Pharmacologic treatment of seborrheic dermatitis

Seborrheic dermatitis is a chronic, recurrent papulosquamous skin disorder characterized by flaking of the skin, erythema, pruritus, and oily skin. It is a common dermatosis, with a prevalence of approximately 1% to 3% of the general population in the United States. The incidence of this skin disease has a bimodal distribution, with peaks noted in newborns and in adults between 30 and 60 years of age. In adults, it predominantly occurs over areas of the body with a high concentration of sebaceous glands. The etiology of this disease is thought to be an inflammatory response of the body to Malassezia yeasts. It is also related to abnormal sebum secretion, as well as a heightened immune response of the host. Based on the characteristic features of this inflammatory skin disease, the mainstays of treatment for seborrheic dermatitis are antifungals, corticosteroids, and immunomodulatory agents. The primary goal of therapy for seborrheic dermatitis is to manage acute symptoms, including pruritus, erythema, and scaling. Maintenance treatment is directed toward preventing the recurrence of acute exacerbations. Patients should be informed that seborrheic dermatitis is a chronic condition, with a tendency to recur despite proper treatment. Clinicians should offer suggestions about lifestyle modifications to avoid triggers and choose proper treatment options that ensure the patient's safety.