From the Guidelines
Seborrheic dermatitis should be treated with topical antifungal medications to reduce the amount of yeast present and topical anti-inflammatory medications to reduce inflammation and itch. This approach is based on the understanding that seborrheic dermatitis is a common condition affecting areas with many oil glands, such as the ears, scalp, central face, and other sebaceous areas of the skin, and is characterized by greasy yellowish scaling, itching, and secondary inflammation from Malassezia yeast 1.
Key Treatment Considerations
- Topical antifungal medications are effective in reducing the amount of yeast present, which contributes to the development of seborrheic dermatitis.
- Topical anti-inflammatory medications can help reduce inflammation and itch associated with the condition.
- Gentle skin care and avoidance of harsh products are also important in managing seborrheic dermatitis.
Management of Seborrheic Dermatitis
Seborrheic dermatitis can be managed with a combination of topical treatments and lifestyle modifications.
- For scalp involvement, anti-fungal shampoos containing ketoconazole 2% can be used 2-3 times weekly.
- For facial involvement, a gentle cleanser and a low-potency topical corticosteroid like hydrocortisone 1% cream can be applied twice daily for up to two weeks.
- Anti-fungal creams containing ketoconazole can also be effective in managing symptoms. It is essential to maintain a regular skin care routine and avoid triggers like stress and extreme temperatures to prevent flare-ups 1.
From the FDA Drug Label
Seborrheic dermatitis: Ketoconazole Cream 2% should be applied to the affected area twice daily for four weeks or until clinical clearing. Uses temporarily relieves itching associated with minor skin irritations, inflammation, and rashes due to: ... seborrheic dermatitis
Treatment for Seborrheic Dermatitis:
- Ketoconazole Cream 2% can be applied twice daily for four weeks or until clinical clearing 2.
- Hydrocortisone can be used to temporarily relieve itching associated with seborrheic dermatitis 3.
From the Research
Seborrheic Dermatitis Treatment
- Seborrheic dermatitis is a chronic, recurring inflammatory skin disorder that can be treated with various therapies, including topical antifungals and anti-inflammatory agents 4.
- Oral therapies, such as itraconazole, terbinafine, and ketoconazole, can be prescribed in severe or unresponsive cases, but the quality of evidence for these treatments is generally low 5.
- Topical ketoconazole is a mainstay of therapy for seborrheic dermatitis of the face and body, while anti-inflammatory agents like topical corticosteroids and calcineurin inhibitors should be used only for short durations due to possible adverse effects 6.
Shampoo Treatments
- Ketoconazole 2% and zinc pyrithione 1% shampoos are effective in alleviating severe dandruff and seborrheic dermatitis, with ketoconazole 2% showing significantly better results 7.
- A herbal and zinc pyrithione-based shampoo and scalp lotion has also been shown to be safe and effective in treating scalp seborrheic dermatitis and dandruff 8.
Treatment Outcomes
- The clinical efficacy outcome of oral therapies for seborrheic dermatitis can vary considerably between studies, making it difficult to compare treatments directly 5.
- Topical treatments, such as ketoconazole and zinc pyrithione, have been shown to provide significant improvement in symptoms of seborrheic dermatitis, with high patient satisfaction and minimal side effects 7, 8.