What therapies do you recommend for patients with recalcitrant seborrheic dermatitis?
What treatment regimen have you found most effective?
Do you recommend any lifestyle changes or prescribe oral azoles?
Any experience with topical roflumilast?
Answer from: at Academic Institution
Topical roflumilast is easily the most effective thing I've ever seen. Prior to that being available, here were the go-to drugs for difficult seb derm:
Itraconazole 200 mg qd until better, then 200 mg qd on weekends long term
Fluconazole, exact same regimen if itraconazole not accessible
Oral R...
Depends if facial, scalp, or ear location and what has previously been tried.
I usually start with some form of ketoconazole (cream or shampoo), but some people respond better to other shampoos like ciclopirox, selenium sulfide, or pyrithione zinc or a rotation of a couple of the above.
I al...