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The skin discoloration, itching, and flaking caused by seborrheic dermatitis can be frustrating, but you have options for relief. Whether you’re looking for gentle shampoos and creams from the drugstore or need a prescription from your doctor, there are many effective ways to manage this skin condition.
For some people, simple skin care routines and over-the-counter (OTC) products bring relief. For others, prescription treatments offer extra help. Let’s explore the range of treatments that can help you take control of seborrheic dermatitis and feel more comfortable in your skin.
Seborrheic dermatitis is a type of eczema that causes dandruff and inflamed patches of scaly skin, particularly on the face and scalp. Doctors aren’t quite sure what causes seborrheic dermatitis. It may be from a combination of:
Seborrheic dermatitis treatment focuses on reducing discoloration, itchiness, and scaling while improving the skin’s overall appearance. Sometimes, a combination of a few different treatments is the most effective. Your dermatologist will recommend treatment based on how much and what parts of your skin are affected, and the severity of your symptoms.
Some topical medications called antifungals target yeast overgrowth. Other topicals like corticosteroids and phosphodiesterase 4 (PDE4) inhibitors target inflammation. Seborrheic dermatitis might not require prescription treatment, but if symptoms are affecting your daily life, ask a healthcare provider about your options.
Treatment options for mild cases of seborrheic dermatitis are typically found over the counter in pharmacies and grocery stores. For seborrheic dermatitis on the scalp, Mayo Clinic recommends trying shampoos that include ingredients such as:
For mild seborrheic dermatitis, stronger antifungal shampoos can be prescribed by your healthcare provider. Examples include ketoconazole 2 percent or ciclopirox. These shampoos are used a few times a week to initially clear your skin. Afterward, they can be used once a week as a maintenance treatment to help prevent flare-ups. Healthcare providers may also prescribe steroid-containing shampoos.
You may have to try a few different shampoos before finding one that works for you. If your skin becomes used to one shampoo, changing to another may help treat your symptoms. When shampooing, massage the shampoo thoroughly into your scalp and leave it for five to 10 minutes before rinsing it out. This helps the medication absorb into the skin.
Practicing gentle skin care that fits your skin’s needs can also help you manage mild seborrheic dermatitis symptoms. Wash your skin regularly with warm (not hot) water and a gentle cleanser to help prevent irritation. While your skin is still warm and damp, apply a moisturizer to keep your skin hydrated. During flare-ups, try to avoid using styling products like gels or hairsprays, or products containing alcohol, as these can irritate your skin.
If you have facial hair, be sure to shampoo it on a regular basis. Seborrheic dermatitis symptoms may worsen under beards or mustaches for some people. You may use a medicated shampoo if needed.
If you have scaly or inflamed skin around your eyes, you can gently wash them every night with warm water and baby shampoo. Use a cotton swab to wipe away any scales or skin flakes. Washing off the scales is part of the treatment.
If your seborrheic dermatitis doesn’t improve with OTC treatments, your doctor may prescribe a topical or oral medication. There are several options, and your healthcare provider might recommend trying different products.
Corticosteroids help address inflammation and itching from seborrheic dermatitis. They are formulated into shampoos, solutions, oils, ointments, and creams to treat skin inflammation, itchiness, and discoloration. Examples include:
Topical corticosteroids should not be used continuously for long periods of time because they can cause side effects like skin thinning and loss of skin color. They are also not advised for use on certain areas of the body and face. For example, only a low-potency corticosteroid might be recommended for symptoms on the face, where the skin is more sensitive. Be sure to closely follow your healthcare provider’s instructions when using these treatments.
Antifungal treatments target yeast overgrowth, which may contribute to seborrheic dermatitis. They come as topical and oral medications.
Topical antifungal treatment options may come as shampoos, creams, lotions, or foams. They may be applied to the affected skin twice daily for two to eight weeks, but you should follow your healthcare provider’s instructions for your specific case. Some topical antifungals include ciclopirox and ketoconazole.
In severe cases of seborrheic dermatitis that don’t respond to other therapies, you may be prescribed an antifungal medication as a pill. These medications include:
You may be prescribed an oral antifungal medication to take for one or several weeks. Follow the instructions on the medication label and ask your healthcare provider or a pharmacist any questions.
Topical calcineurin inhibitors may be used when corticosteroids don’t work to improve your symptoms. They help control skin inflammation and also have fewer side effects than corticosteroids. Examples include tacrolimus ointment and pimecrolimus cream. They are usually applied to the affected skin twice daily.
Possible side effects include skin burning and irritation where the medication is applied.
Another class of medications used to treat moderate to severe seborrheic dermatitis includes the phosphodiesterase-4 inhibitors. Like calcineurin inhibitors, they have fewer side effects than corticosteroids and may be used when topical corticosteroids don’t work.
Phosphodiesterase is a chemical in the body that plays a key role in causing inflammation. By blocking PDE4, this class of drugs can decrease the inflammation that causes seborrheic dermatitis and other skin conditions, like psoriasis and eczema.
The only PDE4 inhibitor approved by the U.S. Food and Drug Administration (FDA) to treat seborrheic dermatitis is roflumilast (Zoryve). For people aged 9 and over with seborrheic dermatitis, this is available as a 0.3 percent foam.
Reported side effects of roflumilast include cold symptoms, nausea, and headache.
Depending on the type of topical you’re prescribed, you may use it daily or twice daily for two weeks, then continue using it twice a week to keep your skin clear. Other topical solutions and foams may be used every day for up to two weeks at a time.
Because the topicals may leave a residue on your hair, discuss with your doctor which formulation will be best for you.
Seborrheic dermatitis that develops in infants is also known as cradle cap. This condition is common and tends to get better on its own within a few weeks or months after an infant is born. However, some infants may have long-term symptoms such as skin flaking, thick crusts, or scaling.
Washing your baby’s scalp gently with baby shampoo daily will help treat cradle cap. While shampooing, use a soft brush to massage the scalp, which helps loosen crusts and scales. In cases of heavy scaling, apply mineral oil or petroleum jelly (such as Vaseline) onto the scalp a few hours before bathtime. This helps moisten and soften the skin to loosen scales.
In more severe cases, your baby’s pediatrician may prescribe a low-dose steroid cream such as hydrocortisone or an antifungal shampoo containing ketoconazole to help. When using medicated shampoos, take extra care not to let any get in your baby’s eyes. Don’t use medicated OTC shampoos on your infant without the guidance and monitoring of a healthcare provider.
There’s currently no cure for seborrheic dermatitis. However, the condition can be managed with treatments that help limit flares and control symptoms. Seborrheic dermatitis is a lifelong condition and usually requires long-term management. It may take a few tries and different combinations of shampoos and topicals to find what works best for you. If you’re interested in trying new treatments, talk to your doctor.
On MySebDermTeam, people share their experiences with seborrheic dermatitis, get advice, and find support from others who understand.
What treatments have you tried for your seborrheic dermatitis? Let others know in the comments below.
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