Meet the Expert
- Joshua Zeichner, MD, is the Director of Cosmetic and Clinical Research in Dermatology at Mount Sinai Hospital in NYC.
- Purvisha Patel, MD, is a board- certified dermatologist and founder of Visha Skincare.
Type of Ingredient: Anti-fungal
Main Benefits: Treats fungal infections, reduces the overgrowth of fungus, prevents fungal acne.
Who Should Use It: Anyone struggling with fungal acne, regardless of skin type.
Works Well With: Salicylic acid and beta-hydroxy acid
Don't Use With: Oily moisturizers or topical antibiotics
What Is Nizoral?
"Nizoral is a brand-name anti-fungal medication called ketoconazole," says Zeichner. "It lowers levels of fungus on the skin and is commonly used to treat conditions like dandruff and athlete's foot. It is also used to treat pimples when they are resistant to other therapies."
Benefits of Nizoral for Acne
Anyone who has experienced acne symptoms may easily mistake fungal acne for bacterial acne, which isnâ€™t surprising as they can look similar, each resulting in texture on or just under the surface of the skin.
Side Effects of Nizoral
While Nizoral is considered an effective way to combat fungus, there is a potential risk of side effects, just like any medication. A common side effect of Nizoral is itching or the development of a rash on or around the area thatâ€™s been treated. Additionally, some people may experience nausea, dizziness, stomach pain, and headaches. If youâ€™re pregnant, nursing, or planning a pregnancy, talk with your doctor before taking Nizoral as it may contaminate breast milk, which can be harmful.It's best to avoid hot, humid conditions when possible. "Pityrosporum folliculitis is most common when the weather is hot and humid because it increases the levels of oil on the skin, creating an environment that allows yeast to grow at high levels," says Zeichner. "We want to make the skin inhospitable for high levels of yeast to grow."
How to Use It
Nizoral can be easily added to your usual skin and body care routine. "I typically recommend using it daily in the shower for two weeks or so or until the pimples improve,â€ Zeichner suggests. "After that, I have my patients use it twice a week as maintenance. Because it comes as a shampoo, I tell my patients to use it like a liquid cleanser. It is important to get enough contact time on the skin for it to do its job, so you should apply, lather, and count to 30 before rinsing off."
If you do have fungal acne, Nizoral is usually effective in a matter of weeks, but if you arenâ€™t seeing signs of improvement just under the one-month mark, finding a different solution will likely be needed to experience results.
An effective part of treating any skin condition is becoming aware of how the active ingredients youâ€™re using works with other products in your skincare regimen. Some products may enhance the efficacy of Nizoral, like certain acids. "I commonly pair Nizoral with salicylic acid, a beta-hydroxy acid that helps remove excess oil and dead cells from the skin to keep the pores clear," says Zeichner.
Additionally, avoiding certain formulas and environmental conditions may help rid your skin of fungal acne symptoms more quickly. Patel adds that "using products such as coconut oil and olive oil on your scalp and hair can cause forehead acneâ€”edible products such as these tend to increase the growth of microorganisms on the skin if you can eat a product, bacteria and fungus can eat a product as well."
The Best Products with Ketoconazole
Nizoral is the brand name of a product, so using this shampoo is always an option for treating fungal acne.
Nizoral is powerful enough to tackle fungal acne yet gentle enough for the skin.
As the active ingredient is ketoconazole, other products that feature this ingredient can also offer relief from symptoms. Some favorites include Lâ€™Emarie Hair Growth Shampoo + Anti-Dandruff Treatment ($38),
ProBliva's shampoo includes ingredients like coconut oil, jojoba oil, and grapeseed extract, which help to nourish and hydrate the skin.
The compounds found in Revita's shampoo have been found to increase new hair growth. The product is backed by thousands of dermatologists, plus, there are no harsh ingredients.
Nizoral is an anti-fungal that treats fungal infections, reduces the overgrowth of fungus, prevents fungal acne.
Anyone struggling with fungal acne, regardless of skin type.
Every day, or every other day, for two to three weeks, in which time you should see improvement. If your condition clears up, use it twice weekly as a maintenance medication. If you havenâ€™t seen changes in two to three weeks, talk to your doctor about other treatment options.
Rubenstein RM, Malerich SA. Malassezia (pityrosporum) folliculitis. J Clin Aesthet Dermatol. 2014;7(3): 37-41.
Cleveland Clinic. Ketoconazole tablets.
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