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Seborrheic dermatitis

Key sources
The following summarized guidelines for the management of seborrheic dermatitis are prepared by our editorial team based on guidelines from the Pathway (Pathway 2023), the College of Optometrists (CO 2023), the Asian Consensus Group on Seborrheic Dermatitis (ACG-SD 2016), the Danish Society of Dermatology (DSD 2015), and the International Union Against Sexually Transmitted Infections (IUSTI 2014).
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Guidelines

1.Medical management

Topical keratolytic/anti-dandruff agents
As per ACG-SD 2016 guidelines:
Offer the following topical keratolytic agents in patients with seborrheic dermatitis of the scalp and hairy areas:
Situation
Guidance
Salicylic acid 3% shampoo
2-3 times weekly
Tar 1-2% shampoo
1-2 times weekly
Selenium sulfide 2.5% shampoo
2-3 times weekly
Zinc pyrithione 1-2% shampoo
2-3 times weekly
B
Consider offering once or twice weekly applications for long-term maintenance.
C
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2.Nonpharmacologic interventions

Skin care: counsel adult patients about the need for proper skin care, as seborrhoeic dermatitis is a chronic condition likely to recur after treatment.
B

3.Specific circumstances

Infant patients
Advise simple measures, such as regular scalp washing with baby shampoo and gentle brushing, to loosen scales in infant patients with seborrhoeic dermatitis. Consider offering daily application of white petrolatum to soften scales.
B
Consider offering ketoconazole 2% shampoo,
B
alone or combined with a weakly potent topical corticosteroid,
B
until the condition resolves if conservative measures are not effective.
B

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