How To Use Nizoral For Acne

Written by Annie Jangam

The small, red, itchy bumps that develop on your skin or your face look a lot like pimples or acne. These are also called ‘fungal acne’ and are most probably caused by Malassezia (pityrosporum) folliculitis (1). The acne is caused due to an overgrowth of yeast in the skin pores and hair follicles. The yeast causes inflammation and acne-like symptoms. Hence, this ‘proxy acne’ needs to be treated differently from the usual acne.

If your acne has not subsided despite using various products, you probably were using the wrong ones. Fungal acne can be treated with the same product that treats dandruff. Nizoral, an anti-dandruff shampoo, is the anti-fungal answer known to address this skin condition.

Here, we discuss Nizoral and how it can help treat your fungal acne. We also will see how to use it right to achieve the maximum benefit.

What Is Nizoral?

Nizoral is a shampoo brand that is also available as a gel and cream. It can also be taken as oral therapy (tablets) if prescribed. The chief ingredient in Nizoral is 1% ketoconazole. Ketoconazole is an anti-fungal medication.

Why Should You Use Nizoral?

Before we understand why you must use Nizoral, let us understand why other common anti-acne measures are not quite effective. Bacterial acne or acne vulgaris can be caused due to numerous reasons, but the causes of fungal acne are more defined.

Oily skin is conducive to fungal growth. Hot and humid conditions and excessive sweating also lead to oil build-up on the skin and attract fungus. Our skin usually has a balance between bacteria and fungus. When fungal acne is misdiagnosed, people often take antibiotics to treat it. The antibiotics eradicate even the good bacteria and keep the fungus in check – and indirectly lead to an increase in fungal acne. Fungal acne, as its name suggests, requires anti-fungal treatment.

Nizoral is an anti-fungal medication used to treat various types of fungal infections and dandruff. Its ketoconazole content reduces the growth of yeast and helps reduce fungal acne.

What Are The Benefits Of Using Nizoral?

Nizoral has many benefits in addressing acne, some of which are:

  • It unclogs the pores
  • It targets the yeast overgrowth
  • It allows the skin to breathe
  • It reduces the excess skin oil
  • It soothes itchy, irritated skin
  • It lightens acne scars

You can see a marked change in your skin before and after using Nizoral. The inflamed, bumpy, itchy, and acne-ridden skin becomes less aggravated and slowly begins to return to normal.

How To Treat Acne With Nizoral?

Before you go ahead and buy Nizoral, it is advisable to visit a dermatologist to confirm that the acne you have is, indeed, the fungal kind. Here is how you can use Nizoral on the different parts of your body:

  1. Dampen the areas of your skin having acne. If your skin is broken or irritated, it is best to wait until it heals.
  2. Apply Nizoral on the affected area of the skin.
  3. Rub Nizoral gently with the tips of your fingers to help it lather. Using your nails could break the skin or hurt you.
  4. Leave it on for 4 to 5 minutes.
  5. Wash it off with lukewarm water. If the water is too hot or too cold, it might further irritate your skin.

Fungal acne also occurs on the face because of dandruff, especially along the hairline and the T-zone (your forehead and nose). Since Nizoral is a shampoo, it can also double as a liquid cleanser or face wash. You need to be more careful if you are planning to use Nizoral on your face. The skin on your face is thinner and more sensitive than the skin on the rest of your body.

You can use Nizoral for your face in the following manner:

  1. Wash your face with lukewarm water.
  2. Apply Nizoral on the affected areas.
  3. Rub the Nizoral gently with your fingers in a circular motion.
  4. Let it lather and leave it on for 30 to 60 seconds.
  5. Rinse your face with lukewarm water.

You can use Nizoral on your face on alternate days. If you see any signs of irritation or a rash, use it just twice a week. Inform your doctor if the condition worsens.

A word of warning: Do not let Nizoral get into your eyes, ears, or mouth. If it does, wash it out immediately. If you feel any burning sensation, visit a doctor.

What Is The Ideal Frequency Of Use?

As mentioned earlier, Nizoral is available as a shampoo, cream, and tablet. These products are available over-the-counter as well as on prescription. The ones that are prescribed by a doctor are more potent – they contain 2% ketoconazole and require fewer applications.

Talking about its use frequency, follow the advice given by your doctor and the instructions shared by your pharmacist.

Fungal acne usually appears on the chest, back, and upper arms. This could be due to dandruff falling from the scalp or the excessive overgrowth of the fungus spreading beyond the hair on your head. In such cases of active breakouts, you can use Nizoral on alternate days. If not, you can use Nizoral twice a week for a couple of months. As the acne improves, you can use it once in a while. However, it is wise to continue using it for at least a few months even after the acne totally subsides.

Fungal acne may recur due to weather changes (cold winters to hot and humid monsoons) or your lifestyle changes (extensive workouts).

Nizoral cream can be applied once a day for a month. It should be applied to the entire affected area as well as to the skin around it. 

Is Nizoral Safe To Use?

Fungal acne is very common in adolescents. Hormonal changes can cause the sebaceous glands to secrete excess oils (2). Fungal acne also occurs in people living in hot and humid climates. The over-the-counter Nizoral can be used by people of any age and any skin type. However, here are certain Don’ts’ to keep in mind before and while using Nizoral:

  • Do not use Nizoral if you are allergic to ketoconazole.
  • Do not use Nizoral without a prescription from a doctor (especially if you have a history of asthma or are allergic to sulfites).
  • Do not use Nizoral without informing your doctor or pharmacist about any other medications you are taking.
  • Do not use Nizoral if you are pregnant or breast-feeding. Certain studies show that Nizoral can be absorbed into the body. Topical application may affect pregnancy (3), (4).
  • Do not overuse Nizoral. Follow the instructions given by your doctor and/or pharmacist. Overuse may aggravate your skin condition. If you do not see any improvement in your skin even after using it for two weeks, inform your doctor.

What Are The Side Effects Of Nizoral?

Nizoral is one of the easiest and most successful methods of treating fungal acne. But it is a medication. The ketoconazole it contains may have side effects. These include (5):

  • Differences in the texture and color of hair
  • Rapid thinning of hair
  • Itchy skin
  • Dryness of skin
  • Rash in and around the treated area
  • Nausea
  • Constipation
  • Headaches
  • Stomach aches
  • Dizziness

Here are some of the more adverse reactions to ketoconazole. Most of these are based on anecdotal evidence. But should you experience any, discontinue use and inform your doctor immediately.

  • Inflamed skin that becomes painful or infected
  • Burning sensation
  • Irritation
  • Hives
  • Swelling of the face, lips, tongue, and throat
  • Difficulty in breathing

What Can You Do To Make Nizoral Work Better?

  • Fix Your Dietary Habits

Stay hydrated. Water is an internal and external cleanser. Avoid highly processed, oily, fatty, and sugary foods. Such foods may hurt your body’s immunity and allow the fungus to thrive.

  • Wear Comfortable Clothing

If you live in hot and humid conditions, wear clothes that are loose, comfortable, and let your skin breathe. Shower and change into clean clothes as soon as you are done with your workouts. Wipe yourself with a clean wipe. Sweaty skin, tight clothes, and humid conditions are perfect conditions for the fungus to develop.

  • Avoid Using Oily Products On Your Skin

Nizoral can cause your skin to become dry and itchy. Look for an oil-free moisturizer that will help hydrate your skin. Makeup products can clog your skin and its pores. Use a face wipe or cleanser to keep your skin clean so that the pores can breathe. Do not leave makeup longer than required.

  • Consider Supplementary Treatments

You can also use other remedies that supplement Nizoral and help it work better and faster. Salicylic acid, a beta-hydroxy acid (BHA), is useful in reducing inflammation and clearing the skin of oil and dead cells (6). Tea tree oil doubles as an anti-fungal medication too (7). However, check with your doctor before using such supplementary treatments.


Fungal acne is caused due to yeast overgrowth and cannot be treated with common acne remedies and medication. Nizoral shampoo is one of the most effective ways of combatting fungal acne because of its anti-fungal properties. The ketoconazole in Nizoral is an anti-fungal ingredients that reduces the overgrowth of yeast, eventually ridding your skin of fungal acne.

But remember to first get your acne diagnosed by your doctor. Follow his advice. And if you experience any adverse effects with Nizoral, stop use and visit your doctor.

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    1. Malassezia (Pityrosporum) Folliculitis
    2. An update on the role of the sebaceous gland in the pathogenesis of acne
    3. Ketoconazole impairs early pregnancy and the decidual cell response via alterations in ovarian function
    4. Drugs and Lactation Database (LactMed),a%20reason%20to%20discontinue%20breastfeeding.
    5. Ketoconazole
    6. Salicylic acid as a peeling agent: a comprehensive review
    7. Antifungal activity of the essential oil of Melaleuca alternifolia (tea tree oil) against pathogenic fungi in vitro
    8. New perspectives on the nutritional factors influencing growth rate of Candida albicans in diabetics. An in vitro study
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    Annie Jangam is a Molecular Biologist with 7 years of research experience in Rice Functional Genomics and Nutrient Signalling with International Publications in Abiotic stress, Nitrogen, and G-protein signaling. She specializes in writing on Health and Wellness. She has been an avid reader since childhood and is passionate about stories that help decipher life and its meaning. She believes in Human Rights for all and that one should "love others like we love ourselves."