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Generic name: ketoconazole topicalkee-toe-KOE-na-zole ]
Drug class: Topical antifungals

Medically reviewed by Philip Thornton, DipPharm. Last updated on Apr 21, 2022.

What is Extina?

Extina is an antifungal foam that prevents fungus from growing on your skin.

Extina Foam is used on the skin (topical) to treat a skin condition called seborrheic dermatitis in patients 12 years of age and older. Seborrheic dermatitis can cause areas of flaky skin (scales) on the scalp, face, ears, chest or upper back.

Extina Foam may also be used for purposes not listed in this medication guide.


Use Extina for the full prescribed length of time. Your symptoms may improve before the condition is completely cleared.

Do not use bandages or dressings over the treated skin areas, unless your doctor has told you to.

Avoid getting this medication in your eyes, nose, or mouth.

Stop using Extina Foam and call your doctor if you have severe burning, irritation, redness, pain, or oozing where the medicine is applied.

Extina Foam is flammable. Do not use it while you are smoking or near an open flame.

Do not use this medication on a child younger than 12 years old.

Before taking this medicine

You should not use Extina Foam if you are allergic to ketoconazole.

Ask a doctor or pharmacist if this medicine is safe to use if you have:

Ask a doctor before using this medicine if you are pregnant.

You should not breast-feed while using Extina.

Always follow directions on the medicine label about using this medicine on a child.

How should I apply Extina?

Apply Extina Foam exactly as prescribed. The foam is usually applied to the affected skin areas two times a day (once in the morning and once at night) for 4 weeks. Talk to your doctor if your skin does not improve after 4 weeks of treatment

  1. Hold the can at an upright angle.
  2. Push the button to spray Extina Foam directly into the cap of the can or other cool surface. Spray only the amount of foam that you will need to cover your affected skin. Do not spray the foam directly onto your affected skin or your hands because it will begin to melt right away when it touches your skin.
  3. If your fingers are warm, rinse them in cold water first. Be sure to dry them well before handling the Extina Foam. If the foam can seems warm or runny, place the can under cool running water for a few minutes.
  4. Using your fingertips, gently massage the foam into the affected areas until the foam disappears.
  5. If you are treating skin areas with hair such as your scalp, move any hair away so that the foam can be applied to the affected skin.
  6. Do not get Extina Foam in your eyes, mouth or vagina. If any foam gets in your eyes, mouth or vagina, rinse areas well with water.
  7. Wash your hands well after applying Extina.

Do not use Extina to treat any skin condition that has not been checked by your doctor.

Store at room temperature away from moisture and heat. Do not place Extina in the refrigerator or freezer.

Extina Foam is flammable. Do not smoke while holding the foam can or while spraying or applying the foam. Keep the can away from and do not spray it near fire, open flame, or direct heat. Never throw the can into a fire, even if the can is empty. Do not leave the can in direct sunlight.

Call your doctor if your symptoms do not begin to improve after 2 to 4 weeks of treatment, or if your condition gets worse.

What happens if I miss a dose?

Use the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not use two doses at one time.

What happens if I overdose?

An overdose of ketoconazole topical is not expected to be dangerous. Seek emergency medical attention or call the Poison Help line at 1-800-222-1222 if anyone has accidentally swallowed the medication.

What should I avoid while using Extina?

Do not get this medicine in your eyes. If contact does occur, rinse with water.

Avoid covering treated skin areas with tight-fitting, synthetic clothing (such as nylon or polyester) that doesn't allow air to circulate to your skin. If you are treating your feet, wear clean cotton socks and sandals or shoes that allow for air circulation. Keep your feet as dry as possible.

You may need to avoid sunlight if you are treating pityriasis. Follow your doctor's instructions.

Avoid using skin products that can cause irritation, such as harsh soaps, shampoos, hair coloring or permanent chemicals, hair removers or waxes, or skin products with alcohol, spices, astringents, or lime.

Avoid using other medications on the areas you treat with Extina unless your doctor tells you to.

Extina side effects

Get emergency medical help if you have signs of an allergic reaction to Extina: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

  • burning, stinging, or severe irritation after using this medicine;

  • redness, pain, or oozing of treated skin; or

  • shortness of breath.

Common Extina side effects may include:

  • thinning hair;

  • changes in the color or texture of your hair;

  • dry skin; or

  • mild itching.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect Extina?

Medicine used on the skin is not likely to be affected by other drugs you use. But many drugs can interact with each other. Tell each of your healthcare providers about all medicines you use, including prescription and over-the-counter medicines, vitamins, and herbal products.

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Extina only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.