My husband uses Nizoral, an otc ketoconazole shampoo. Looking at the ingredients it contains two red flag ingredients for those of us with Allergic Contact Dermatitis, ACD, although these are common allergies I do not have either of these. 1. Sodium Lauryl Sulfate, SLS 2. Perfume Bouquet. Not sure what is in this perfume mix, but most often it is Balsam of Peru BP, very common allergen. If not BP other fragrances are common allergens. Yet you are using px ketonazole and you will probably have different ingredients in your shampoo.
Ketonazole is an anti-fungal to kill yeast fungus which resided on the scalp in plaques and often is causes seborriheic dermatitis, but it helps with psoriasis too.
Want to think outside the box since you are still having scalp issues. If your doctors believe it is a fungus and if this fungus is caused by yeast in your system diet can benefit. I have 3 forms of eczema, but the most miserable is my allergic form which the patch test identified my allergens. Yes I changed my environment and the rashes were gone, but even with all my changes I still had internal itching and stinging inside my skin. I required a strong cortico-steroid shot once a year to calm it down. About 10 months after the shots my stinging and tingling would start up again and I would make myself wait the full year for another shot. I was inspired to try diet modification to help control my eczema. I began this diet about 10 months after my annual steroid shot when the tingling was beginning. The results were amazing, the symptoms went away and for the first time in 4 years didn't need this shot.
The book was The Yeast Connection Handbook by Dr. William Crook, MD. Simple book, simple plan but takes disciple. He was a pioneer in believing in alternative medicine to help with skin issues. This is an anti-inflammation diet. Yeast in our system raises our inflation. Its waste products which are released by the residual yeast which lives in our intestines, transfers though the membranes and into our bloodstream raising up our histamine army. We must kill this residual yeast by starving it. It will die out without processed sugar, natural sugar, gluten and few other foods. This is not a calorie diet, but a food type diet, however you can't help but loose weight and following the maintenance program it will not come back. I was happy to loose 5 lbs, but thank goodness I stopped at 15 lbs because I am now too thin for my age. It is a challenge, harder for me to eat like this than it was for me to quite alcohol 5 years ago. Giving up sugar, my mouth used to water with saliva just looking at a piece of candy or dessert. This yeast causes us to crave sugar- it demands to be fed and signals are sent to our brain demanding it. It takes a minimum of 2 months to kill it off, the detox period. I did 3 months as other anti-yeast diets require. My female yeast issues which I battled for decades are gone.I no longer even think about sugar, no more watering mouth looking at others eat dessert. No yeast telling my brain I need it. I no longer need the strong steroid shot. So- could your yeast fungus on your scalp be tied into the yeast in your body feeding it?
Conditioner- I can safely use the VMV conditioner. Also if I wash with the VMV Clark Wash Shampoo for the first wash I can use Grandma's Bar Soap for face and body for the second and because it is moisturizing I use it makes the comb out easier. A small amount of glycerin can be mixed in a spray bottle with water and sprayed on and not rinsed out. I also do this for my granddaughter who has long fine hair and comb out is easier. Some people use apple cider vinegar as a rinse, but as much as I like to consume it I don't like the smell on my hair and also comb out is still hard.
I react to Free and Clear Shampoo and can't figure it out, so I stopped using the conditioner also.
Until you are tested try using products with the fewest ingredients and as mentioned take the time to research all ingredients, especially those with 15 letters in their names. Many on line websites provide allergen information.
November is coming up quickly but make sure now your dermatologist is licensed to perform patch testing. Not all doctors are. You may need to go to a different Kaiser Clinic. Better to learn that now than have to wait longer and schedule with someone else. Once I learned about testing the fastest I could get in, in my area, for testing was 3 months as my derm wasn't licensed to perform this test. Instead I got into an allergist who was licensed for patch testing in 2 weeks. I cannot put in words how miserable I was, to the point of suicide.