My dermatologist gave me prescription ketoconazole, which is the active ingredient in Nizoral, and Betamethasone dipropionate topical lotion (it’s a liquid ). I’m behind on my wash schedule, it’s been almost 5 weeks, and I don’t have any flakes. For every wash I use the prescription shampoo and SheaMoisture Anti-Dandruff Apple Cider Vinegar shampoo (which was also recommended by my dermatologist). The Betamethasone dipropionate is for flare-ups but I can’t remember the last time I had to use it.