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FDA-approvedPrescription only
Dandruff Treatment (ketoconazole shampoo)
Prescription — medicated shampoo, used twice weekly as prescribed
A prescription-strength antifungal shampoo for dandruff and seborrheic dermatitis of the scalp that over-the-counter shampoos have not controlled. Sent to a local pharmacy if prescribed.
FDA-approved for dandruff at the over-the-counter strength and, at the prescription strength, for tinea versicolor; the prescription cream carries the seborrheic dermatitis indication, and providers use the prescription shampoo for seborrheic dermatitis of the scalp at their judgment. Prescribed by a licensed provider only if appropriate for you.
From$99$32 consultation included, not refunded · medication paid at your pharmacy, if prescribed
Choose your plan
One-time
Price
$99for the provider visit — medication paid at your pharmacy, if prescribed
Includes your $32 provider consultation (non-refundable). If your provider decides treatment isn’t appropriate, the rest is refunded automatically.
- Picked up at a local pharmacy you choose. If prescribed, the medication itself is paid for at the pharmacy; the price here covers the provider visit.
- Your provider confirms the dose. If they start you on a lower step, we refund the difference; if they choose a higher one within the same plan, the price you paid stands.
Adding to cart books a provider visit. You pay the shown total; the provider decides; the medication portion comes back automatically if they say no.
Questions
Will I definitely be prescribed this?
No. A consultation does not guarantee a prescription. A licensed provider reviews your scalp history and prescribes only if it is appropriate for you — and may conclude an over-the-counter shampoo is enough, or that your scalp needs a different diagnosis. If prescribed, the prescription is sent to a local pharmacy and you pay for the medication there; what you pay here is the consultation.
How is this different from the ketoconazole shampoo on the shelf?
Same active ingredient at twice the concentration, and prescription-only at that strength. The over-the-counter version is approved for dandruff; the prescription shampoo's own label indication is tinea versicolor, and its use for scalp seborrheic dermatitis is a provider's judgment — which is why a provider, not a shelf, decides whether the step up suits you.
Will I need to use it forever?
Dandruff is a tendency rather than an infection that clears, so most people keep a maintenance rhythm once it is controlled. The frequency is yours and your provider's to set; many settle at once a week or less.
How it works
Dandruff and its more inflamed relative, seborrheic dermatitis, are driven by a yeast called Malassezia that lives on everyone's scalp. It feeds on sebum and leaves behind fatty acids that irritate the skin of susceptible people, which responds by shedding faster and, in seborrheic dermatitis, by becoming red and greasy-scaled. Ketoconazole is an azole antifungal: it blocks the fungal enzyme that makes ergosterol, the essential component of a fungal cell membrane, so the membrane leaks and the yeast population falls; it also has an anti-inflammatory action of its own on the skin. As a shampoo it stays on the scalp for a few minutes and is rinsed away, with negligible absorption into the bloodstream — which is why the serious liver warning that belongs to oral ketoconazole tablets does not apply to it. Used twice a week for a course and then as maintenance, it keeps the yeast in check; it does not change the underlying tendency, which is why flaking returns if it is stopped for long.
The full mechanismA provider may consider it if
- Persistent flaking and itch that over-the-counter dandruff shampoos have not controlled
- Greasy scale with redness at the hairline, eyebrows or behind the ears — the seborrheic pattern
- You want a provider to confirm it is dandruff rather than something else on the scalp
It won’t be prescribed if
- A scalp that is weeping, crusted, has pustules, or comes with tender swollen glands in the neck — infection needs examination, not shampoo
- Hair loss in patches, scarring, or scale that lifts off in thick silvery plaques — alopecia and psoriasis need a dermatologist's diagnosis
- A rash spreading well beyond the scalp, or a scalp so inflamed it is painful — needs in-person assessment
- A known allergy to ketoconazole, other azole antifungals, or any ingredient of the shampoo — this is a hard stop
- Broken or sunburned scalp skin, which the shampoo will sting and where absorption rises
- Under 18 — online treatment here is for adults
These are the same checks your provider runs in the visit. If one applies, they will tell you plainly — and the medication portion of what you paid comes back automatically.
What to expect
After your visit
If prescribed, the prescription is sent to a local pharmacy you choose and you pay for the medication at the counter. What you paid here covers the consultation.
Weeks 1–4
Lather into a wet scalp, leave it three to five minutes, rinse; typically twice a week with a normal shampoo in between. Flaking and itch usually ease over the first two to four weeks.
Ongoing
Once controlled, most people step down to once a week or every other week to keep the yeast in check. A scalp that has not improved after a month is the point to be seen in person.
Safety
Side effects, before you decide
Mostly local: itching, stinging or a burning feeling on the scalp, dryness or oiliness of the hair, and occasionally irritation or a rash. Changes in hair texture and, rarely, hair loss or discolouration of chemically treated or grey hair have been reported. Keep it out of the eyes and rinse thoroughly if it gets in. Absorption through intact skin is minimal, so the liver and hormone warnings that apply to oral ketoconazole do not apply to the shampoo.
- FDA prescribing information (DailyMed): ketoconazole shampoo, prescription strength — indications, clinical pharmacology (systemic absorption not detected after topical use), adverse reactions; ketoconazole cream — indications; current labels as of 2026
- Borda LJ, Wikramanayake TC. Seborrheic Dermatitis and Dandruff: A Comprehensive Review. J Clin Investig Dermatol. 2015;3(2):10.13188/2373-1044.1000019 — Malassezia, sebum and host response; antifungal and anti-inflammatory treatment
- Tucker D, Masood S. Seborrheic Dermatitis. StatPearls, 2024
Complete safety information is provided during your visit and with every prescription. This page is a summary, not a substitute for your provider's advice.
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See whether dandruff treatment (ketoconazole shampoo) is right for you.
A licensed provider reviews your visit and decides. You receive medication only if prescribed, and that portion of your payment is refunded automatically if they say no.