Ketoconazole cream typically shows noticeable improvement within 2 to 4 weeks for most skin infections, with some conditions like seborrheic dermatitis or dandruff improving a bit sooner (a few days to a couple of weeks), while more extensive or resistant infections may take longer. For athlete’s foot or other tougher infections, it can take up to 6 weeks in some cases. Always use the cream as directed and complete the full course even if symptoms improve earlier, and consult a clinician if there’s no betterment after about 4 weeks. [sources synthesize general guidance from reputable health sources]