Administration:

1. Shake the container well to ensure the foam is properly mixed before applying.
   
   
2. Apply a small amount of foam to the palm of your hand and rub it gently into the affected area. If you are applying to the scalp, part your hair and directly apply the foam to the scalp.
   
   
3. Massage gently to ensure the foam covers the entire affected area.
   
   
4. Leave the foam on for a few minutes (usually 3-5 minutes) to allow it to work before rinsing.
   
   
5. Rinse thoroughly with warm water. Be careful to avoid contact with eyes.
   
   

Precautions:

• Avoid contact with eyes: Ketoconazole foam should not come into contact with the eyes or mucous membranes. If it does, rinse thoroughly with water.
  
  
• Do not use on broken or irritated skin: Only apply Extina to intact, non-broken skin. If you have severe irritation or broken skin, consult your healthcare provider before use.
  
  
• Discontinue use if irritation occurs: If you experience significant skin irritation, itching, or redness, discontinue use and consult your doctor.
  
  

The active ingredient in Extina, ketoconazole, is an antifungal medication that works by inhibiting the growth of fungi and yeast on the skin. Malassezia, a type of yeast that naturally exists on the skin, can overgrow and cause inflammation, leading to the symptoms of seborrheic dermatitis such as redness, scaling, and irritation.

Ketoconazole works by interfering with the ergosterol synthesis in the fungal cell membrane. Ergosterol is a vital component of the cell membrane in fungi, and by inhibiting its synthesis, ketoconazole destabilizes the fungal cell membrane, ultimately leading to cell death and the reduction of fungal growth.

By controlling the overgrowth of Malassezia, Extina helps to reduce the itching, flaking, and inflammation associated with seborrheic dermatitis and dandruff. This leads to improved skin appearance and a reduction in discomfort for affected individuals.

Common Side Effects:

• Skin Irritation: Some users may experience mild irritation at the application site, including redness, itching, or dryness.
  
  
• Headache: Some individuals may experience headaches, especially during the initial stages of treatment.
  
  
• Application Site Reactions: Temporary burning or stinging sensations may occur when applying Extina, but these symptoms typically subside with continued use.
  
  

Serious Side Effects:

• Severe Allergic Reactions: Although rare, some users may experience a severe allergic reaction, such as swelling of the face, lips, tongue, or throat, which may cause difficulty breathing. In such cases, seek immediate medical attention.
  
  
• Contact Dermatitis: Rarely, some users may develop contact dermatitis, which causes redness, swelling, and irritation at the application site.
  
  

If any of these serious side effects occur, it’s important to discontinue use and consult a healthcare provider immediately.

• Allergic Reactions: If you have a known allergy to ketoconazole or other antifungal medications, you should avoid using Extina.
  
  
• Not for Systemic Use: Extina is a topical medication and should not be ingested or used on areas of broken skin or mucous membranes.
  
  
• Pregnancy and Breastfeeding: The safety of Extina during pregnancy and breastfeeding has not been well established. Consult with your healthcare provider if you are pregnant or breastfeeding before starting treatment.
  
  
• Sensitivity to Sunlight: Some individuals may experience increased sensitivity to sunlight. It’s advisable to limit sun exposure and use sunscreen while using Extina to avoid sunburn or skin irritation.
  
  

• CYP450 Enzyme Inhibitors: Ketoconazole is metabolized by the liver enzyme CYP3A4. Medications that inhibit this enzyme, such as certain antifungals, antivirals, and antidepressants, could increase ketoconazole levels in the blood, potentially leading to an increased risk of side effects.
  
  
• Other Topical Medications: Caution is advised when using other topical treatments in combination with Extina, as certain ingredients could irritate the skin or cause interactions.
  
  
• Oral Medications: Although Extina is a topical product, if used in conjunction with oral ketoconazole or other systemic antifungals, the total antifungal burden may need to be considered to avoid overuse and excessive suppression of the skin’s natural flora.
  
  

Always inform your healthcare provider about any other medications you are using, including over-the-counter drugs and topical treatments, to ensure there are no potential interactions.

• Seborrheic Dermatitis: Apply Extina once daily for 2-4 weeks or as prescribed. For maintenance treatment, use once or twice a week.
  
  
• Dandruff: Apply Extina once a week as a preventive measure or during flare-ups.
  
  

It is important to follow the instructions provided by your healthcare provider to ensure the best results.

Extina is a prescription-only medication and must be prescribed by a healthcare provider. Your doctor will evaluate your condition and recommend the appropriate dosage and duration of treatment. If you experience any side effects or do not see improvement, follow up with your healthcare provider for further guidance.

• What is Extina used for?
  It is prescribed to treat seborrheic dermatitis of the scalp, a skin condition that causes redness, flaking, and itching.

• What is the active ingredient?
  Ketoconazole 2%, an antifungal medication.

• How does Extina work?
  It reduces the growth of fungus (Malassezia) on the scalp that contributes to seborrheic dermatitis.

• What form does Extina come in?
  It is available as a topical foam for application to the scalp.

• How should I use Extina?
  Apply the foam to the affected scalp areas twice daily for 4 weeks, or as directed by your doctor.

• How long does it take to see results?
  Improvement is usually seen within 2–4 weeks of consistent use.

• Is Extina a prescription medicine?
  Yes, Extina is prescription-only.

• What are the common side effects?
  Application site burning, itching, dryness, or skin irritation.

• Are there serious side effects?
  Rare, but allergic reactions (rash, swelling, difficulty breathing) may occur.

• Can Extina be used for dandruff?
  While it treats scalp fungus like dandruff shampoos, it is specifically approved for seborrheic dermatitis, not routine dandruff.

• Who should not use Extina?
  People allergic to ketoconazole or other antifungal azoles.

• Is Extina safe for children?
  Safety in patients under 12 years of age has not been established.

• Is Extina safe during pregnancy?
  Topical use may be considered if clearly needed—consult your doctor.

• Can I use Extina while breastfeeding?
  Yes, but avoid applying it directly to areas that may contact the infant.

• Does Extina interact with other medications?
  Since it is topical, interactions are unlikely, but always inform your doctor of other treatments.

• Can I wash my hair after applying Extina?
  Wait at least a few hours before shampooing to allow absorption.

• What happens if I miss a dose?
  Apply as soon as remembered, but do not double apply if it’s close to the next dose.

• Does Extina cure seborrheic dermatitis?
  It controls symptoms but does not permanently cure the condition—flare-ups may return.

• Is there a generic version?
  Yes, generic ketoconazole foam is available.

• Where can I get Extina?
  Available at pharmacies with a prescription.