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Antifungal treatment

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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Antifungal treatment Treatment options include:

  • topical imidazole antifungals such as ketoconazole cream may be useful in the removal of yeast commensals such as Pityrosporum; however it does not work in all patients with seborrhoeic dermatitis (1)
    • ketoconazole 2% shampoo (twice a week application, for 2-4 weeks) is prescribed for seborrhoeic dermatitis of the scalp and beard areas. Selenium sulphide shampoo is an alternative. Use of antifungal shampoos once a week, or once every other week will help maintain remission (2)
    • ketoconazole 2% cream (or other topical imidazoles) can be considered for face or body seborrhoeic dermatitis. Apply to the affected area once or twice a day. Continue for a few days after the affected area has healed
    • if ketoconazole and selenium sulphide containing shampoos aren't acceptable, other options such as anti-dandruff shampoos containing salicylic acid (2), zinc pyrithione and tar shampoos are also available
    • other options include pimecrolimus and ciclopiroxolamine applications (3)

If more extensive or recalcitrant symptoms then consider systemic itraconazole 100 mg per day for 14 days (4)

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