WHAT IS THE TREATMENT FOR SEBORRHEIC DERMATITIS?

* Be aware that the recommended treatments of illnesses are always being improved. This website was last update on 11/1/2024. The best treatment option MIGHT have changed since that time.

1. Antifungal Shampoos (eg, Ketoconazole 2% or 1%) 2x/week or more
2. Keratolytic Shampoos (Zinc Pyrithione, Selenium Sulfide, or Sulfur and Salicylic acid)

3. Tar Shampoos {OTC} used daily or every other day until dandruff is controlled and twice/week thereafter. Examples: Neutrogena T/Gel Original, DHS Tar, Doak Tar, Ionil T Plus, PC-Tar, Pentax, Polytar Shampoo, TeraGel, Zetar, and Selsun Blue

Mild Cortisone:
a. hydrocortisone butyrate 1% *
b. fluocinonide 0.05% *
c. desonide 0.05% *
d. hydrocortisone 2.5% *
e. betamethasone dipropionate 0.05% *

Antifungal Creams;
a.  2 % Ketoconazole * 
b.  2% Sertacibazike * 
c.  Econazole 1% cream MIGHT be helpful in severe cases.

Topical calcineurin inhibitors
a. Pimecrolimus 1% *
b. Tacrolimus 0.1% *
 

CAUTION:

1. Realize that there are several other disorders that look similar to Seborrheic Dermatitis for example:
A. Atopic dermatitis of the scalp. This disorder usually appears as fine, white, dry scaling rather than the greasy yellowish scale of seborrheic dermatitis.
B. Scalp psoriasis. In psoriasis the rash is usually dry, and scaly. It is also sharply demarcated.
C. Acne Rosacea. This disorder usually has bumps and pus pockets—but there is no scaling.

2. All medication, including medications for treating seborrheic dermatitis have some risk.

3. Possible mild side effects are itching and a skin rash.

4. Possible Ssevere side effects are a severe rash or an anaphylactic allergic reaction (leading to the inability to breathe and subsequent death if not treated rapidly).

Consult “Epocrates.com” for each Specific Medication’s possible “Adverse Reactions.” Side effects are also referred to as “Adverse Reactions.” Epocrates.com will tell you both “common reactions” and “serious reactions.” You will have to create an account, but it is simple, fast, and free.

WHAT ARE THE SYMPTOMS OF SEBORRHEIC DERMATITIS (ALSO CALLED DANDRUFF IF IT OCCURS ON THE SCALP?

If Seborrheic Dermatitis occurs on the scalp, we will commonly see little flakes on the hair and if the person is wearing dark clothing also on the cloths. If the scalp underlying the hair is examined closely, there may also be some redness to the scalp. We call this dandruff.

If seborrheic dermatitis occurs in the eyebrows, beard, or mustache we may see the same symptoms as that of dandruff.

If seborrheic dermatitis occurs on places where there is no hair, the skin is often red, oily, and have skin flakes or scales.

WHAT CAUSES SEBORRHEIC DERMATITIS?

The cause of Seborrheic Dermatitis is the overgrowth of a specific type of skin fungus called Malassezia. There are two species of Malassezia that usually cause Seborrheic Dermatitis (Malssezia Globosa and Malassezia Restricta). These fungi are on most peoples’ bodies. However, for some unknown reason, on some people this fungus is excessive. The reddened skin is the bodies defense mechanism to what it perceives is a foreign substance on the skin—even though it isn’t.

HOW IS SEBORRHEIC DERMATITIS DIAGNOSED?

The diagnosis of Seborrheic Dermatitis can be made by a careful history and a visual inspection.