From the Guidelines
Seborrheic dermatitis of the scalp is a common condition characterized by greasy yellowish scaling, itching, and secondary inflammation from Malassezia yeast. This condition typically affects areas with many oil glands, particularly the scalp, and can range from mild dandruff to more severe inflammation. According to the study 1, seborrheic dermatitis is more pronounced in patients with Down syndrome, HIV infection, and Parkinson's disease. The treatment for seborrheic dermatitis of the scalp includes the use of topical antifungal medications to reduce the amount of yeast present and topical anti-inflammatory medications to reduce inflammation and itch.
Some key features of seborrheic dermatitis of the scalp include:
- Greasy yellowish scaling
- Itching
- Secondary inflammation from Malassezia yeast
- More pronounced in patients with certain medical conditions such as Down syndrome, HIV infection, and Parkinson's disease
- Treatment with topical antifungal and anti-inflammatory medications
It is essential to note that seborrheic dermatitis cannot be cured, but it can be effectively managed with consistent treatment, proper scalp hygiene, and stress management. As stated in the study 1, management of seborrheic dermatitis includes gentle skin care, application of emollients, prevention of secondary skin infection, and the use of topical corticosteroids and other antipruritics. Topical antifungal medications and anti-inflammatory medications are the primary treatment options for seborrheic dermatitis of the scalp, and they should be used under the guidance of a healthcare professional to ensure proper management of the condition.
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. Seborrheic dermatitis of the scalp is a condition that can be treated with Ketoconazole Cream 2%.
- Treatment duration: twice daily for four weeks or until clinical clearing.
- Application: to the affected area on the scalp. 2
From the Research
Definition and Symptoms
- Seborrheic dermatitis (SD) is a common skin disease characterized by flaky, "greasy" patches, and/or thin plaques accompanied by erythema of the scalp, face, ears, chest, and groin 3.
- The presentation may vary in different skin types and hyper- or hypopigmentation may occur, with or without erythema and minimal or no scaling 3.
- The characteristic symptoms of seborrheic dermatitis include scaling, erythema, and itching, which occur most often on the scalp, face, chest, back, axilla, and groin 4.
Causes and Pathogenesis
- The pathogenesis of seborrheic dermatitis is not certain, but 3 key factors are generally agreed upon: lipid secretion by sebaceous glands, Malassezia spp. colonization, and some form of immunologic dysregulation that predisposes the patient to SD 3.
- Lipophilic yeasts of the Malassezia genus, as well as genetic, environmental, and general health factors, contribute to this disorder 5.
Treatment Options
- Treatment involves reducing proliferation of, and inflammatory response to, Malassezia spp. Topical therapies, including antifungal agents and low potency corticosteroids, are the mainstay of treatment 3.
- Several over-the-counter shampoos are available for treatment of seborrheic dermatitis of the scalp, and patients should be directed to initiate therapy with one of these agents 4.
- Ketoconazole shampoo is a topical antifungal that is a promising treatment option for individuals affected by seborrheic dermatitis of the scalp, with numerous trials displaying significant improvement in irritation and scaling 6.
Scalp Seborrheic Dermatitis
- Scalp seborrhea varies from mild dandruff to dense, diffuse, adherent scale 5.
- Seborrheic dermatitis of the scalp is characterized by itchy, sensitive patches of greasy, flaky skin, with cases ranging from asymptomatic to debilitating 6.
- Antifungal shampoos (long-term) and topical corticosteroids (short-term) can be used as second-line agents for treatment of scalp seborrheic dermatitis 4.