Ketoconazole foam (Extina) is an azole antifungal. It's used to treat seborrheic dermatitis in people 12 years and older. The foam is applied to the affected area(s), such as face and scalp, twice a day. Typically, a treatment lasts 4 weeks. One of the more common side effect of ketoconazole foam (Extina) is burning sensation at the application site.
Ketoconazole foam (Extina) is an azole antifungal. Some forms of seborrheic dermatitis might be linked to an yeast infection. Ketoconazole foam (Extina) is thought to treat this skin condition by getting rid of the yeast and lowering inflammation.
Source: DailyMed
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
Less common—For cream, shampoo, foam, or gel
Itching, stinging, burning, or irritation not present before use of this medicine
Rare—For cream, foam, or gel
bleeding from sore in the mouth
blistering, crusting, irritation, itching, or reddening of the skin
burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
cracked, dry, or scaly skin
discoloration of the fingernails or toenails
dizziness
eye dryness, irritation, or swelling
red rash with watery, yellow-colored, or pus filled blisters with or without thick yellow to honey-colored crusts
skin dryness, pain, rash, redness, or swelling
sore in the mouth or on the gums
swelling of the face
Rare—For shampoo
Hair loss and irritation
Incidence not known—For gel
Incidence not known—For shampoo
Blistering, burning, crusting, dryness, or flaking of the skin
burning sensation of the skin
burning, itching, redness, skin rash, swelling, or soreness at the application site
discoloration of the hair
fast heartbeat
hoarseness
irritation
itching, scaling, severe redness, or soreness of the skin
joint pain, stiffness, or swelling
rash
shortness of breath
swelling of the eyelids, face, lips, hands, or feet
thinning of the hair
tightness in the chest
troubled breathing or swallowing
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
Less common—For shampoo or gel
Dryness or oiliness of the hair and scalp
headache
Rare—For shampoo
Abnormal hair texture
mild dryness of the skin
scalp pustules
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Applied directly to the skin
Has few side effects
Stored at room temperature
Applied twice daily
Might need to use for 4 weeks
Not approved for children under 12 years old
Spray ketoconazole foam (Extina) into the cap or on a cool surface and apply it on the affected area with your fingertips. If your fingertips are warm, rinse them in cold water first. Don't spray ketoconazole foam (Extina) into the palm of your hand as the warmth will cause the medication to begin melting.
Wash your hands well after using ketoconazole foam (Extina) to prevent it from getting in your eyes, mouth, or other sensitive areas. If ketoconazole foam (Extina) does accidentally get in one of these areas, rinse it with water right away.
If you're putting ketoconazole foam (Extina) on an area where hair is present, move your hair out of the way and try to apply ketoconazole foam (Extina) directly onto the skin.
Ketoconazole foam (Extina) is flammable. Avoid fire, flames, or smoking during and after applying ketoconazole foam (Extina).
The area where you applied ketoconazole foam (Extina) might be more sensitive to the sun. Protect that area from the sun by wearing clothing like hats, long sleeve shirts, or long pants, to lower the risk of rash from the sun.
If you notice signs of an allergic reaction after using ketoconazole foam (Extina), such as a rash, hives, or swelling, contact your healthcare provider.
Ketoconazole foam (Extina) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Risk factors: Exposure to sunlight after applying ketoconazole foam (Extina)
Ketoconazole foam (Extina) can cause an allergic rash to form where it was applied. Sometimes, this rash doesn't happen unless you are exposed to sunlight after applying the medication. If possible, avoid the sun or cover up areas where you applied ketoconazole foam (Extina) right after you use it. If you notice any signs of an allergic reaction like a rash, hives, or swelling, let your healthcare provider know. You'll need to use a different medication.
Ketoconazole foam (Extina) contains flammable ingredients. Stay away from fires or open flames, and don't smoke during and immediately after using ketoconazole foam (Extina). Don't store ketoconazole foam (Extina) at high temperatures (over 120 degrees Fahrenheit) and avoid getting the container close to fires, flames, or other heat sources. Even if the ketoconazole foam (Extina) can is empty, don't poke holes in it or throw it into a fire.
Spray the foam into the ketoconazole foam (Extina) cap of the bottle or on a cool surface. Use your fingers to pick up a small amount needed to cover the affected area(s). Then, apply ketoconazole foam (Extina) to the affected area(s) twice daily for 4 weeks.
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Tell your healthcare professional if you are taking any other prescription or nonprescription (over-the-counter [OTC]) medicine.
Skin inflammation
Skin rashes
Eczema
Psoriasis
Insect bites
Poison ivy or oak
Skin allergies
Dry scalp
Genital or rectal irritation
Seborrheic dermatitis of the scalp (condition that causes dry, scaly, red, and itchy skin)
Tinea versicolor (fungal skin infection that causes discolored patches or spots on the body)
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Goularte-Silva, V., et al. (2021). Ketoconazole beyond antifungal activity: Bioinformatics-based hypothesis on lipid metabolism in dandruff and seborrheic dermatitis. Experimental Dermatology.
Gupta, A. K., et al. (2004). Role of antifungal agents in the treatment of seborrheic dermatitis. American Journal of Clinical Dermatology.
Johnson, B. A., et al. (2000). Treatment of seborrheic dermatitis. American Family Physician.
Medimetriks Pharmaceuticals, Inc. (2023). Ketodan- ketoconazole aerosol, foam [package insert]. DailyMed.
Vázquez-Herrera, N. E., et al. (2018). Scalp itch: A systematic review. Skin Appendage Disorders.
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