What are the treatment options for seborrheic dermatitis?

From the Guidelines

Seborrheic dermatitis treatment should include the use of topical antifungal medications to reduce the amount of yeast present and topical anti-inflammatory medications to reduce inflammation and itch. When managing seborrheic dermatitis, it is essential to consider the condition's chronic nature and the need for ongoing treatment to prevent flare-ups.

• Treatment options include:
  • Topical antifungal medications to reduce the amount of Malassezia yeast present, as this yeast is thought to contribute to the development of seborrheic dermatitis 1
  • Topical anti-inflammatory medications, such as corticosteroids or calcineurin inhibitors, to reduce inflammation and itch
• For mild cases, over-the-counter anti-dandruff shampoos containing ingredients like ketoconazole, selenium sulfide, or zinc pyrithione can be effective, used 2-3 times weekly
• For facial or body involvement, topical antifungal creams or hydrocortisone creams can be applied to affected areas twice daily for 1-2 weeks
• In more severe cases, prescription-strength corticosteroids or topical calcineurin inhibitors like tacrolimus 0.1% or pimecrolimus 1% may be necessary for short-term use It is crucial to maintain good skin hygiene, manage stress, and avoid harsh skin products to help prevent flare-ups and improve quality of life for individuals with seborrheic dermatitis.

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
• Key points:
  • Ketoconazole Cream 2% is applied twice daily for a recommended duration of four weeks
  • Hydrocortisone is used to relieve itching associated with seborrheic dermatitis

From the Research

Seborrheic Dermatitis Treatment Options

• Seborrheic dermatitis is a chronic, recurring inflammatory skin disorder that can be treated with various topical and oral therapies 4, 5, 6, 7, 8
• Topical antifungal and anti-inflammatory agents are the most commonly used treatments, with options including lithium gluconate/succinate, coal tar, salicylic acid, selenium sulfide, sodium sulfacetamide, glycerin, benzoyl peroxide, aloe vera, and mud treatment 4
• Alternative therapies have also been reported, such as tea tree oil, Quassia amara, and Solanum chrysotrichum 4
• Systemic therapy is reserved for widespread lesions or cases that are refractory to topical treatment 4

Topical Treatments

• Topical steroids are an effective treatment for seborrheic dermatitis of the face and scalp in adolescents and adults, with no differences between mild and strong steroids in the short-term 6
• Calcineurin inhibitors and lithium salts have also shown benefit in treating seborrheic dermatitis, with comparable efficacy to topical steroids in some cases 6
• Azoles, such as ketoconazole, are also effective in treating seborrheic dermatitis, with similar efficacy to topical steroids in some cases 5, 6

Oral Treatments

• Oral antifungals, such as itraconazole, terbinafine, and fluconazole, have been used to treat severe or unresponsive cases of seborrheic dermatitis 8
• The quality of evidence for oral treatments is generally low, and more research is needed to determine the efficacy and safety of these therapies 8

Treatment Considerations

• Treatment should be individualized based on the severity and location of the disease, as well as the patient's medical history and preferences 4, 5, 6, 7, 8
• Patients should be educated on the importance of adherence to treatment and the potential for relapse 4, 5, 6, 7, 8