How to manage small patches of seborrheic (sebaceous) dermatitis?

From the Guidelines

To manage small patches of seborrheic dermatitis, treatment includes the use of topical antifungal medications to reduce the amount of yeast present and topical anti-inflammatory medications to reduce inflammation and itch. When considering management options, it's essential to prioritize treatments that address the underlying causes of seborrheic dermatitis, such as the presence of Malassezia yeast [ 1 ]. Some key considerations for treatment include:

• Gentle skin care to prevent irritation and secondary infection
• Application of emollients to moisturize the skin
• Use of topical antifungal medications, such as ketoconazole, to reduce yeast presence
• Use of topical anti-inflammatory medications, such as hydrocortisone cream, to reduce inflammation and itching [ 1 ]. It's also crucial to identify and avoid triggers that can exacerbate the condition, such as stress, harsh skincare products, and extreme temperatures. If symptoms persist or worsen despite treatment, consultation with a healthcare provider may be necessary to explore prescription-strength medications or alternative treatment options [ 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. For small patches of seborrheic dermatitis, the management involves applying Ketoconazole Cream 2% to the affected area twice daily for four weeks or until clinical clearing 2.

• Apply the cream to the affected area
• Use twice daily
• Treat for four weeks or until clinical clearing If a patient shows no clinical improvement after the treatment period, the diagnosis should be redetermined.

From the Research

Managing Small Patches of Seborrheic Dermatitis

To manage small patches of seborrheic dermatitis, the following treatment options can be considered:

• Topical antifungal agents such as ketoconazole, ciclopirox, and clotrimazole 3, 4, 5
• Anti-inflammatory agents like mild-to-moderate potency corticosteroids and calcineurin inhibitors 3, 4, 5
• Keratolytic/humectant agents such as propylene glycol 3
• Lithium succinate/gluconate and topical calcineurin inhibitors (off-label use) 3

Treatment Approaches

Treatment approaches for seborrheic dermatitis focus on:

• Clearing signs of the disease
• Ameliorating associated symptoms like pruritus
• Maintaining remission with long-term therapy 4
• Using topical agents and shampoos containing antifungal agents, anti-inflammatory agents, keratolytic agents, and calcineurin inhibitors 6

Considerations

When managing small patches of seborrheic dermatitis, it is essential to:

• Examine all commonly affected areas, as multiple body sites are usually involved 6
• Be aware that seborrheic dermatitis is a chronic condition that will probably recur even after successful treatment 6
• Consider the use of over-the-counter shampoos and topical agents as first-line treatments 5