From the Research
Tacrolimus ointment is a viable treatment option for seborrheic dermatitis, particularly for facial involvement, and can be considered as a second-line treatment after traditional first-line therapies have been tried. The most recent and highest quality study 1 suggests that maintenance therapy with tacrolimus 0.1% ointment can be effective in preventing the occurrence of facial seborrheic dermatitis exacerbations.
Key Points to Consider
- Tacrolimus works by inhibiting calcineurin, which reduces inflammation and suppresses T-cell activation without causing skin thinning (atrophy) that can occur with topical steroids 2.
- It is typically prescribed as 0.03% or 0.1% strength, applied thinly to affected areas twice daily until improvement, then reduced to maintenance therapy as needed.
- Most patients see improvement within 1-2 weeks of consistent use.
- Side effects may include temporary burning or itching upon application, which typically diminishes with continued use.
- For optimal results, the skin should be clean and dry before application, and the medication should be used as part of a comprehensive skin care regimen that may include gentle cleansing.
Comparison with Other Treatments
- A study comparing tacrolimus 0.03% cream with sertaconazole 2% cream found that sertaconazole may be an excellent alternative therapeutic modality for treating seborrheic dermatitis, with a higher level of patient satisfaction 3.
- However, another study found that tacrolimus 0.1% was better than low-potency corticosteroids, pimecrolimus 1%, and tacrolimus 0.03% in treating atopic dermatitis, which has some similarities to seborrheic dermatitis 4.
Recommendation
Based on the available evidence, tacrolimus ointment can be a useful treatment option for seborrheic dermatitis, particularly for facial involvement, and can be considered as a second-line treatment after traditional first-line therapies have been tried. It is essential to weigh the potential benefits and risks of tacrolimus ointment and to monitor patients closely for any adverse effects.