From the Guidelines
Seborrheic dermatitis on the face should be treated with a combination of antifungal and anti-inflammatory medications to reduce inflammation and itch. The treatment approach involves using topical antifungal medications to reduce the amount of yeast present, and topical anti-inflammatory medications to reduce inflammation and itch, as seen in patients with seborrheic dermatitis affecting the ears, scalp, central face, and other sebaceous areas of the skin 1. Some key points to consider in the treatment of seborrheic dermatitis on the face include:
- Using gentle skin care and application of emollients to prevent secondary skin infection
- Applying topical corticosteroids and other antipruritics to reduce inflammation and itch
- Using topical antifungal medications to reduce the amount of yeast present
- Avoiding triggers like stress and harsh skincare products, maintaining good skin hygiene, and using fragrance-free moisturizers to help manage this chronic condition. It is also important to note that seborrheic dermatitis is more pronounced in patients with certain conditions, such as Down syndrome, HIV infection, and Parkinson's disease, and treatment should be tailored to the individual patient's needs 1.
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. The treatment for seborrheic dermatitis on the face is to apply Ketoconazole Cream 2% to the affected area twice daily for four weeks or until clinical clearing, as stated in the drug label 2.
From the Research
Treatment Options for Seborrheic Dermatitis on the Face
- Topical antifungal and anti-inflammatory agents are the most commonly used treatments for seborrheic dermatitis, as the primary underlying pathogenic mechanisms comprise Malassezia proliferation and inflammation 3.
- Other broadly used therapies include lithium gluconate/succinate, coal tar, salicylic acid, selenium sulfide, sodium sulfacetamide, glycerin, benzoyl peroxide, aloe vera, mud treatment, and phototherapy 3.
- Topical non-pharmacological products such as cosmetics or medical devices may improve clinical outcomes, with products containing antimicrobial and anti-inflammatory ingredients like zinc, piroctone olamine, dihydroavenanthramide, biosaccharide gum-2, and stearyl glycyrrhetinate potentially speeding up recovery and avoiding flare-ups 4.
- The use of specific cleansers, moisturizers, and sunscreens formulated as light creams or gel/creams is strongly recommended for all facial seborrheic dermatitis patients 4.
Pharmacological Treatments
- Antifungal agents such as topical ketoconazole are the mainstay of therapy for seborrheic dermatitis of the face and body 5.
- Anti-inflammatory agents like topical corticosteroids and calcineurin inhibitors should be used only for short durations due to possible adverse effects 5.
- Oral therapies can be prescribed in severe or unresponsive cases, with options including itraconazole, terbinafine, fluconazole, ketoconazole, pramiconazole, prednisone, isotretinoin, and homeopathic mineral therapy 6.
Specific Treatment Examples
- Ketoconazole gel 2% has been shown to be an effective treatment for moderate to severe seborrheic dermatitis, with a once-daily application regimen and advantages in patient acceptance and adherence to treatment 7.
- A combination gel containing ketoconazole 2% and desonide 0.05% has been compared to individual components and a vehicle control, with results suggesting that ketoconazole alone is comparable to the combination gel and desonide gel alone for up to 2 weeks after the end of treatment 7.