Seborrheic Dermatitis Drug Summary

Last updated: 30 March 2026
Reviewed by

Antifungals - Oral

Drug Dosage Remarks
Itraconazole 200 mg/day PO x 7 days
Prophylaxis: 200 mg PO 24 hourly for the first 2 days of each month until 11 months		 Adverse Reactions
  • GI effects (nausea/vomiting, diarrhea, abdominal pain, anorexia); CNS effects (headache, dizziness, somnolence); Dermatologic effects (rash, pruritus); Other effects (decreased libido, malaise, impotence, hypokalemia, edema, fatigue, fever, abnormal hepatic function, albuminuria)
Special Instructions
  • Contraindicated in patients with ventricular dysfunction; co-administration with Cisapride, Dofetilide, oral Midazolam, ergot alkaloids and statins
  • Caution in patients with risk factor for CHF, pulmonary disease, renal failure and edematous disorders

Antifungals - Topical*

Drug Available Strength Dosage Remarks
Bifonazole 1% cream Apply 24 hourly for 2-4 weeks Adverse Reactions
  • Irritation, pruritus, burning sensation, rash, dryness, headache, stinging, erythema
  • Ketoconazole may cause oily or dry hair, abnormal hair texture, scalp pustules. Rarely allergic local skin phenomena (contact dermatitis), hair discoloration with 2% shampoo
Special Instructions
  • Do not use occlusive wrappings or dressings
  • Contraindicated in patients with known hypersensitivity to active ingredients
  • Imidazoles are contraindicated in patients <2 years of age
  • Terbinafine is contraindicated in patients <12 years of age and patients with active or chronic liver disease
  • Avoid contact with eyes and mucous membranes
  • Use Ciclopirox with caution in patients <10 years of age
  • Spray should not be used on the face and should be used with caution in patients with open wounds or lesions where alcohol could be irritating
Ciclopirox
(Ciclopiroxolamine)		 1% cream Apply 12 hourly
1% shampoo Use as shampoo 2-3x/week
Clotrimazole 1% cream, lotion,
ointment, powder, solution		 Apply 8-12 hourly
Ketoconazole 1% scalp solution,
shampoo
2% scalp solution, shampoo, solution		 Apply 2x weekly
2% cream, gel,
lotion, ointment		 Apply 12-24 hourly
Metronidazole 0.75% gel Apply 12 hourly
Miconazole 2% cream, ointment,
powder, solution		 Apply 8-12 hourly
Sertaconazole 2% cream Apply 24 hourly for 2-4 weeks
Terbinafine 1% cream, gel, lotion, solution, spray Apply 12-24 hourly
Other Agent
Sulfur 2% bar soap
Lotion, ointment		 Bar soap: Bathe with warm water then soap thoroughly; allow soap to stay on skin for 2-3 minutes before rinsing off
Lotion/ointment: Apply 12-24 hourly		 Adverse Reactions
  • Irritation, dermatitis
  • May stain the skin black and give off a foul smell when applied concomitantly with mercurial compounds
Special Instructions
  • Contraindicated in patients <2 years of age and with known hypersensitivity to sulfur
  • Avoid contact with eyes, mouth and mucous membranes
*Topical antifungals are available in combination with topical antibiotics and corticosteroids. Please see the latest MIMS for specific formulations and prescribing information.

Corticosteroids - Systemic

Drug Dosage Remarks
Betamethasone 2-3 mg/day PO, then decrease to
0.25-0.5 mg/day x 2-5 days		 Adverse Reactions
  • GI effects (gastritis); Musculoskeletal effects (muscle weakness, muscle wasting, osteoporosis, vertebral compression and long bone fractures); Metabolic effects (electrolyte imbalances, decreased carbohydrate tolerance); CNS effects (vertigo, headache); Ophthalmologic effects (glaucoma, increased intraocular pressure, exophthalmos); Dermatologic effects (facial erythema, petechiae, increased sweating); Other effects (weight gain, pain, weakness, increased susceptibility to infection, impaired wound healing)
Special Instructions
  • Take with food
  • Use with caution in patients with active infection, increased stress, DM, hypothyroidism, cirrhosis
Dexamethasone Individualize dose
Initial dose: 0.75-9 mg/day PO
or
0.2-6 mg IM/IV once every 3-5 days to
2-3 weekly
Hydrocortisone 100-500 mg IV/IM over 30 seconds-10 minutes 2, 4 or 6 hourly
Methylprednisolone 4-48 mg/day PO 24 hourly or in divided doses
or
80 mg IM weekly
Prednisolone 5-60 mg/day PO 24 hourly or in divided doses

Corticosteroids - Topical*

Drug Available Strength Dosage Remarks
Very Potent Application
  • Twice daily applications are recommended for most agents
    • More frequent administration may be necessary for palms or soles of feet
  • Length of cream/oint squeezed from tube can be measured by finger tip unit (FTU) which is tip of adult index finger to first crease
  • 1 FTU (approximately 500 mg) is sufficient to cover 2x the size of flat adult hand
  • Recommended use of very potent agents is 1-2 weeks (max 3 weeks) followed by weaker potency preparations as the condition improves
Adverse Reactions
  • The more potent the agent, the more chance of adverse reactions
  • Local effects: Thinning of skin which may be restored after stopping treatment, worsening of underlying infection, contact dermatitis, acne at site of application, hypopigmentation which may be reversible, irreversible telangiectasia and striae atrophica
  • Systemic effects: Absorption through the skin can cause pituitary-adrenal-axis suppression, growth retardation, hypertension and Cushing’s syndrome
    • Absorption is increased by thin and/or raw skin, intertriginous areas or occlusion
    • Absorption is more likely when used over very large areas and in children
  • Tachyphylaxis can occur
Special Instructions
  • Very potent agents should not be used in patients <1 year of age
  • Moderately potent and potent agents will rarely cause side effects if used for <3 months (except if used on face or intertriginous areas)
    • Intermittent therapy is usually preferable to long-term continuous therapy
Clobetasol
propionate		 0.05% cream, gel,
ointment, scalp application,
shampoo		 Apply 12-24 hourly
Potent
Amcinonide 0.1% cream, lotion,
ointment		 Apply 8-12 hourly
Beclometasone dipropionate 0.025% cream, solution Apply 8-24 hourly
Betamethasone dipropionate 0.025% cream Apply 12 hourly
0.05% cream, ointment
0.064% cream, solution		 Apply 12-24 hourly
Betamethasone
valerate		 0.025% cream
0.05% cream		 Apply 12 hourly
0.06% cream Apply 24 hourly
0.1% cream, lotion,
ointment, scalp application,
solution		 Apply 8-24 hourly
Desoximetasone
(Desoxymetasone)		 0.05% cream, gel, ointment
0.25% cream, ointment		 Apply 8-24 hourly
Diflucortolone valerate 0.1% cream, fatty ointment, ointment Apply 8-24 hourly
Fluclorolone acetonide 0.02% cream, ointment Apply 12-24 hourly
Fluocinolone acetonide 0.01% cream, ointment
0.025% cream, gel, ointment
0.2% cream		 Apply 8-24 hourly
Fluocinonide 0.05% cream, gel, lotion, solution, ointment Apply 8-12 hourly
Fluocortolone/fluocortolone
caproate		 0.25% cream Apply 12-24 hourly
Fluticasone propionate 0.005% ointment
0.05% cream		 Apply 12-24 hourly
Halometasone 0.05% cream Apply 12-24 hourly
Hydrocortisone aceponate 0.127% cream Apply 12-24 hourly
Methylprednisolone aceponate 0.1% cream, ointment Apply 24 hourly
Mometasone furoate 0.1% cream, fatty ointment, gel, lotion, ointment Apply 24 hourly
Prednicarbate 0.1% cream, ointment
0.25% cream		 Apply 12-24 hourly
Moderately Potent
Alclometasone
dipropionate		 0.05% cream, ointment Apply 8-12 hourly
Clobetasone butyrate 0.05% cream, ointment Apply up to 6 hourly
Desonide 0.05% cream, lotion, ointment Apply 6-12 hourly
Flumetasone 0.02% cream, lotion, ointment Apply 8-12 hourly
Fluprednidene acetate 0.1% cream Apply 12-24 hourly
Hydrocortisone butyrate 0.1% cream, lotion, ointment, solution Apply 6-12 hourly
Triamcinolone acetonide 0.025%, 0.05%
cream, lotion, ointment
 Apply 6-12 hourly
0.5%, 0.1% cream, lotion, ointment, scalp lotion, solution 
Mildly Potent
Hydrocortisone 1% cream, lotion, ointment
2.5% lotion		 Apply 6-12 hourly
Prednisolone 0.5% cream Apply 8-24 hourly
*Topical corticosteroids are available in combination with topical antibiotics. Please see the latest MIMS for specific formulations and prescribing information.

Emollients, Cleansers & Skin Protectives*

Drug Available Strength Dosage Remarks
Bisabolol 0.01% cream, lotion, ointment,
scrub, wash		 Apply 12-24 hourly or as needed Adverse Reactions
  • Local irritation
Special Instructions
  • Avoid contact with eyes and other mucous membranes
Glycyrrhetinic acid
(Enoxolone, Glycyrrhetic acid)		 2% cream, lotion Apply to affected area 8 hourly
or as needed		 Adverse Reactions
  • Local irritation
Special Instructions
  • Avoid contact with eyes and other mucous membranes
Lactic acid Wash Apply as needed Special Instructions
  • Avoid repeated use on sensitive skin, acute eczema and with permanent compresses
Piroctone olamine Cream Apply to affected area 8 hourly
or as needed		 Adverse Reactions
  • Local irritation
Special Instructions
  • Avoid contact with eyes and other mucous membranes
Shampoo Apply to hair and rinse off after
3 minutes 2x weekly x ≥6 weeks
Shea butter
(Butyrospermum parkii)		 Cream, lotion, wash Apply 24 hourly Special Instructions
  • Avoid contact with eyes and other mucous membranes
Vitamin A Cream, ointment Apply 8-12 hourly Adverse Reactions
  • Local irritation
Special Instructions
  • Avoid contact with eyes and other mucous membranes
Vitamin E Lotion Apply as needed Special Instructions
  • Avoid contact with eyes and other mucous membranes
Vitis vinifera seed extract
(Grape seed extract)		 Cream, lotion Apply to affected area 8 hourly
or as needed		 Adverse Reactions
  • Local irritation
Special Instructions
  • Avoid contact with eyes and other mucous membranes
*Products combined with other emollients are available. Please see the latest MIMS for specific formulations and prescribing information

Other Dermatologicals

Drug Available Strength Dosage Remarks
Calcineurin Inhibitors
Pimecrolimus 1% cream Children ≥2 years old and
Adult: Apply 12 hourly		 Application
  • Apply a thin layer to affected skin, rub in gently and completely
Adverse Reactions
  • Local effects: Burning, sensation of warmth which usually decreases with continued use, application site reactions (eg irritation, erythema, itching)
  • Less common: Bacterial and viral infections
  • Higher dose than used in humans, shortened time to skin tumor formation in animal photocarcinogenicity study
Special Instructions
  • Do not apply to areas of acute cutaneous viral infections
  • Bacterial and fungal infections should be treated before application of calcineurin inhibitors
  • If no improvement within 6 weeks, patient should be re-evaluated
  • Should not be used with occlusive dressing
  • Patients should minimize or avoid natural or artificial sunlight
Tacrolimus 0.03% ointment
0.1% ointment		 2-15 years old:
Apply 0.03% ointment 12 hourly
>15 years old:
Apply 0.03% or 0.1%
ointment 12 hourly
Phosphodiesterase Type-4 (PDE-4) Inhibitor
Roflumilast 0.3% foam Children ≥9 years old and
Adult: Apply foam 24 hourly		 Application
  • Apply a thin layer to affected area (eg skin, scalp) after drying and rub in completely
Adverse Reactions
  • GI effects (nausea/vomiting, diarrhea); CNS effects (headache, insomnia); Respiratory effects (nasopharyngitis, upper respiratory tract infection); Other effects (urinary tract infection, application-site pain)
Special Instructions
  • Contraindicated in patients with moderate to severe hepatic impairment
  • Avoid contact with eyes and other mucous membranes

Psoriasis, Seborrhea & Ichthyosis Preparations

Drug Available Strength Dosage Remarks
Coal tar1 5% cream Apply 6-12 hourly Adverse Reactions
  • Skin irritation, acne-like skin eruptions
Special Instructions
  • Observe caution when used on the face, near the eyes and mucous membranes
  • Avoid use on the genital or rectal area, and in patients with psoriasis exacerbation; direct sunlight exposure
12% ointment Apply weekly
May increase to 24 hourly x
3-7 days
1%, 2.5%, 4.25%, 12%
solution		 Apply to hair and scalp then rinse
Repeat procedure, massage for several minutes then
rinse thoroughly
Povidone iodine 4% shampoo Apply 2x weekly, then once weekly Adverse Reactions
  • Local irritation
Special Instructions
  • Use with caution in patients with iodine idiosyncrasy
Salicylic acid 6% lotion Apply to crusts 12 hourly x 3-5 days without washing the
hair		 Adverse Reactions
  • Mild irritation. High concentrations can cause skin ulceration or erosion. Excessive use produces symptoms of acute salicylate poisoning
Special Instructions
  • Protect surrounding healthy skin with soft paraffin or specially designed plasters
  • Do not use for prolonged periods or apply on inflamed or broken skin
  • Avoid contact with mouth, eyes and other mucous membranes
  • Avoid use on the extremities of patients with impaired peripheral circulation or diabetes
Selenium
sulfide		 1%, 1.8% lotion, shampoo Apply to hair and rinse off after 2-3 minutes 24 hourly
or 2x weekly		 Adverse Reactions
  • Skin irritation especially in the genital area and skin folds, increase in normal hair loss, oiliness or dryness of hair and scalp, hair discoloration, cutaneous sensitization
Special Instructions
  • Contraindicated in patients with acute inflammation or exudation
  • Do not use within 48 hours of applying hair colors or permanent waving preparation
  • Avoid contact with eyes, mouth and other mucous membranes, or with inflamed or broken skin
  • Use with caution in infants
2.5% lotion, shampoo Apply to hair and rinse off after 2-3 minutes 2x weekly
x 2 weeks
Repeat weekly or 2-4 weekly to maintain control
Zinc
pyrithione		 Various strengths and
combinations are available		 Use as shampoo 2-3x/week
Apply on skin 24 hourly		 Application
  • Massage onto wet hair and scalp for 2-3 minutes then rinse off
  • Apply on wet skin and leave on for 5 minutes then rinse off
Adverse Reactions
  • Irritation, rashes, hair loss, dryness of hair and scalp. Rarely photosensitivity, peripheral neuritis, hair discoloration, abnormal hair texture
Special Instructions
  • Avoid contact with eyes and mucous membranes
  • Avoid prolonged use
1Products combined with warts and calluses preparation are available. Please see the latest MIMS for specific formulations and prescribing information.

Warts & Calluses Preparations

Drug Available Strength Dosage Remarks
Propylene glycol Various strengths and combinations are available Apply 12-24 hourly Adverse Reactions
  • Local irritation; hypersensitivity reactions
Special Instructions
  • Avoid contact with eyes
  • Use with caution when applied under occlusive dressings and to mucous membranes
1Warts and calluses preparations combined with a number of agents in several strengths are available. Please see the latest MIMS for specific formulations and prescribing information.

Disclaimer

All dosage recommendations are for non-pregnant and non-breastfeeding women, and non-elderly adults with normal renal and hepatic function unless otherwise stated.  
Not all products are available or approved for above use in all countries.  
Products listed in the Drug Summary are based on indications stated in the locally approved product monographs.   
Please refer to local product monographs in Related MIMS Drugs for country-specific prescribing information.