Keto-Z shampoo is presented with ketoconazole 2% which is an over the counter product in some countries and in others it is considered as a medicine.
The ketoconazole in combination with the zinc pyrithione has a synergic effect and this makes the Keto-Z an effective anti dandruff shampoo. The Keto-Z with ketoconazole is a medicated shampoo that treats both the underlying cause of dandruff that is the pityrosporum ovale but also has an excellent symptomatic effect because it reduces scaling as from the first use.
In cases when the fungal infection is mixed Keto-Z OTC medicated shampoo is recommended. In some cases because of registration purposes Keto-Z shampoo is presented with 0,5% ketoconazole instead of 2% ketoconazole. Studies showed that the there is equal efficacy with both concentrations of ketoconazole.