From the Guidelines
Seborrheic dermatitis is typically treated with a combination of medicated shampoos, topical anti-inflammatory agents, and proper skin care. The treatment approach may vary depending on the severity and location of the condition. For seborrheic areas, gels can be useful in providing symptomatic relief and promoting skin healing 1. In addition to topical treatments, patients should maintain good standards of hygiene, keep the affected area clean and dry, and avoid skin irritants such as perfumes, deodorants, or alcohol-based lotions 1. Key considerations in the management of seborrheic dermatitis include:
- Using gentle cleansers and avoiding harsh skin products
- Applying topical treatments such as gels, creams, or hydrophilic dressings as needed
- Avoiding triggers like stress and sun exposure
- Maintaining good skin hygiene and keeping the affected area clean and dry It is essential to note that seborrheic dermatitis is typically chronic, with periods of flare-ups requiring ongoing maintenance therapy. Patients should be advised to gently clean and dry the skin before applying any topical treatments, and to avoid applying topical moisturizers, gels, emulsions, and dressings shortly before radiation treatment, if applicable 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
The treatment for seborrheic dermatitis includes:
- Applying Ketoconazole Cream 2% to the affected area twice daily for four weeks or until clinical clearing 2
- Using hydrocortisone to temporarily relieve itching associated with seborrheic dermatitis 3
From the Research
Treatment Options for Seborrheic Dermatitis
- Topical antifungal and anti-inflammatory agents are the most commonly used treatments for seborrheic dermatitis, as they target the primary underlying pathogenic mechanisms of Malassezia proliferation and inflammation 4.
- Topical corticosteroids, such as hydrocortisone 1% cream, can be effective in treating facial seborrheic dermatitis, with significant improvement in SD lesions and a similar rate of adverse events compared to antifungal treatments 5.
- Antifungal agents, such as ketoconazole, can be used to treat seborrheic dermatitis of the face and body, and are the mainstay of therapy 6.
- Over-the-counter shampoos, including antifungal shampoos, can be used to treat seborrheic dermatitis of the scalp, with topical corticosteroids used as second-line agents for short-term treatment 6.
- Oral therapies, such as itraconazole, terbinafine, and fluconazole, can be prescribed in severe or unresponsive cases of seborrheic dermatitis, with varying dosing regimens and efficacy outcomes 7.
Comparison of Treatment Efficacy
- A double-blind, randomized clinical trial found that sertaconazole 2% cream and hydrocortisone 1% cream had similar efficacy in treating facial seborrheic dermatitis, with significant improvement in SD lesions and a similar rate of adverse events 5.
- A double-blind trial found that 2% ketoconazole cream and 1% hydrocortisone cream had similar symptomatic improvement in treating seborrhoeic dermatitis, with a significant reduction in P. ovale yeasts after ketoconazole application 8.
Considerations for Treatment
- Treatment with topical corticosteroids and calcineurin inhibitors should be used only for short durations due to possible adverse effects 6.
- The quality of evidence for oral therapies is generally low, and clinical efficacy outcomes vary considerably between studies, preventing statistical analysis and direct comparison between treatments 7.