Seborrheic Dermatitis Treatment and Dandruff Treatment
Mild to moderate facial seborrheic dermatitis may respond well to topical antifungal creams or gels (Loprox) applied daily. Daily facial washing with antidandruff shampoo or soaps containing zinc pyrithione or selenium sulfide is also effective. Group VI or VII topical steroid creams or lotions applied b.i.d. for several days may be required periodically for control. Off-label use of Protopic 0.1% ointment or Elidel 1% cream applied daily are effective long-term alternatives to topical steroids.
Mild to moderate scalp involvement is best managed with frequent and extended shampooing with antidandruff shampoos. Effective formulations may contain ketoconazole coal tar, salicylic acid, selenium sulfide, zinc pyrithione, or sulfur. Dense, thick, adherent scale is removed by applying warm mineral or olive oil to the scalp and washing several hours later. At bedtime apply 10% liquor carbonis detergens (LCD) in Nivea oil or Derma-Smoothe FS lotion (peanut oil, mineral oil, fluocinolone acetonide 0.01%) to the scalp and wash out in the morning. Wetting the scalp prior to application and using a shower cap will help penetration.
Blepharitis may be suppressed by lid massage and frequent washing with zinc- or tar-containing antidandruff shampoos.
Severe cases may require oral antifungal therapy to eradicate Pityrosporum ovale. Antifungal therapy includes ]ketoconazole (200 mg q.d.) or fluconazole (150 mg q.d.) or itraconazole (200 mg q.d.) for 1 or 2 weeks.