Treatment of Seborrheic Dermatitis

TABLE 1
Treatment of Seborrheic Dermatitis

OVER-THE-
PRODUCTS SCALP BEARD FACE BODY INSTRUCTIONS COST*
COUNTER?

Shampoos

Selenium sulfide, 1% (Selsun Blue) Yes X X X X 5- to 10-minute application daily initially; then twice weekly as needed $3 per 120 mL bottle

Selenium sulfide, 2.5% (Exsel, Selsun) No X X X X Same as above 15 per 120 mL (Exsel)

12 per 120 mL (Selsun)

Pyrithione zinc, 1% (Dandrex, Zincon, Yes X X X X Same as above 5 per 240 mL (Dandrex)
Head and Shoulders)
3 per 120 mL (Zincon)

3 per 450 mL (Head and Shoulders)

Pyrithione zinc, 2% (DHS Zinc, Yes X X X X Same as above 7 per 240 mL (DHS Zinc)
Sebulon, ZNP Bar, Theraplex Z)
11 per 240 mL (Sebulon)

6 per 135 g (ZNP Bar)

7 per 240 mL (Theraplex Z)

Coal tar May be irritating, especially on the face

Crude coal tar: 5- to 10-minute application daily initially, then as needed

DHS Tar (0.5%) Yes X X X X 5 per 120 mL (DHS Tar 0.5%)

Zetar (1%) Yes X X X X 14 per 180 mL (Zetar 1%)

Ionil T Plus (2%) Yes X X X X 12 per 240 mL (Ionil T Plus 2%)

Coal tar combinations: Same as above 10 per 210 mL (Sebutone)

Sebutone (0.5% with salicylic Yes X X X X

acid, 2%, and sublimed sulfur,
2%)

Coal tar distillate:

Doak-Tar (3%) Yes X X X X Same as above 7 per 60 mL (Doak-Tar)

Coal tar extract: Same as above

Neutrogena T/Gel (2%) Yes X X X X 4 per 132 mL (Neutrogena T/Gel)

Tegrin Dandruff (7%) Yes X X X X 5 per 210 mL (Tegrin Dandruff)

Pentrax (7.71 %) Yes X X X X 7 per 120 mL (Pentrax)

Coal tar topical solution:

Denorex Medicated (9%) Yes X X X X Same as above 4 per 120 mL (Denorex Medicated)

Denorex Extra Strength Yes X X X X 4 per 120 mL (Denorex Extra Strength)

(12.5%)

Coal tar solution combinations: Same as above

Ionil T (5% with salicylic acid, Yes X X X X 8 per 120 mL (Ionil T)

2%)

X-Seb T Plus (10% with Yes X X X X 12 per 120 mL (X-Seb T Plus)

salicylic acid, 3%)

Tarsum (10% with salicylic Yes X X X X 7 per 120 mL (Tarsum)

acid, 2%)

Chloroxine No X 3-minute application twice weekly 20 per 120 mL

Capitrol, 2%

Ketoconazole

Nizoral, 1% Yes X X X X 5- to 10-minute application to scalp before rinsing clear; use daily 7 per 120 mL (Nizoral 1%)
initially, then twice weekly

Nizoral, 2% No X X X X 21 per 120 mL (Nizoral 2%)

Steroid shampoo No X X 5- to 10-minute application to scalp before rinsing clear; use daily 15 per 120 mL
initially until inflammation clears, then as needed
FS Shampoo (0.01%
fluocinolone acetonide)

Topical Preparations

Corticosteroids Yes X X X X Apply once or twice daily until inflammation clears, then as needed 3 per 15 g (Cortaid, 1%) 3 per 15 g (Cortizone 10) 12 per
For scalp preparations, apply to scalp nightly until inflammation 15 g (Tridesilon) 25 per 30 g (Hytone) 18 per 120 mL
Cortaid, 1%; Cortizone 10 clears, then 1 to 3 times weekly as needed (Derma-smoothe/GS Topical oil)
(hydrocortisone cream, 1%)

Tridesilon (desonide, 0.5%) No X X X† X

Hytone (hydrocortisone No X X X† X†
cream, 2.5%)
 OVER-THE-
PRODUCTS SCALP BEARD FACE BODY INSTRUCTIONS COST*
COUNTER?

Derma-smoothe/FS Topical oil No X†

(fluocinolone acetonide,
0.01% in oil)

Antifungals Apply once or twice daily 5 per 15 g (Micatin)

Miconazole cream, 2% Yes X X

(Monistat)

Clotrimazole cream, 1% Yes X X 6 per 12 g (Lotrimin)

(Lotrimin)

Terbinafine solution, 1% Yes X X X X 33 per 15 g (Lamisil)

(Lamisil)

Ketoconazole cream, 2% No X X 17 per 15 g (Nizoral)

(Nizoral)

Other preparations

Sodium sulfacetamide Apply once or twice daily

Sebizon (10% lotion) No X‡ X‡ X X 24 per 85 g (Sebizon)

Novacet (10% sodium No X‡ X‡ X X 28 per 30 g (Novacet)

sulfacetamide plus 5% sulfur)

Sulfacet R Lotion (10% No X‡ X‡ X X 34 per 25 g (Sulfacet R Lotion)

sodium sulfacetamide plus 5%
sulfur)

Benzoyl peroxide washes Apply to affected area for 5 to 10 minutes; then rinse off; may bleach
clothing or hair
Benzac AC Wash (2.5%, 5%, No X X 21 to 26 per 240 mL (Benzac AC Wash)
10%)

Benzac W Wash (5%, 10%) No X X 21 to 23 per 240 mL (Benzac W Wash)

Desquam-X Wash (5%, 10%) No X X 15 to 16 per 150 mL (Desquam-X Wash)

* —Estimated cost to the pharmacist based on average wholesale prices (rounded to the nearest dollar) in Red book. Montvale, N.J.: Medical Economics Data, 1999. Cost to the patient may be greater.

† —May cause skin atrophy and telangiectasis with chronic use.

‡ —May not be cosmetically acceptable for some patients.

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