Which treatments help in teenagers and adults?

Photo of a man talking to a doctor (PantherMedia / Wavebreakmedia Premium) Anti-inflammatory and antifungal creams and shampoos can effectively relieve the symptoms of seborrheic dermatitis in teenagers and adults. But these medications only have a temporary effect, so they won’t get rid of it for good.

If you develop seborrheic dermatitis as a teenager or adult, you’ll likely keep on getting inflamed flaky patches of skin on your scalp and face. Your skin will clear up during some periods, but the dermatitis often comes back again. Various effective treatments can keep the flakes in check during these acute phases.

In babies, seborrheic dermatitis is commonly known as cradle cap. It doesn't need to be treated with medication because it goes away on its own.

Are antifungal medicines effective?

Experts believe that a type of fungus known as yeast is one of the factors that play a role in the development of seborrheic dermatitis. So creams, shampoos and lotions that kill fungus or slow its growth (called antifungals or antimycotics) are used as a treatment.

Researchers at the Cochrane Collaboration (an international research network) looked for studies on these kinds of medications. They found the most data on the medications ketoconazole and ciclopirox. It showed that antifungal medicines relieve the symptoms better than placebos (fake medications) do, and are less likely to cause side effects like redness, itching or hair loss than steroid medications are. Most of these studies were low-quality, though.

How effective are steroid medications?

Steroid medications that are applied directly to the skin (topical medications, such as creams or gels) have an anti-inflammatory effect, so they're often used to treat seborrheic dermatitis. Because they're not suitable for long-term treatment, they're used for a limited time only.

Another group of Cochrane researchers looked into the effectiveness of various anti-inflammatory products in the treatment of seborrheic dermatitis. They analyzed studies comparing steroid solutions, lotions and shampoos with a placebo (treatment with no medication in it). The researchers found the following: When applied for 2 to 4 weeks, all of the inflamed patches went away in

  • 8 out of 100 people who used the placebo.
  • 30 out of 100 people who used the steroid medication.

In other words, topical treatment with steroid medications caused the seborrheic dermatitis to go away in 22 out of 100 people.

Another study that lasted 12 weeks confirmed these results.

But it isn't possible to say whether the symptoms came back after the treatment and, if so, when. Steroids may have side effects, such as changes in the skin.

What can help to remove the flakes of skin?

If you have bothersome crusty flakes of skin on your scalp or other parts of your body, you can try to soften them and then remove them. One gentle way to do this is by dabbing the flakes with olive oil and letting them soften overnight. They can be washed out the next day using a mild shampoo.

Special shampoos and creams for removing crusty flakes of skin are also available from pharmacies. They contain drugs such as

  • salicylic acid,
  • zinc pyrithione or
  • coal tar.