If regular anti-dandruff shampoos stop working after a few washes, the problem is usually Malassezia — a yeast that lives on every scalp but overgrows on some. That is exactly what ketoconazole targets.
How it works
Ketoconazole is an antifungal that damages the yeast’s cell membrane, cutting flaking, itching and the inflammation that drives hair fall. Combined with salicylic acid (which lifts away built-up flakes) and ZPTO (zinc pyrithione, which keeps regrowth in check), it treats the cause rather than masking it.
Using it correctly
Wet hair, lather, and — this is the step everyone skips — leave it on the scalp for 3–5 minutes before rinsing. Use two to three times weekly for about four weeks, then once weekly to maintain. Conditioning additives like D-panthenol, amla and hibiscus extracts keep hair soft while the medicine works.
Beyond dandruff
Doctors also prescribe ketoconazole preparations for seborrhoeic dermatitis and certain fungal skin infections; soaps and creams (like luliconazole for stubborn skin patches) extend the same principle to the body.
When to see a dermatologist
If flaking persists after a month, if the scalp is painfully inflamed, or if patches spread beyond the hairline, get a professional look rather than cycling through more shampoos.
This article is for general information only and is not a substitute for professional medical advice. Always consult your doctor before starting, stopping or changing any medication or supplement.