Mild seborrhoeic dermatitis of the scalp is often easily controlled with medicated shampoos which
contain antifungal ingredients such as ciclopirox olamine, ketoconazole or zinc pyrithione. Most
patients with seborrhoeic dermatitis prefer to wash their hair daily due to the greasiness of the
scalp. On the other hand, it is not recommended that they use the medicated shampoos daily as this
can cause the hair to become dry, frizzy and friable. A better alternative would be to intersperse
the medicated shampoo with a mild shampoo that is designed for daily use. One such shampoo is the
Scalp Care Shampoo which has the added benefit of a cool, mentholated feel to relieve the itch that
is often associated with seborrhoeic dermatitis.
Mild cases of seborrhoeic dermatitis affecting non-hair bearing areas such as the face and chest can
be treated with nonsteroidal anti-inflammatory creams such as Sebclair, pimecrolimus or tacrolimus
or antifungal cream such as ketoconazole.
For cases with associated redness and itch, shampoo or drops containing steroids are very effective.
Similarly, for moderate seborrhoeic dermatitis of the face, a steroid based cream can be used on a
short-term basis.
As seborrhoeic dermatitis tends to be recurrent, maintenance with non-steroid creams such as
Sebclair, pimecrolimus or tacrolimus will provide good control without extended exposure to steroid
creams. Antifungal creams like ketoconazole are also helpful for preventing recurrent flares of
seborrhoeic dermatitis.
Lastly, resistant or more severe forms of seborrhoeic dermatitis can be treated initially with oral
medication. These may be directed against the yeast (antifungal tablets like itraconazole) or the
excess oiliness (isotretinoin). Once improved, the patient can then be switched over to creams and
shampoos for maintenance.
Although seborrhoeic dermatitis is a benign condition, it can be frustrating and even distressing
for patients who are either self-conscious about the appearance of the flakes on their clothing or
disturbed by the itching of their scalps. With the wide range of treatment options available, many
of which are safe for long term use, these patients need no longer put up with “snowflakes on their
shoulders”.
