From the Guidelines
Seborrheic dermatitis can be effectively managed with topical antifungal medications and anti-inflammatory medications to reduce inflammation and itch. The treatment approach should focus on reducing the amount of yeast present and alleviating symptoms.
- For seborrheic dermatitis, treatment includes the use of topical antifungal medications to reduce the amount of yeast present and topical anti-inflammatory medications to reduce inflammation and itch, as mentioned in the study 1.
- Topical corticosteroids can also be used to manage symptoms, but their use should be limited to short-term periods to avoid side effects.
- The condition tends to be chronic with periods of flare-ups and remission, so maintenance therapy with topical antifungal medications may be necessary for long-term control.
- It is essential to note that seborrheic dermatitis is more pronounced in patients with certain conditions, such as Down syndrome, HIV infection, and Parkinson's disease, and these patients may require more aggressive treatment and monitoring.
- In addition to topical treatments, gentle skin care and application of emollients can help manage symptoms and prevent secondary skin infections.
- The use of medicated shampoos, such as those containing ketoconazole or selenium sulfide, can also be effective in managing seborrheic dermatitis, especially for scalp involvement.
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. Uses temporarily relieves itching associated with minor skin irritations, inflammation, and rashes due to: ... seborrheic dermatitis
Treatment options for seborrheic dermatitis include:
- Ketoconazole Cream 2% applied twice daily for four weeks or until clinical clearing 2
- Hydrocortisone to temporarily relieve itching associated with seborrheic dermatitis 3
From the Research
Treatment Options for Seborrheic Dermatitis
- 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 4
- 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 4
- Alternative therapies have also been reported, such as tea tree oil, Quassia amara, and Solanum chrysotrichum 4
Specific Treatment Regimens
- A combination therapy of clobetasol propionate shampoo 0·05% and ketoconazole shampoo 2% has been shown to be efficacious and safe in the treatment of moderate to severe scalp seborrhoeic dermatitis 5
- Hydrocortisone 1% cream and sertaconazole 2% cream have been compared in a double-blind, randomized clinical trial, with both treatments resulting in significant improvement of facial seborrheic dermatitis lesions 6
- Topical ketoconazole is the mainstay of therapy for seborrheic dermatitis of the face and body, while anti-inflammatory agents such as topical corticosteroids and calcineurin inhibitors should be used only for short durations due to possible adverse effects 7
Treatment for Specific Areas
- For scalp seborrheic dermatitis, several over-the-counter shampoos are available, and patients should be directed to initiate therapy with one of these agents 7
- Antifungal shampoos (long-term) and topical corticosteroids (short-term) can be used as second-line agents for treatment of scalp seborrheic dermatitis 7
- Facial and trunk seborrhea can be treated with topical ketoconazole cream or terbinafine solution, topical sodium sulfacetamide, and topical corticosteroids 8