From the Guidelines
Seborrheic dermatitis should be treated with topical antifungal medications, such as ketoconazole 2% cream, and gentle skin care to reduce inflammation and prevent secondary skin infections, as recommended by the most recent and highest quality studies 1. To manage seborrheic dermatitis, it is essential to:
- Use anti-dandruff shampoos containing ketoconazole 2%, selenium sulfide 1%, or zinc pyrithione, 2-3 times weekly, applied to affected areas for 5-10 minutes before rinsing
- Apply topical antifungal creams like ketoconazole 2% cream once or twice daily for facial or body involvement
- Use mild topical corticosteroids like hydrocortisone 1% sparingly for up to 7 days to reduce inflammation in more severe cases
- Maintain good skin hygiene, avoiding harsh soaps and reducing stress, which can trigger flares
- Avoid irritants, such as perfumes, deodorants, or alcohol-based lotions, and minimize sun exposure The condition is believed to be caused by an inflammatory reaction to Malassezia yeast, combined with genetic factors and immune system responses, as noted in studies 1. While seborrheic dermatitis is chronic and may recur, these treatments can effectively manage symptoms when used consistently, as supported by the evidence 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.
- Treatment duration: 4 weeks or until clinical clearing
- Application frequency: Twice daily
- Drug: Ketoconazole Cream 2% 2 is used for seborrheic dermatitis.
From the Research
Symptoms and Diagnosis of Seborrheic Dermatitis
- Seborrheic dermatitis is a common skin condition characterized by scaling, erythema, and itching, typically occurring on the scalp, face, chest, back, axilla, and groin 3.
- The condition is thought to result from an inflammatory response to Malassezia yeast, a common skin organism 3, 4.
Treatment Options for Seborrheic Dermatitis
- Topical antifungal agents, such as ketoconazole, are the mainstay of therapy for seborrheic dermatitis of the face and body 3, 5.
- Anti-inflammatory agents, such as topical corticosteroids and calcineurin inhibitors, can be used for short durations due to possible adverse effects 3.
- Over-the-counter shampoos, including antifungal shampoos, are available for treatment of seborrheic dermatitis of the scalp 3, 6.
- Systemic therapy, including oral antifungals, can be prescribed in severe or unresponsive cases 7.
Efficacy of Ketoconazole in Treating Seborrheic Dermatitis
- Ketoconazole shampoo has been shown to be a safe and effective treatment for seborrheic dermatitis of the scalp, with significant improvement in irritation and scaling 6.
- Ketoconazole gel 2% has been found to be an effective treatment for moderate to severe seborrheic dermatitis, with a significant proportion of subjects considered effectively treated 5.
- The efficacy of ketoconazole alone has been found to be comparable to combination therapy with desonide gel alone for up to 2 weeks after the end of treatment 5.