Topical treatments for seborrhoeic dermatitis of the scalp – need for more evidence
3 Sep, 15 | by BMJ
By Janouk Diphoorn and Luigi Naldi
Seborrhoeic dermatitis is one of the most common skin conditions. It occurs in 3 to 10% of the population. The scalp is one of the areas most frequently involved. For people with seborrhoeic dermatitis of the scalp it can be very distressing since there is itching and visible scaling, which can cause social embarrassment.
As the condition tends to relapse after treatment, it is important to consider maintenance treatment after clearance. Nowadays the most used treatment in clinical practice is ketoconazole, which is thought to inhibit the Malessezia furfur yeasts considered to play a role in the development of this condition. For the acute phase corticosteroids are often added to inhibit the inflammatory reaction.
In general there is limited evidence available on the treatment of seborrhoeic dermatitis of the scalp with topical agents. This is unfortunate as it is such a common condition. Only ketoconazole and ciclopirox were studied in multiple RCT’s that met the inclusion criteria for our recent BMJ Clinical Evidence systematic overview. For other topical treatments such as bifonazole, selenium sulfide, tar shampoo and corticosteroids the evidence was much sparser. more…