The quick verdict: Ketomac is the best value by a wide margin — the same 2% ketoconazole as Nizral at roughly a third of the price per ml. Nizral is the one to ask for if your pharmacist knows it by name (it's what "Nizoral" means in India). Salisia KT adds salicylic acid, useful if you have thick, stuck-on flakes. Check the Scalpe+ pack carefully before buying — see below.
Prices verified 3 August 2026 across Indian pharmacy listings and move constantly — check before you buy. Some product links are Amazon affiliate links; we earn a small commission at no extra cost to you, and it never changes what we recommend. This article is general information, not medical advice.
First: Nizoral or Nizral?
This trips up almost everyone. Nizoral is the international brand name — it's what people search for, and searches for it have climbed sharply. But walk into an Indian chemist and the bottle you'll be handed is Nizral, spelled without the second "o".
Same molecule, different market. If you search "Nizoral India" and find nothing on the shelf, you're not going mad — you're looking for the wrong spelling.
What ketoconazole actually does
Dandruff isn't a dirt problem. It's driven by Malassezia, a yeast that lives on everyone's scalp, feeding on your natural oil. In people whose skin reacts to its by-products, the scalp sheds cells faster — and you get flakes.
Ketoconazole is an antifungal. It reduces the yeast itself, which is why it works when ordinary "anti-dandruff" cosmetic shampoos stop helping. Those clean oil; this treats the cause. That distinction is the whole reason people graduate to it.
The comparison: what you actually pay
Price per bottle is misleading, because the bottles are wildly different sizes. Price per ml is the honest comparison:
| Product | Active(s) | Size | Typical price | Per ml |
|---|---|---|---|---|
| Ketomac | Ketoconazole 2% | 110 ml | ~₹198 (MRP ₹225) | ₹1.80 |
| Salisia KT | Ketoconazole 2% + salicylic acid 2% | 75 ml | ~₹310 (MRP ₹365) | ₹4.13 |
| Scalpe+ Expert | see the warning below | 75 ml | ~₹316 | ₹4.22 |
| Nizral | Ketoconazole 2% | 50 ml | ~₹274 (MRP ₹319) | ₹5.48 |
Roughly translated into washes — assuming about 5 ml per wash for short-to-medium hair — a 110 ml Ketomac bottle gives you around 22 washes at under ₹10 each, while a 50 ml Nizral gives about 10 washes at nearer ₹27 each. Long or thick hair uses more, so treat those as directional, not precise.
⚠️ Check the Scalpe+ pack before you pay
This is the finding that made this comparison worth writing, and it's the one no other page covers.
Sources disagree about whether Scalpe+ Expert actually contains ketoconazole. Apollo Pharmacy's listing states the composition as ketoconazole 2% + zinc pyrithione 1%. But a full published INCI ingredient list for the same product name shows no ketoconazole at all — the antifungals present are zinc pyrithione, climbazole and piroctone olamine.
We can't resolve that contradiction from the outside, and we're not going to guess on your behalf. Both are legitimate anti-dandruff formulations — but they are not the same thing, and only one of them is the ketoconazole product you may think you're buying.
What to do: read the actual ingredient panel on the bottle in your hand, not the shelf label or the product title. If "ketoconazole" isn't printed on the pack, it isn't in the bottle. This is worth 10 seconds in the shop.
1% vs 2%: what the research says
You'll see both strengths sold. The evidence favours 2% clearly.
In a randomised trial of 66 people with severe dandruff and seborrhoeic dermatitis, published in Dermatology, 2% ketoconazole was significantly better than 1% (p<0.001) at reducing both flaking and Malassezia density, measured at two and four weeks — and the 2% group trended towards fewer relapses afterwards (PubMed). Pooled data show the same dose-response pattern: 2% outperforms 1%, which outperforms 0.5%.
In short: if your dandruff is stubborn enough that you're reading a ketoconazole comparison, 2% is the strength worth having.
Is 2% prescription-only in India?
Messier than anyone admits. General guidance holds that 1% is the maximum sold over the counter and 2% needs a prescription. In practice, Indian pharmacy sites don't apply that consistently — Netmeds lists Nizral 2% under prescriptions, while Apollo lists Ketomac 2% and Scalpe+ Expert as OTC products.
Practically: you can usually buy these at a chemist, but if a pharmacist asks for a prescription, that's them following the stricter reading rather than being difficult. And genuinely severe scalp disease deserves a doctor anyway.
How to use it correctly (most people don't)
Ketoconazole shampoo fails far more often from misuse than from being the wrong product.
Why your ketoconazole shampoo "stopped working"
Four culprits, in the order they're usually to blame:
- Contact time crept down. People start with five patient minutes and drift to thirty seconds. Re-time it once and you'll often find the shampoo was fine.
- You stopped too early. Flakes clear, treatment stops, yeast repopulates, flakes return. Maintenance is the fix.
- It was never dandruff. Psoriasis, eczema and a genuinely dry scalp all flake, and none of them respond to an antifungal. If four weeks of correct use changes nothing, the diagnosis is the problem, not the product.
- Same active, every wash, for months. Rotating with a different active — zinc pyrithione or selenium sulfide — is a common practical strategy.
Side effects and who should be careful
For most people it's well tolerated. Worth knowing:
- Dryness is the usual complaint — medicated shampoos strip more than cosmetic ones. Condition the lengths, not the scalp.
- Colour-treated hair can fade faster with frequent medicated washing. Space out washes rather than abandoning treatment.
- Irritation, redness or increased shedding means stop and speak to a pharmacist or doctor.
- Pregnancy, breastfeeding, or using it on a child — ask a doctor first rather than self-prescribing. For children specifically, see our parent's guide to dandruff shampoo for kids, because the actives here are not all suitable.
The cheaper generics nobody mentions
Every roundup names the same three brands. But ketoconazole is a generic molecule, and Salisia KT is the one worth knowing: 2% ketoconazole plus 2% salicylic acid, which loosens and lifts flakes that have already built up. If your problem is thick, stuck-on scale rather than loose powder, that combination does something the plain ketoconazole shampoos don't.
The label-reading rule is simple: find the active ingredient and its percentage on the pack. Once you're comparing "ketoconazole 2%" to "ketoconazole 2%", the rest is price and bottle size.
Which one should you actually buy?
Best value overall
Ketomac 2%
Same 2% ketoconazole as Nizral, in a 110 ml bottle at roughly a third of the price per ml. The default pick.
~₹198 · 110 ml
Check price →
Thick, stuck-on flakes
Salisia KT
Ketoconazole 2% plus salicylic acid 2% to lift built-up scale as well as treat the yeast.
~₹310 · 75 ml
Check price →
The name your chemist knows
Nizral 2%
India's "Nizoral". Effective and widely stocked — you're paying a brand premium per ml.
~₹274 · 50 ml
Check price →
Check the pack first
Scalpe+ Expert
Popular and well-formulated, but sources conflict on whether this bottle contains ketoconazole. Read the ingredient panel.
~₹316 · 75 ml
Check price →When to skip the shampoo aisle and see a dermatologist
- No improvement after four weeks of correct use, including the full contact time
- Scalp that is red, swollen, weeping or painful
- Thick silvery plaques, or a rash spreading past the hairline onto the face, ears or neck
- Patches of hair loss along with the flaking
- Itching bad enough to disturb sleep
These are common and treatable, but they need the right prescription rather than a stronger shampoo (AAD).
Buy on the active ingredient and the price per ml, use it on your scalp for the full five minutes, and taper instead of stopping. That's the entire game — everything else is branding.
Shedding as well as flaking? See dandruff and hair fall together — including what a 150-man trial found about ketoconazole and hair loss.
Next: the year-round routine in how to remove dandruff, and why it spikes every rainy season in dandruff in the monsoon.
Medical note: This article is general information, not medical advice, and has not been reviewed by a clinician. Ketoconazole is a medicine — follow the directions on the pack, and consult a pharmacist, doctor or dermatologist about persistent or severe scalp problems, before use in pregnancy or breastfeeding, or before using it on a child.