Tinnitus Likely from Ketaconazole

I'm going to have to start off my introduction with a story. I've been using Nizoral (Ketaconazole 2%) medicated shampoo as regular shampoo for about 6 years. I started using it after I read online that it could help with hair loss. I don't know if it helped or not, but in the end I figured it can't hurt and I didn't mind it, so it became my brand. I've been using it daily.

Over the past several years my hearing has become sensitive. Loud sounds and even not so loud sounds cause a painful recoil in my ear. Kids screaming, dishes clanking, that kind of stuff. When a fire engine is near I have to cover both ears or it really hurts, it just sounds way too loud. I work in light construction and I am sometimes briefly exposed to loud noises. I started noticing that brief work with a hammerdrill or grinder would cause a tinnitus flare up that lasts days or a week or more. I started wearing earplugs whenever possible and that mostly stopped the tinnitus but I would still get a faint bit of it.

Last September I needed to help a friend with a project. I spend about 5 minutes with a grinder and forgot to put the earplugs in. I've been dealing with the worst tinnitus I've had ever since. There were a few good days where it was very background and I didn't notice it, but overall it's been overbearing. I haven't been exposed to a lot of loud noises in my life, and I know a lot of people who take less care and have no problems.

This is a recent connection that I've made, I remembered reading about someone who was experimenting with different otc antifungals (could have been fluconazole or miconazole), and reported gaining tinnitus from one of them. I looked up Ketoconazole and sure enough it's listed as a potential ototoxic drug. It's in the same class as other anti-fungals that are known ototoxics. I'm not a chemist or a doctor, but this only makes sense to me. I've stopped using the shampoo and am anxiously hoping my condition will improve. I hope I haven't done too much damage, any decrease in symptoms would be welcome. At least I hope my experience might help someone else.

 

I decided to test my tinnitus for fun to see what frequency it is. Apparently it's about 13.5-15 kHz (but louder than my speakers can produce), it's like having a little fairy screaming in my ears. It's not a constant tone but oscillates randomly. I also just discovered that listening to these frequencies gives me momentary relief that lasts for a few seconds even after I stop listening.

 

@bur547, interesting. I haven't found much info about Nizoral (Ketaconazole 2%) being correlated with tinnitus. However, I've used that shampoo maybe once a week for the past year, so it may be part of my problem. I have a similar type of tinnitus in the 12.5 kHZ - 13.5 kHz range. Sounds like the high pitched whine of an old cathode ray tube television. I also get temporary relief when listening to tones in that range.

I have very minor high pitched hearing loss, associated with having been in bands in my youth. The onset of my tinnitus is associated with my taking an increased dosage (300 mg) of Wellbutrin, which I promptly quit under my doctor's advice. My ENT thinks Wellbutrin caused the tinnitus or exacerbated some existing tinnitus that I hadn't noticed. I wonder if Nizoral is a factor in my situation.

I'll stop using the shampoo also and see if I experience a decline in severity. Please keep me posted. I'll do the same.

 

Hi everyone, just doing a follow up. So, it's been 7 months since I officially had tinnitus. What has changed since then?

Firstly, I blamed ketoconazole for contributing to my condition, and I swore to stop using it. I did stop using ketoconazole and the week that I stopped was the week of most rapid improvement I have seen. It might have been a coincidence because of timing and maybe my body was just ready to heal that week, but things did improve noticeably.

The next weeks / months after were kind of spotty. I wasn't sure sometimes whether anything was improving or not. Some days I would swear it was almost normal and some days it felt like it hadn't changed. It's been hard to gain a perspective on this condition due to how much it can affect my thoughts, and the times I don't notice it I don't know whether it's because I'm not paying attention or whether it's because it's actually getting better, and I don't want to pay attention to it because that makes it worse. It's been hard to evaluate.

I still have hyper acuity. When I hear a sharp sound my eardrums recoil, and I hear a "Fwuf" sound and feel them reflex. I'm not sure if it's actually my eardrums but it's something in my ear. I'm satisfied that this is something to do with my genetics and not due to anything I've been exposed to. It hurts to hear loud noises, and in particular my left ear seems to be worse than my right one. I have been wearing an earplug in my left ear every day now when I leave my house. Something as simple as a motorbike throttling up, a fire engine coming by, or a screaming kid can be enough to flare up my tinnitus for a day or more.

So what is the state of my current tinnitus? It's not bad, it's way better than I thought it would get. I realize that it's in a constant fragile state and I have to protect my hearing more than ever. I would say it's 90% improved from its peak. I still don't hear silence and I doubt I ever will, but the ring I hear is quiet and tolerable. I would say I've grown used to it and I think about it less as time goes on.

@dnl, you asked me to keep you in the loop and so I am. To anyone else suffering, please give it some time before you freak out. If you ask the person who lives near the train tracks what they think about the train they will say, "What train?". Our brains have an amazing capability to adapt, and our bodies can still heal even after months or years.

 

@bur547, thanks for keeping us in the loop. These updates are great to hear. So many threads on this forum are people posting a few times and then they never post again. I'm glad to hear that your tinnitus is better/more bearable. I've stopped using Ketaconazole over the past couple of months, but haven't noticed a significant change to my tinnitus... My biggest drop in volume came after stopping Wellbutrin. Thanks for the advice. I'm hoping for similar progress/healing/habituation over the next year.

 

The first thing I would point out is that you're not supposed to use that strength everyday. I think at most twice a week?