From the Guidelines
Seborrheic dermatitis is typically treated with a combination of medicated shampoos, topical anti-inflammatory agents, and proper skin care. For mild cases, over-the-counter antifungal shampoos containing ketoconazole 1%, selenium sulfide, or zinc pyrithione should be used 2-3 times weekly, leaving the shampoo on the affected areas for 5-10 minutes before rinsing. The provided evidence does not directly address the treatment of seborrheic dermatitis, however, it does mention that gels can be useful in seborrhoeic areas 1. Some key points to consider when treating seborrheic dermatitis include:
- Using gentle cleansers and avoiding harsh skin products
- Maintaining good skin hygiene without over-washing
- Avoiding triggers like stress
- Using topical antifungal creams or corticosteroids for facial or body involvement
- Considering prescription-strength options for more severe cases, such as fluocinolone 0.01% shampoo or topical calcineurin inhibitors like tacrolimus 0.1% ointment or pimecrolimus 1% cream. It is essential to note that seborrheic dermatitis tends to recur, and maintenance therapy is crucial to manage the condition effectively.
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
The treatment for seborrheic dermatitis includes various options, such as:
- Application of selenium sulfide, pyrithione zinc or ketoconazole-containing shampoos 4
- Topical ketoconazole cream or terbinafine solution 4
- Topical sodium sulfacetamide and topical corticosteroids 4
- Antifungal agents, including azoles, allylamines, benzylamines, hydroxypyridones, and immunomodulators 5
- Tea tree oil, honey, and cinnamic acid, which have antifungal activity against Malassezia species 5
- Oral therapy, such as ketoconazole, itraconazole, and terbinafine, for widespread cases 5
- Medicated shampoos, which contain active ingredients related to antimycotic or anti-inflammatory effects 6
- Ketoconazole shampoo, which is a promising treatment option for seborrheic dermatitis of the scalp 7
- Ciclopirox shampoo, which combines anti-Malassezia activity with an anti-inflammatory action 8
Mechanism of Treatment
The treatment of seborrheic dermatitis aims to reduce the number of yeasts on the skin, leading to an improvement in the condition 5. Antifungal therapy, such as ketoconazole shampoo, has been shown to be effective in reducing irritation and scaling of scalp seborrheic dermatitis 7. Additionally, medicated shampoos can help control yeast elimination and inflammation 6.
Safety and Efficacy
Most studies report optimally low relapse rates and little to no side effects with ketoconazole shampoo treatment 7. Ciclopirox shampoo has also been shown to be an effective and safe treatment for seborrheic dermatitis of the scalp 8. Overall, the treatment options for seborrheic dermatitis are safe and effective, and can help improve the quality of life for individuals affected by this condition 4, 5, 7, 8