Ketoconazole not working

Newly joined but been lurking this sub for a year. It appears to me that different things work for each person, even if it comes down to simply which anti-fungal shampoo you use.

I personally have tried all three kinds of anti fungals (i.e., ketoconazole 2%, zinc pyrithione, and selenium sulfide), and none has worked in treating sebderm on my scalp. In my experience, ketoconazole has a longer lasting effect where flakes only come out on the 2nd day.

My current routine is switching between ketoconazole and selenium sulfide. I sometimes would use tsal before applying ketoconazole to remove the biofilm, but my head will start flaking on the 2nd day. I get build ups very fast as well, where I’ll be able to catch oil and flakes if I run my nails through my scalp on the 2nd day. The products I use are ketoconazole shampoo and Head and Shoulders Clinical Strength.

Is anybody else encountering the same issue? Feeling really hopeless in my current situation as there appears to be no way to completely treat this. I think I’ve had this issue since my teenage years. Currently in my early twenties.