Ketoconazole 2% + Zinc Pyrithione(ZPTO) 1% provides complementary antifungal pathways
1. Dual antifungal mechanism
� Ketoconazole ? inhibits the fungal cytochrome P450 enzyme (14-a-demethylase) which
ergosterol synthesis. Loss of ergosterol disrupts membrane permeability, leading to fungal growth inhibition
anti-inflammatory activity by inhibiting 5-lipoxygenase and leukotriene B4 production in the skin

� Zinc Pyrithione ?It disrupts fungal cell membrane transport by blocking proton pumps and functions as a copper ionophore, increasing intracellular copper levels that damage iron-sulfur cluster enzymes essential for fungal metabolism. This results in inhibition of fungal energy production and cell division
2. Broader antimicrobial spectrum
� Targets Malassezia yeast + bacterial flora
3. Anti-inflammatory synergy
� Reduces cytokines, leukotrienes, and microbial inflammation

Useful for:
� Potent antifungal activity against Malassezia species responsible for dandruff, seborrheic dermatitis, and fungal acne.
� Reduces scaling, erythema, and pruritus associated with seborrheic dermatitis
� Fungal acne (Malassezia folliculitis)
� Dandruff-associated facial dermatitis
� Oily acne-prone skin with yeast overgrowth