Steroid treatment

Control of the disease can generally be gained quickly and without recourse to potent steroids - such as the use of hydrocortisone ointment on the face

When necessary, eg. in seborrhoeic dermatitis of the scalp and beard with severe itching: (1)

• add a topical corticosteroid scalp application, such as betamethasone valerate 0.1%, hydrocortisone butyrate 0.1%, or mometasone furoate 0.1%. Betamethasone is available as a mousse as well as a cream, ointment and lotion for use on the scalp
  • try 4-6 weeks of this treatment (to the scalp, not the beard). If symptoms do not resolve during this period or if response to treatment is poor seek specialist advice

For adults who are affected by face and/or body seborrhoeic dermatitis, a mild topical corticosteroid cream, such as hydrocortisone 1% (or a combined imidazole and hydrocortisone preparation) can be considered to settle inflammation more quickly (2).

If there are concerns about how much topical steroid is being used on the face consider topical calcineurin inhibitors eg Elidel ® cream (pimecrolimus) or Proptopic ® ointment (tacrolimus) (3)

Reference:

1. Kastarinen H, Oksanen T, Okokon EO, et al. Topical anti-inflammatory agents for seborrhoeic dermatitis of the face or scalp. Cochrane Database Syst Rev. 2014;(5)

2. Cicek D, Kandi B, Bakar S, et al. Pimecrolimus 1% cream, methylprednisolone aceponate 0.1% cream and metronidazole 0.75% gel in the treatment of seborrhoeic dermatitis: a randomized clinical study. J Dermatolog Treat. 2009;20(6):344-9.

3. Kim TW, Mun JH, Jwa SW, et al. Proactive treatment of adult facial seborrhoeic dermatitis with 0.1% tacrolimus ointment: randomized, double-blind, vehicle-controlled, multi-centre trial. Acta Derm Venereol. 2013 Sep 4;93(5):557-61.