From the Guidelines
Seborrheic dermatitis treatment should prioritize topical antifungal and anti-inflammatory medications, with consideration of phototherapy in select cases, as evidenced by the British Journal of Dermatology study 1.
Treatment Options
- Medicated shampoos: ketoconazole 1%, selenium sulfide, or zinc pyrithione, used 2-3 times weekly, as these ingredients have been shown to reduce Malassezia yeast overgrowth, a key factor in seborrheic dermatitis 1.
- Topical anti-inflammatories: hydrocortisone 1% cream, applied once or twice daily for 1-2 weeks, to control inflammation and reduce symptoms.
- Proper skin care: gentle cleansers, avoiding harsh products, and maintaining good skin hygiene to prevent flare-ups.
Severe Cases
- Prescription-strength options: ketoconazole 2% shampoo, fluocinolone 0.01% shampoo, or topical calcineurin inhibitors like pimecrolimus or tacrolimus for facial areas, as these have been shown to be effective in reducing symptoms and controlling the condition 1.
- Oral antifungals: fluconazole may be needed for resistant cases, although this should be considered on a case-by-case basis due to potential side effects.
Phototherapy
- Narrowband ultraviolet B (UVB) phototherapy, such as TL-01, may be considered for select cases, as it has been shown to be effective in treating various skin conditions, including seborrheic dermatitis, although the evidence is based on an open, uncontrolled study 1.
Key Considerations
- Maintaining a regular treatment schedule and following a comprehensive treatment plan can help prevent flare-ups and improve quality of life for patients with seborrheic dermatitis.
- It is essential to weigh the potential benefits and risks of each treatment option, considering the individual patient's needs and medical history, to ensure the best possible outcome in terms of morbidity, mortality, and quality of life.
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
The treatment options for seborrheic dermatitis include:
- Antifungal agents such as fluconazole 4 and ketoconazole 5, 6
- Anti-inflammatory agents such as topical corticosteroids and calcineurin inhibitors 5, 7
- Keratolytic agents 7
- Shampoos containing antifungal agents, anti-inflammatory agents, and keratolytic agents 5, 7
- Topical applications of anti-fungals and anti-inflammatory agents 8
Treatment Approaches
Different treatment approaches can be used depending on the severity and location of the seborrheic dermatitis, including:
- Topical therapy with clobetasol propionate 0.05% ointment and fluconazole 50 mg/day for two weeks 4
- Once-daily ketoconazole gel 2% for the treatment of moderate to severe seborrheic dermatitis 6
- A treatment algorithm that allows for the treatment of all severity grades of scalp seborrheic dermatitis 8
Considerations
When treating seborrheic dermatitis, it is important to consider the following:
- The disease is chronic and recurring, and treatment may need to be ongoing 7
- Multiple body sites are usually involved, and the physician should examine all commonly affected areas 7
- Patients should be made aware that seborrheic dermatitis is a chronic condition that will probably recur even after successful treatment 7