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Seborrheic Dermatitis Medication

  • Author: Samuel T Selden, MD; Chief Editor: William D James, MD  more...
 
Updated: Feb 26, 2016
 

Medication Summary

The goals of pharmacotherapy are to reduce morbidity and to prevent complications.

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Antifungals

Class Summary

The mechanism of action may involve alteration of RNA and DNA metabolism or an intracellular accumulation of peroxide that is toxic to fungal cells.

Ketoconazole topical

 

Ketoconazole topical is available as ketoconazole cream 2% (Nizoral), ketoconazole foam (Extina), ketoconazole shampoo 2% (Nizoral 2%; prescription only in United States), and ketoconazole shampoo 1% (Nizoral A-D Shampoo; over-the-counter in United States). It is an imidazole broad-spectrum antifungal agent. It inhibits the synthesis of ergosterol, causing cellular components to leak, resulting in fungal cell death.

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Corticosteroids

Class Summary

Corticosteroids have anti-inflammatory properties and cause profound and varied metabolic effects. They also modify the body's immune response to diverse stimuli.

Betamethasone topical (Valisone)

 

Betamethasone is a medium-strength topical corticosteroid for body areas. It decreases inflammation by suppressing the migration of polymorphonuclear leukocytes and reversing capillary permeability. Betamethasone affects the production of lymphokines and has inhibitory effects on Langerhans cells.

Desonide

 

Desonide is used for inflammatory dermatoses responsive to steroids. It decreases inflammation by suppressing the migration of polymorphonuclear leukocytes and reversing capillary permeability.

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Keratolytics

Class Summary

Keratolytics cause cornified epithelium to swell, soften, macerate, and then desquamate.

Coal tar shampoo (DHS Tar, MG217, Theraplex T, Psoriasin); Scytera foam

 

Coal tar shampoo inhibits deregulated epidermal proliferation and dermal infiltration; it is antipruritic and antibacterial.

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Immunosuppressants

Class Summary

Immunosuppressants exert anti-inflammatory affects by inhibiting T-lymphocyte activation. They are safer than topical steroids for prolonged use or in skin folds.

Tacrolimus ointment (Protopic)

 

Tacrolimus ointment is a nonsteroidal anti-inflammatory agent. It should not cause steroid-type skin atrophy. It is currently indicated only for atopic dermatitis in immunocompetent patients aged 2 years and older.

Pimecrolimus (Elidel cream 1%)

 

Pimecrolimus is a nonsteroidal anti-inflammatory agent. It should not cause steroid-type skin atrophy. It is currently indicated only for atopic dermatitis in immunocompetent patients aged 2 years and older. Use cream sparingly to avoid maceration in skin folds.

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Contributor Information and Disclosures
Author

Samuel T Selden, MD Assistant Professor Department of Dermatology Eastern Virginia Medical School; Consulting Staff, Chesapeake General Hospital; Private Practice

Samuel T Selden, MD is a member of the following medical societies: American Academy of Dermatology, International Society of Geriatric Dermatology

Disclosure: Nothing to disclose.

Specialty Editor Board

Richard P Vinson, MD Assistant Clinical Professor, Department of Dermatology, Texas Tech University Health Sciences Center, Paul L Foster School of Medicine; Consulting Staff, Mountain View Dermatology, PA

Richard P Vinson, MD is a member of the following medical societies: American Academy of Dermatology, Texas Medical Association, Association of Military Dermatologists, Texas Dermatological Society

Disclosure: Nothing to disclose.

Jeffrey Meffert, MD Associate Clinical Professor of Dermatology, University of Texas School of Medicine at San Antonio

Jeffrey Meffert, MD is a member of the following medical societies: American Academy of Dermatology, American Medical Association, Association of Military Dermatologists, Texas Dermatological Society

Disclosure: Nothing to disclose.

Chief Editor

William D James, MD Paul R Gross Professor of Dermatology, Vice-Chairman, Residency Program Director, Department of Dermatology, University of Pennsylvania School of Medicine

William D James, MD is a member of the following medical societies: American Academy of Dermatology, Society for Investigative Dermatology

Disclosure: Nothing to disclose.

Additional Contributors

Robin Travers, MD Assistant Professor of Medicine (Dermatology), Dartmouth University School of Medicine; Staff Dermatologist, New England Baptist Hospital; Private Practice, SkinCare Physicians

Robin Travers, MD is a member of the following medical societies: American Academy of Dermatology, American Medical Informatics Association, Massachusetts Medical Society, Women's Dermatologic Society, Medical Dermatology Society

Disclosure: Nothing to disclose.

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Seborrheic dermatitis affecting the scalp line and the eyebrows with red skin and scaling. Courtesy of Wilford Hall Medical Center Dermatology slide files.
Seborrheic dermatitis may affect any hair-bearing area, and the chest is frequently involved. Courtesy of Wilford Hall Medical Center Dermatology Teaching slides.
African Americans and persons from other darker-skinned races are susceptible to annular seborrheic dermatitis, also called petaloid seborrheic dermatitis or seborrhea petaloides. Sarcoidosis, secondary syphilis, and even discoid lupus may be in the differential in such cases. Courtesy of Jeffrey J. Meffert, MD.
 
 
 
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