The use of antifungal shampoos in treating pityriasis versicolor, a recurrent noninflammatory superficial fungal infection, is a simple and practical treatment approach, especially for extensive areas of the body. A triple-blind randomized clinical trial compared the efficacy of 2% ketoconazole shampoo with 2% climbazole shampoo in patients with pityriasis versicolor.

The study enrolled 60 patients diagnosed with pityriasis versicolor and randomized them into two groups: Group A received ketoconazole shampoo and Group B received climbazole shampoo. Potassium hydroxide (KOH) smears were obtained from all participants at the beginning of the study, 4 weeks after starting treatment and during a 3-month follow-up period. The participants were instructed to apply the shampoo three times a week for 3 weeks, covering all affected body surfaces and the scalp, leaving it on for 10 minutes before rinsing. The study evaluated the treatment response based on clinical improvement and the results of KOH smears.

The results showed that after 4 weeks of treatment, 70% of patients in the ketoconazole group and 43.3% in the climbazole group had negative KOH smears, indicating a mycological cure. However, the rates of complete clinical improvement at the 3-month follow-up were 26.7% in the ketoconazole group and 13.3% in the climbazole group.

In conclusion, based on this study, 2% ketoconazole shampoo demonstrated significantly greater efficacy in mycological cure than climbazole shampoo in patients with pityriasis versicolor. 

Source: Amiri R, Omidvand Z, Mohammadi S, Khalili M, Aflatoonian M. Comparison of the efficacy of 2% ketoconazole shampoo vs. 2% climbazole shampoo in the treatment of pityriasis versicolor. Iran J Dermatol. 2021;24:300-5.