From the Research
Oral treatment for seborrheic dermatitis should prioritize antifungal medications, with terbinafine being a more effective option compared to fluconazole, as shown in a study published in 2014 1. When considering oral treatments for seborrheic dermatitis, it's essential to weigh the benefits and risks of each option.
- Antifungal medications like terbinafine (250mg daily) or fluconazole (300mg weekly) are effective in reducing the severity of seborrheic dermatitis by targeting the Malassezia yeast that contributes to the condition.
- For severe or widespread cases, short courses of oral corticosteroids such as prednisone (10-60mg daily, tapered over 2-3 weeks) may be prescribed to quickly reduce inflammation.
- In cases with significant bacterial involvement, antibiotics like doxycycline (100mg twice daily for 2-4 weeks) might be used.
- Isotretinoin (0.1-0.3mg/kg daily for several months) can be considered for severe, recalcitrant cases. These oral treatments are typically reserved for moderate to severe seborrheic dermatitis that hasn't responded to topical therapies. Patients should be aware of potential side effects:
- Antifungals may cause gastrointestinal upset and liver enzyme elevations.
- Corticosteroids can lead to mood changes and increased blood sugar.
- Isotretinoin requires monitoring for multiple side effects, including lipid abnormalities and teratogenicity in women of childbearing potential, as noted in various studies 2, 3, 4, 5.