if I misunderstood the following text, but I think that
the shampoo must be applied on the hair, not directly to your face:
"For dandruff and seborrhoeic dermatitis, the shampoo should be used
to wash the hair twice weekly for two to four weeks. Once these
conditions have cleared up they can be prevented from coming back by
using the shampoo once every one to two weeks."
From "Ketoconazole shampoo":
http://www.tiscali.co.uk/lifestyle/healthfitness/health_advice/netdoctor/archive/100004467.html

Other paragraphs on this subject are:
"This medicine should not be used if you are allergic to one or any of
its ingredients. Please inform your doctor or pharmacist if you have
previously experienced such an allergy. If you feel you have
experienced an allergic reaction, stop using this medicine and inform
your doctor or pharmacist immediately."

"Side effects

Medicines and their possible side effects can affect individual people
in different ways. The following are some of the side effects that are
known to be associated with this medicine. Because a side effect is
stated here, it does not mean that all people using this medicine will
experience that or any side effect.
Itching (pruritus) 
Allergic inflammation of the skin (contact dermatitis) 
Burning sensation 
Dry hair 
Oily hair 
Discolouration of hair (rare and mainly affecting chemically-damaged
or grey hair) "

Note that you must apply it with at least three days between each
shampooing. It is not for everyday use. If a reaction suggesting
sensitivity or chemical irritation should occur, the use of this
medication should be discused with your doctor inmediatly.

In order to improve your knowledge regarding this product and can
raise the level of discussion with your doctor I suggest you to read
the following pages:
"Nizoral Pharmacology, Pharmacokinetics, Studies, Metabolism -
Ketoconazole - RxList Monographs":
Just navigate the blue tabbed menu.
http://www.rxlist.com/cgi/generic/ketocon_cp.htm


I hope this helps you. Let me know if this sufice as an answer so I
can claim the prize by posting this in the answer box.

Regards,
livioflores-ga

my derm prescribed nizoral about 20 years ago it help my dandruff it
worked i use over the counter nizoral only when needed 1-2 a month
then last year diagnose with rosacea red/dry flaky skin on my face so
i tried it on wash cloth
just made my face reder and flaky skin on my face.
after months of dry flaky skin i discover a lotion at trader joes that
work for me this lotion called [a midsummer nights cream]it in a gray
bottle $2.19 18 fl oz
ive allways had trouble with anything on my face[stinging] but this
lotion worked for too keep it hydrated and thats a big problem for
those of us with rosacea if you need more info on "rosacea" yahoo has
a group there with great info.p s im not saying you have rosacea but i
did have seb/derm and a lot of us that have rosacea have seb/derm
hope this helps
sincerely hud