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Ketoconazole & Pimples

The medication ketoconazole is primarily prescribed to cure fungal infections; it slows the growth of fungi 1. Ketoconazole also reduces levels of male hormones, or androgens, making it useful for treating certain other health disorders 13. Limited research shows that ketoconazole has some effectiveness for treating acne, but your doctor is unlikely to prescribe it for this use 1.


The main use of ketoconazole is treating fungal infections that can spread through the bloodstream 1. It also heals skin and nail fungal infections and vaginal yeast infections. Because of the anti-androgen effects of ketoconazole, some doctors prescribe it for off-label uses, such as:

  • treating prostate cancer
  • high blood levels of cortisol
  • excessive hair growth in women
  • known as hirsutism 1

Hormonal Acne Treatment

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Using anti-androgen medication for acne can be effective if you're a woman with high levels of male hormones. Women normally have low levels of these hormones, but high levels can cause pimples and other problems. Taking birth control pills is the most common treatment for this type of acne, according to eMedTV 4. Spironolactone is a medication with anti-androgen effects that doctors prescribe for severe acne in women when the condition hasn't responded to other treatment 4.

Ketoconazole and Acne

Some research has shown ketoconazole to be effective for acne in women as well 1. A study published in the August 1990 issue of the "Journal of Clinical Endocrinology and Metabolism," for instance, evaluated the effects of ketoconazole in 17 women with acne, as well as for women experiencing hirsutism 12. Levels of male hormones in these women dropped progressively during treatment and acne symptoms in all cases improved. However, ketoconazole is rarely prescribed because its effectiveness is weak, reports a 1998 article in the journal "Dermatology." In addition, ketoconazole is associated with several side effects, some severe 1.

Side Effects

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Taking ketoconazole may cause liver damage 1. During the 1990 "Journal of Clinical Endocrinology and Metabolism" study, hepatitis was a reported side effect 2. The authors state that scrupulous monitoring is required for patients taking this drug. If you drink large amounts of alcohol, if you take medications that can have negative effects on the liver or if you have ever had liver disease, tell your doctor before taking ketoconazole, instructs the National Center for Biotechnology Information's PubMed Health website 1. Ketoconazole may be inadvisable in these situations 1. Other side effects reported in the 1990 study included headaches, nausea and loss of scalp hair. Ketoconazole also may cause stomach pain and depression 1.