From the Guidelines
Seborrheic dermatitis can be effectively managed with narrowband ultraviolet B phototherapy, as shown in a study where all patients improved or cleared with TL-01 treatment 1. When considering treatment options for seborrheic dermatitis, it's essential to prioritize morbidity, mortality, and quality of life.
- Medicated shampoos, such as those containing ketoconazole 1-2%, selenium sulfide, or zinc pyrithione, can be used 2-3 times weekly to manage mild cases.
- Topical antifungal creams, including ketoconazole 2% or hydrocortisone 1%, can be applied to affected areas twice daily for 1-2 weeks for facial or body involvement.
- For more severe cases, prescription-strength corticosteroids like fluocinolone 0.01% or desonide 0.05% may be needed for short-term use (7-10 days) to reduce inflammation.
- Topical calcineurin inhibitors, such as tacrolimus 0.1% or pimecrolimus 1%, are steroid-free alternatives for facial application. However, narrowband ultraviolet B phototherapy, specifically TL-01, has shown promise in treating seborrheic dermatitis, with all patients improving or clearing in an open, prospective study 1. It's crucial to note that seborrheic dermatitis is a chronic condition with periods of flare-ups and remission, so maintenance therapy with medicated shampoos once or twice weekly is often necessary for long-term control. The exact mechanism of seborrheic dermatitis is not fully understood, but it's believed to result from an inflammatory reaction to Malassezia yeast that naturally lives on the skin, which explains why antifungal treatments are effective 1.
From the FDA Drug Label
DOSAGE & ADMINISTRATION SECTION ... Seborrheic dermatitis: Ketoconazole Cream 2% should be applied to the affected area twice daily for four weeks or until clinical clearing. Uses temporarily relieves itching associated with minor skin irritations, inflammation, and rashes due to: ... seborrheic dermatitis The treatment options for seborrheic dermatitis include:
- Topical ketoconazole 2% cream applied twice daily for four weeks or until clinical clearing 2
- Topical hydrocortisone for temporary relief of itching associated with seborrheic dermatitis 3
From the Research
Treatment Options for Seborrheic Dermatitis
- Topical corticosteroids are a common treatment option for seborrheic dermatitis, but long-term use may lead to adverse effects 4
- Topical antifungal agents, such as ketoconazole, are also effective in treating seborrheic dermatitis, especially for lesions on the face and body 5
- Calcineurin inhibitors, such as pimecrolimus, are a non-steroidal alternative to topical steroid therapy and have been shown to be effective in treating seborrheic dermatitis 4, 6
- Sertaconazole 2% cream has been compared to hydrocortisone 1% cream and found to have a higher cure rate and patient satisfaction 6
- Lithium salts have been shown to be more effective than azoles in producing total clearance of symptoms, with a comparable safety profile 7
Topical Treatments
- Topical anti-inflammatory agents, such as steroids and calcineurin inhibitors, are effective in reducing erythema, scaling, and pruritus 7
- Azoles, such as ketoconazole, are effective in treating seborrheic dermatitis, especially for lesions on the face and body 5, 7
- Tea tree oil, honey, and cinnamic acid have antifungal activity against Malassezia species and may be of benefit in the treatment of seborrheic dermatitis 8