Treatments for seborrheic dermatitis can be found over the counter or by prescription from your doctor. Although a variety of topicals (applied to the skin), shampoos, and oral medications are available, it can be difficult to treat the condition. This is because seborrheic dermatitis can be mistaken for other skin conditions such as psoriasis or atopic dermatitis. Once you receive a seborrheic dermatitis diagnosis, you can begin treating the condition properly.
Seborrheic dermatitis is a skin condition that causes the formation of 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 caused by the overgrowth of Malassezia yeast, which can trigger inflammation in the skin, or other factors like a family history of dermatitis.
Seborrheic dermatitis treatment focuses on reducing discoloration, itchiness, and scaling while improving the skin’s overall appearance. Oftentimes, a few different treatments combined are the most effective. Your dermatologist will choose these based on the affected skin areas and the severity of your symptoms.
Topical medications are used to help target yeast growth. Topical corticosteroids are used to help control inflammation. For most teenagers and adults, seborrheic dermatitis symptoms won’t go away on their own and usually require treatment.
Seborrheic dermatitis that develops in infants is known as cradle cap. This condition is common and tends to get better on its own a few weeks or months after an infant is born. However, some infants may still have long-term symptoms such as skin flaking, thick crusts, or scaling.
Wash your baby’s scalp gently with baby shampoo daily to 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 (Ala-Cort, Hytone, Nutracort) or antifungal shampoo containing ketoconazole (Nizoral) to help. When using medicated shampoos, take extra care to not let any get in your baby’s eyes.
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, the Mayo Clinic recommends trying dandruff shampoos:
Your doctor may prescribe prescription shampoos with antifungal agents to help you get rid of dandruff and keep your scalp clear. Examples include ketoconazole 2 percent or ciclopirox (Loprox). These shampoos are used daily or a few times a week to initially clear your skin. Afterward, they can be used once every few weeks as a maintenance treatment to help prevent flare-ups. There are also steroid-containing shampoos that may be prescribed.
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 can be effective at treating 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 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 made with 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 be worse underneath 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 over-the-counter treatments, your doctor may prescribe corticosteroids, other antifungal medications, or calcineurin inhibitors. These are topical medications applied directly to the affected areas.
Corticosteroids are anti-inflammatory medications. They are formulated into shampoos, solutions, oils, and foams to treat skin inflammation, itchiness, and redness on the scalp. Examples include:
Depending on the type of shampoo you’re prescribed, you may use it daily or twice daily for two weeks, then continue to use 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 can also affect the face, ears, and other areas of the body. Treatment options are usually lotions, foams, creams, or gels.
Topical antifungals used as creams or ointments are applied to the affected skin twice daily for two to eight weeks. These include:
Topical corticosteroids can be used for a short time to treat more severe cases of seborrheic dermatitis or to help control flare-ups. They’re also used when antifungal medications can’t clear the skin. However, topical corticosteroids should only be used for a few weeks at a time because they can cause skin thinning. These medications are used once or twice daily and are available as creams, lotions, foams, or ointments. Examples include:
Topical calcineurin inhibitors are used as an alternative to corticosteroids. These medications help control skin inflammation and have fewer side effects than corticosteroids and do not thin the skin. Examples include tacrolimus (Protopic) ointment and pimecrolimus (Elidel) cream. These medications are applied to the affected skin twice daily.
In severe cases that don’t respond to other therapies, you may be prescribed an oral antifungal medication (a pill). These include:
Phototherapy uses ultraviolet (UV) light waves to reduce inflammation in skin diseases, including seborrheic dermatitis, psoriasis, and atopic dermatitis (eczema). UV light comes from the sun, but phototherapy uses a controlled, human-made source. Studies have found that narrow-band UVB light can be used to treat inflammation, redness, and itchiness from seborrheic dermatitis. This treatment is typically used for severe cases that don’t respond to topical treatments.
Narrow-band light treatments are required two to three times per week and only take a few minutes per session. After a session, it will feel like you have a mild sunburn. Your skin may also become itchy, or your seborrheic dermatitis may get slightly worse before it gets better. If you notice any signs of infection such as fever or chills, or if your skin begins to blister or produce discharge, contact your doctor.
There currently is 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.
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