From the Guidelines
For scalp seborrheic dermatitis, I recommend using topical antifungal medications and topical anti-inflammatory medications to reduce inflammation and itch, as well as medicated shampoos containing active ingredients such as ketoconazole 1-2% or zinc pyrithione. When considering treatment options, it's essential to prioritize reducing Malassezia yeast overgrowth and decreasing inflammation on the scalp.
- Medicated shampoos can be used 2-3 times weekly, leaving them on the scalp for 5-10 minutes before rinsing thoroughly, as seen in the management of seborrheic dermatitis 1.
- Topical corticosteroid solutions or foams like fluocinolone 0.01% or clobetasol 0.05% can be applied directly to affected areas once or twice daily for 1-2 weeks for more severe cases.
- Antifungal creams containing ketoconazole or ciclopirox may also help when applied to the scalp, as they work by reducing Malassezia yeast overgrowth and controlling oil production on the scalp. It's crucial to maintain a consistent treatment regimen, as seborrheic dermatitis tends to recur, and identifying triggers such as stress, certain skincare products, or extreme weather conditions can help manage symptoms 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. temporarily relieves itching associated with minor skin irritations, inflammation, and rashes due to: ... seborrheic dermatitis For scalp seborrheic dermatitis, you can use:
- Ketoconazole Cream 2% applied to the affected area twice daily for four weeks or until clinical clearing 2
- Hydrocortisone to temporarily relieve itching associated with seborrheic dermatitis 3
From the Research
Treatment Options for Scalp Seborrheic Dermatitis
- Ketoconazole shampoo is a promising treatment option for scalp seborrheic dermatitis, as it has been shown to significantly improve irritation and scaling with minimal side effects 4
- Other topical treatments that have been studied for their effectiveness in treating scalp seborrheic dermatitis include:
- Bifonazole
- Ciclopirox
- Pyrithione zinc
- Selenium sulfide
- Tar shampoo
- Terbinafine
- Topical corticosteroids (such as betamethasone valerate, clobetasol propionate, clobetasone butyrate, hydrocortisone, and mometasone furoate) 5
Mechanism of Action
- Malassezia yeast species are thought to be the responsible organisms for seborrheic dermatitis, causing inflammation through poorly defined mechanisms 5