From the Guidelines
For treating seborrheic dermatitis, I strongly recommend using medicated shampoos containing active ingredients such as ketoconazole 1-2%, selenium sulfide 1%, zinc pyrithione 1-2%, coal tar, or salicylic acid, as they have been shown to effectively target the Malassezia yeast and reduce inflammation 1. When selecting a treatment shampoo, consider the following options:
- Ketoconazole 1-2%: Start with ketoconazole shampoo (like Nizoral) twice weekly, applying it to wet hair, lathering, and leaving it on for 3-5 minutes before rinsing thoroughly.
- Selenium sulfide 1%: Can be used as an alternative to ketoconazole, with similar application instructions.
- Zinc pyrithione 1-2%: Can be used in combination with ketoconazole or as an alternative, applying it to wet hair and leaving it on for 3-5 minutes before rinsing.
- Coal tar: Can be used as a shampoo or in combination with other treatments, but be aware of potential adverse effects such as folliculitis, irritation, and photosensitivity 1.
- Salicylic acid: Can be used as an alternative to other ingredients, but be cautious of potential irritation and dryness. It's essential to note that the treatment of seborrheic dermatitis should prioritize reducing inflammation and controlling scale buildup, while also considering the potential risks and benefits of each treatment option 1. For persistent or severe cases, consider prescription-strength options like ketoconazole 2% or adding a mild topical corticosteroid solution for short-term use. Using lukewarm water (not hot) and avoiding hair products with alcohols and fragrances can help prevent irritation and flare-ups. Regular follow-up with a healthcare professional is crucial to monitor the effectiveness of the treatment and adjust the regimen as needed.
From the FDA Drug Label
For treatment of dandruff and seborrheic dermatitis of the scalp. Massage 1 or 2 teaspoonfuls of shampoo into wet scalp. Allow to remain on scalp for 2 to 3 minutes. Rinse scalp thoroughly. Repeat application and rinse thoroughly.
- Treatment: Selenium sulfide shampoo can be used to treat seborrheic dermatitis of the scalp.
- Application: Massage 1 or 2 teaspoonfuls into wet scalp, leave on for 2 to 3 minutes, then rinse thoroughly.
- Repeat: Repeat application and rinse thoroughly, with repeat treatments as directed by a physician 2.
From the Research
Seborrheic Dermatitis Treatment Shampoos
- Seborrheic dermatitis is a chronic, recurring inflammatory skin disorder that can be treated with various shampoos, including those containing antifungal and anti-inflammatory agents 3.
- Topical antifungals, such as ketoconazole, are commonly used to treat seborrheic dermatitis, as they help to reduce the proliferation of Malassezia species, which are thought to contribute to the development of the condition 4, 5.
- Ketoconazole shampoo 2% has been shown to be effective in reducing the symptoms of seborrheic dermatitis, including erythema, scaling, and itching 4, 5.
- Other shampoos, such as those containing selenium disulfide, have also been found to be effective in treating seborrheic dermatitis, with some studies suggesting that they may be as effective as ketoconazole shampoo 6.
- Combination therapies, such as using a shampoo containing clobetasol propionate and ketoconazole, may also be effective in treating seborrheic dermatitis, particularly in cases where the condition is moderate to severe 4.
Treatment Options
- Over-the-counter shampoos are available for the treatment of seborrheic dermatitis of the scalp, and patients should be directed to initiate therapy with one of these agents 7.
- Antifungal shampoos, such as those containing ketoconazole or selenium disulfide, can be used as first-line agents for the treatment of scalp seborrheic dermatitis 7, 6.
- Topical corticosteroids can be used as second-line agents for the treatment of scalp seborrheic dermatitis, but should be used for short durations due to the risk of adverse effects 7.
Efficacy and Safety
- Studies have shown that shampoos containing ketoconazole or selenium disulfide are effective in reducing the symptoms of seborrheic dermatitis, with significant improvements in erythema, scaling, and itching 4, 5, 6.
- These shampoos have also been found to be well-tolerated, with low incidences of adverse events, such as skin atrophy, telangiectasia, and burning 4, 6.