From the Guidelines
For seborrheic dermatitis, the best medication approach typically involves antifungal and anti-inflammatory treatments, with ketoconazole 2% shampoo being a first-line treatment, used 2-3 times weekly for the scalp and face, leaving it on for 3-5 minutes before rinsing 1.
Treatment Overview
The treatment of seborrheic dermatitis focuses on reducing the symptoms and preventing flare-ups.
- Antifungal medications, such as ketoconazole, are used to target the Malassezia yeast that triggers the inflammatory response.
- Anti-inflammatory medications, such as hydrocortisone cream, are used to control inflammation and itching.
Medication Options
- Ketoconazole 2% cream can be applied once or twice daily for 2-4 weeks for facial involvement 1.
- Hydrocortisone 1% cream can be used for short periods (7-10 days) to control inflammation.
- For more severe cases, prescription-strength corticosteroids like fluocinolone 0.01% solution may be needed, though these should be used sparingly to avoid skin thinning.
- Selenium sulfide 1% or zinc pyrithione shampoos are good alternatives, used 2-3 times weekly.
Maintenance Therapy
Maintenance therapy is often necessary, as seborrheic dermatitis tends to recur.
- Using antifungal shampoo once or twice weekly after the condition clears can help prevent flare-ups.
- It is essential to note that the provided evidence does not directly support the use of narrowband ultraviolet B phototherapy for seborrheic dermatitis, as the study primarily focuses on its use in psoriasis and atopic eczema 1.
Important Considerations
- The treatment approach may vary depending on the severity and location of the condition.
- It is crucial to follow the recommended treatment regimen and consult a healthcare professional for proper guidance and management of seborrheic dermatitis.
From the FDA Drug Label
Ketoconazole Cream 2% should be applied to the affected area twice daily for four weeks or until clinical clearing. Ketoconazole Cream 2% is indicated for the topical treatment of ... seborrheic dermatitis.
The best medication for seborrheic dermatitis, according to the provided drug labels, is Ketoconazole Cream 2% 2 2.
- It is applied twice daily to the affected area.
- Treatment duration is four weeks or until clinical clearing.
From the Research
Treatment Options for Seborrheic Dermatitis
- Topical corticosteroids and antifungals are commonly used to treat seborrheic dermatitis 3
- Oral therapies, such as itraconazole, terbinafine, and ketoconazole, can be prescribed in severe or unresponsive cases 3
- Ketoconazole therapy has been associated with more relapses compared to other treatments 3
Comparison of Treatments
- A study comparing ciclopiroxolamine 1% cream and ketoconazole 2% foaming gel found that ciclopiroxolamine was non-inferior to ketoconazole in treating mild to moderate facial seborrheic dermatitis 4
- Another study found that once-daily ketoconazole 2% gel was effective and well-tolerated in treating moderate to severe seborrheic dermatitis 5
- A double-blind trial comparing 2% ketoconazole cream and 1% hydrocortisone cream found that both treatments resulted in significant symptomatic improvement, but ketoconazole reduced the number of P. ovale yeasts more effectively 6
Recommended Treatments
- Antifungal agents, such as topical ketoconazole, are the mainstay of therapy for seborrheic dermatitis of the face and body 7
- Over-the-counter shampoos, such as antifungal shampoos, can be used to treat seborrheic dermatitis of the scalp 7
- Topical corticosteroids and calcineurin inhibitors can be used for short durations to treat seborrheic dermatitis, but may have adverse effects 7