The Ultimate Guide to Seborrheic Dermatitis Treatment

Seborrheic dermatitis is a skin condition that can be both irritating and embarrassing. The good news is that there are a number of treatment options available. Over-the-counter medications, home remedies, and prescription strength treatments can all be effective in managing seborrheic dermatitis. The key is to find the right combination of treatments for your individual case.

I briefly discuss the most common treatment options here with links to detailed articles about them. It’s a monster guide so the easiest way to read it is to click through to what you want from the table of contents.

Over-the-counter medications

There are many over-the-counter treatments available for seborrheic dermatitis and dandruff. These treatments can be found at most pharmacies and drug stores. Many of these treatments are safe and effective, but some can have serious side effects. Make sure you read the labels carefully and follow the directions before using any over-the-counter treatment.

Antifungal creams

These creams help to control the overgrowth of Malassezia yeast on the skin, which can reduce inflammation and itching. There are a variety of antifungal creams available, Examples include ketoconazole, miconazole and clotrimazole cream.

You can read more in What is the best antifungal cream for seborrheic dermatitis? but my favorite is clotrimazole cream. It’s been shown to be effective, works well, and is easily available over-the-counter.

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Read more about clotrimazole here: Is clotrimazole effective against seborrheic dermatitis?

Medicated shampoos

There are a number of medicated shampoos available over-the-counter that can help treat seborrheic dermatitis. These shampoos contain active ingredients such as ketoconazole, selenium sulfide or zinc pyrithione which help to reduce scaling and itch.

Admittedly I’m not a fan of any of them as they dry out your scalp and hair. I would rather use tea tree oil shampoo but that’s just my personal preference. Any of these medicated shampoos will work against SD but you’ll need to try them out to see which one works best for you.

Zinc pyrithione shampoo

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Zinc pyrithione shampoo is available over-the-counter and usually needs to be used for at least two weeks before you notice any improvement. Examples include Head & Shoulders Shampoo. Please note that the European Union has banned zinc pyrithione in Europe. Read more about zinc pyrithione and seborrheic dermatitis.

Ketoconazole shampoo

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Ketoconazole shampoo is a medicated shampoo used to treat dandruff and seborrheic dermatitis of the scalp. The active ingredient in ketoconazole shampoo is ketoconazole, which is an antifungal medication. Ketoconazole shampoo 1% is available over-the-counter but if you need anything stronger, it’s by prescription.

You can read more about Nizoral and dandruff here.

Interestingly, ketoconazole shampoos were found to have less side effects compared to selenium sulfide shampoo.

Further reading: Is ketoconazole an effective treatment for seborrheic dermatitis?

Selenium sulfide shampoo

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Selenium sulfide shampoo is commonly used to treat dandruff and seborrheic dermatitis. It works by reducing the amount of oil on the scalp and has antifungal activity against Malassezia. Selenium sulfide shampoos are available over-the-counter. It’s usually used two or three times a week for four weeks.

Ciclopirox olamine shampoo

Ciclopirox shampoo is a medicated shampoo used to treat dandruff, seborrheic dermatitis, and psoriasis. It’s available by prescription. Ciclopirox shampoo works by reducing the build-up of skin cells and preventing the growth of fungi.

Using Ciclopirox 1% shampoo 1-2 times a week improved scalp SD and when used once every 1-2 weeks, it reduced the relapse rate. It’s safe for most people to use, but side effects may include dryness, irritation, and redness.

Coal tar shampoo

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Coal tar is a thick, black liquid that is a by-product of the production of coke and coal gas. It has been used for centuries as a treatment for psoriasis and other skin conditions. In recent years, it has been increasingly used in shampoos and other hair products as a treatment for dandruff and other scalp conditions.

Further reading: Is coal tar good for seborrheic dermatitis? You can also read my thoughts on Neutrogena T/gel for seborrheic dermatitis.

Salicylic acid shampoo

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Salicylic acid is a type of beta hydroxy acid that is derived from willow bark and works as a keratolytic agent, meaning it helps to break down tough skin cells. This property makes it an effective ingredient in dandruff shampoos. When used as directed, salicylic acid can help to reduce the amount of dead skin cells on the scalp, which can lead to fewer flakes and less dandruff.

Read my review of Dermarest Shampoo and Conditioner for seborrheic dermatitis.

Home remedies

There are many different home remedies that people swear by. Some of these remedies are backed by scientific evidence, while others are more traditional cures that have been passed down through the generations.

Home remedies can be inexpensive and easy to make, and they often have fewer side effects than over-the-counter or prescription medications. Just make sure you research the ingredients and possible side effects before using a home remedy.

Here are some of the most effective home remedies that you can use to alleviate symptoms of seborrheic dermatitis:

Essential oils

There are many essential oils that can be used to treat seborrheic dermatitis. These oils can be used in a variety of ways on the skin and the scalp. When used correctly, essential oils can be very effective. Read about the 19 best essential oils for seborrheic dermatitis.

Pure essential oils are potent compounds. Make sure you dilute them in a carrier oil that is safe for seborrheic dermatitis before using.

Some of the most effective oils include:

• Tea tree oil
• Manuka oil
• Geranium oil
• Chamomile oil
• Neem oil
• Black seed oil
• Rosemary oil
• Oregano oil
• Peppermint oil
• Vitamin E oil
• Lavender oil

Although not essential oils, you may also be interested in scalp oils and hair oils for seborrheic dermatitis.

Gentle moisturizer

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Applying a moisturizer to the affected area can help to soothe the skin and reduce flakiness. But you know how difficult it can be to find a moisturizer that doesn’t aggravate your condition. Many moisturizers are too harsh for seborrheic dermatitis sufferers, but there are a few gentle options out there.

I list my favorite moisturizers in The 9 Best Face Moisturizers For Seborrheic Dermatitis.

I unpack a seborrheic dermatitis skincare routine that actually works in this article.

Collagen cream

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One of the core issues with seborrheic dermatitis is damage to our skin barrier. Collagen is a protein found in the skin that helps to keep it firm and elastic. There is a lack of clinical evidence, but when applied topically, collagen creams may help to reduce inflammation and rebuild the skin barrier. Just make sure you use creams that contain hydrolyzed collagen.

You may be interested in my reviews of Dr Lewinn’s Ultra R4 Collagen Surge Plumping Gel Review and Dr. Lewinn’s Ultra R4 Collagen Surge Overnight Sleep Mask review

Hyaluronic acid

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Hyaluronic acid is a sugar molecule that is found naturally in the skin. It helps to keep the skin hydrated and plump. Some studies have shown that using products with hyaluronic acid may help to reduce the symptoms of seborrheic dermatitis.

Niacinamide

Niacinamide is a derivative of Vitamin B3 and is used in almost every skincare product due to its skin benefits. Niacinamide cream is proven to improve symptoms of seborrheic dermatitis when used regularly. This isn’t surprising seeing as topical niacinamide has potent anti-inflammatory properties, regulates sebum production and helps to strengthen the skin lipid barrier. 

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Further reading: Is niacinamide good for seborrheic dermatitis?

Gentle cleanser

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Use gentle cleansers that are designed specifically for people with sensitive skin and is safe for everyday use. The best cleansers are made with natural ingredients that are gentle on the skin, and is also hypoallergenic and non-irritating.

Makeup

Seborrheic dermatitis is a skin condition that can be embarrassing. Over time, I decided to not cover up but if you are still feeling self-conscious about your rash, the good news is that there are a number of makeup products that can help to camouflage the symptoms of seborrheic dermatitis.

Check out makeup for seborrheic dermatitis for some great options.

Apple cider vinegar

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Apple cider vinegar (ACV) is made from fermented apples and has a high acidic content. ACV has anti-inflammatory and antifungal properties, which may help reduce the symptoms of seborrheic dermatitis. You can read more about ACV and seborrheic dermatitis here.

Aloe vera

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Aloe vera is a natural remedy that has been used to treat skin ailments for centuries. Aloe vera has anti-inflammatory and antimicrobial properties that make it an effective treatment for seborrheic dermatitis. Read my deep dive on aloe vera and SD.

Witch hazel

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Witch hazel is a natural astringent that can help to reduce inflammation and itchiness. It can also help to control the production of oil, which can reduce the likelihood of flare-ups. Read more about the benefits of witch hazel for seborrheic dermatitis.

Rose water

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Rose water has no antifungal activity against Malassezia. However, it smells amazing, and has anti-inflammatory and antiseptic properties that can soothe your skin and reduce redness. It also has hydrating properties that can keep the skin from becoming too dry and reduce flaking.

Further reading: Rose water for seborrheic dermatitis: Good or bad?

Goat milk

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The fatty acids in goat milk help to moisturize the skin and reduce inflammation. Goat milk also contains lauric acid, which has antibacterial and antifungal properties. Read more about goat milk and seborrheic dermatitis.

Epsom salt

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If you suffer from seborrheic dermatitis, you may want to try using epsom salt. Epsom salt can help to soothe the skin and relieve the itching and inflammation. It makes for a relaxing bath and many have found it useful when used in conjunction with other therapies. You can read my deep dive on Epsom salts and SD here.

Manuka honey

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Manuka honey is a type of honey that’s derived from the nectar of the manuka tree. It’s thought to be better than regular honey. Manuka honey has anti-inflammatory and antibacterial properties. Read more about how manuka honey helps seborrheic dermatitis.

Curd

Curd is a natural source of probiotics and lactic acid, which can help to restore the skin’s natural balance. Probiotics are beneficial bacteria that help to keep the skin healthy, while lactic acid helps to exfoliate the skin and remove dead skin cells.

Curd has anti-inflammatory and antibacterial properties that can help to soothe the skin and reduce redness. It can also help to control sebum production, which can reduce the likelihood of flare-ups.

Further reading: Curd for seborrheic dermatitis

Kefir

Some people swear that kefir helped get rid of their seb derm. Studies have shown that consuming kefir can improve your skin barrier and reduce redness. However, it needs to be ongoing rather than a one-off consumption.

Some people have even used kefir on their face. The good bacteria in kefir may improve your skin condition by rebalancing your skin microbiome. 

Read more: Is kefir good for seborrheic dermatitis?

Henna Hair Dye

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Henna has been used to treat seborrheic dermatitis, athlete’s foot, ringworm and other fungal infections for centuries. In fact, lab studies show that henna has antifungal activity against Malassezia. As an added bonus, henna nourishes and repairs your hair. However, if you are allergic to mess or have G6PD deficiency, avoid henna. 

I take a deep dive in: Is henna good for seborrheic dermatitis?

Fenugreek Seeds

Fenugreek (methis) seed is an Indian and middle Eastern spice that is commonly used in cooking and Ayurvedic medicine. Surprisingly, fenugreek extract has been found to have antifungal activity against Malassezia. Fenugreek fans have also gushed on how effective a fenugreek pack is against dandruff. You can buy fenugreek powder on Amazon or make your own paste at home from the seeds:

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Further reading: Is Fenugreek good for Seborrheic Dermatitis?

Vitamins and supplements

There is no confirmed link but some vitamin and mineral deficiencies have been associated with seborrheic dermatitis.

Some of the most common vitamin and mineral deficiencies include:

• Collagen
• Fish oil
• Zinc
• Iron
• Vitamin A
• B vitamins
• Probiotics

You can find these vitamins and minerals in whole foods like meat, carrots, oranges, and spinach. You can also take supplements.

Prescription medications

If home remedies don’t help, you may need to see a doctor for medical treatment. Your doctor may prescribe a medicated shampoo, cream, or even oral medications to treat your seborrheic dermatitis.

Antifungal creams

While clotrimazole and miconazole creams are over-the-counter, ketoconazole and ciclopirox creams (which are purportedly more effective) is prescription-only.

Sertaconazole, nitrate, and even metronidazole creams may be prescribed to treat SD.

Corticosteroid creams

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Hydrocortisone and a wide variety of other low- to mid-potency steroid creams have been used successfully in the treatment of SD. A double-blind study that compared hydrocortisone 1% cream with ketoconazole 2% cream in 72 patients with mild-to-moderate SD found that the two agents produced similar rates of response and similar reductions in scaling, redness, itching, and papules.

Having said that, I’m not a fan of steroid creams as they transiently suppress your symptoms but doesn’t actually treat the root cause.

Calcineurin inhibitors

Topical calcineurin inhibitors like tacrolimus 0.1% ointment and pimecrolimus 1% cream have the ability to modify our local immune response and is also anti-inflammatory. In clinical trials, these creams were found to be just as effective as steroid creams but were rated more favorably by patients.

Oral antifungals

In some cases, oral medications may be necessary to control seborrheic dermatitis. These medications include antifungals such as ketoconazole or itraconazole.

Oral itraconazole given in a dose of 200 mg/day for one week followed by a maintenance dose improved SD in two trials.

Oral corticosteroids

In some cases when seborrheic dermatitis proves resistant to other treatments, prescription oral steroids may be necessary to help clear the skin. While oral steroids can be effective, they can also cause serious side effects. Therefore, it is important to work with a healthcare provider to determine if they are the right treatment for you.

Non-invasive procedures

Some people may turn to non-invasive procedures to try to get relief from seborrheic dermatitis. These procedures are expensive and may not be right for everyone, but they can be worth considering if other treatments have failed.

Light therapy

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Light therapy involves exposure to specific types of light that can help reduce inflammation and skin cell turnover. Some studies have shown that light therapy may be an effective treatment for seborrheic dermatitis, although more research is needed.

Light therapy involves exposure to ultraviolet light, which can help kill the yeast that causes seborrheic dermatitis. A course of light therapy usually consists of several sessions, and it may take a few weeks to see results. Side effects are rare, but they can include sunburn and skin cancer.

Lifestyle changes

You may think medications are the only solution to seborrheic dermatitis. However, there are many lifestyle changes you can make to help control this condition. You’ll need to identify triggers for your condition and then, make the necessary changes to avoid these triggers.

Common factors that have been associated with seborrheic dermatitis include:

• Lack of sunlight
• Humidity
• Hard water
• Lack of sleep
• Sugar
• Coffee
• Fatigue
• Stress
• Anxiety
• Depression

Take a deep dive on the common triggers for seborrheic dermatitis and the foods that you may want to think about avoiding. No need to go all-out on a keto diet but a keto-slant diet focused on whole foods would probably do you good. 

To wrap up

And there you go. This is a monster article giving you a birds eye view of treatments for seborrheic dermatitis. It links out to individual articles reviewing the data behind these treatments and how effective they really are. Hope you found this helpful!