From the FDA Drug Label
Ketoconazole Cream 2% should be applied to the affected area twice daily for four weeks or until clinical clearing. The best treatment for seborrheic dermatitis is applying Ketoconazole Cream 2% twice daily to the affected area for four weeks or until clinical clearing, as stated in the drug label 1.
- The treatment should be applied twice daily.
- The treatment duration is for four weeks or until clinical clearing.
- If no clinical improvement is seen after the treatment period, the diagnosis should be redetermined.
From the Research
The best treatment for seborrheic dermatitis is typically an over-the-counter anti-dandruff shampoo containing one of these active ingredients: zinc pyrithione, selenium sulfide, ketoconazole, or salicylic acid, with ketoconazole 2% shampoo being the most effective option, as shown in a multicenter randomized trial 2. Start with a medicated shampoo containing 2% ketoconazole, used 2-3 times per week. Apply to the scalp, massage gently, and leave on for 5 minutes before rinsing. Continue this regimen for at least 2-4 weeks. If symptoms persist, try alternating with a shampoo containing 1% selenium sulfide or 1% zinc pyrithione, following the same usage instructions. For severe cases, consider a prescription-strength ketoconazole shampoo (2%). These ingredients work by reducing the fungus Malassezia, which contributes to seborrheic dermatitis, and by helping to remove dead skin cells from the scalp. Salicylic acid-based shampoos can help if there's significant scalp buildup. In addition to medicated shampoos, maintain good scalp hygiene by washing your hair regularly, especially after sweating. Manage stress and maintain a balanced diet, as these factors can influence seborrheic dermatitis severity. Some studies have also shown that a combination of antidandruff actives and conditioning silicones can provide superior efficacy and desired end sensory benefits, ensuring compliance and longer-term seborrheic dermatitis removal 3. It's worth noting that other ingredients like piroctone olamine and climbazole have also shown efficacy in treating seborrheic dermatitis, but the evidence is not as strong as for ketoconazole 2% shampoo 4, 3. If seborrheic dermatitis persists or worsens despite these measures, consult a dermatologist, as it may indicate a more serious scalp condition requiring prescription treatment.