Topical Treatment of Facial Seborrheic Dermatitis: A Systematic Review.
BACKGROUND
Facial seborrheic dermatitis (SD), a chronic inflammatory skin condition, can impact quality of life, and relapses can be frequent. Three broad categories of agents are used to treat SD: antifungal agents, keratolytics, and corticosteroids. Topical therapies are the first line of defense in treating this condition.


OBJECTIVE
Our objective was to critically review the published literature on topical treatments for facial SD.


METHODS
We searched PubMed, Scopus, Clinicaltrials.gov, MEDLINE, Embase, and Cochrane library databases for original clinical studies evaluating topical treatments for SD. We then conducted both a critical analysis of the selected studies by grading the evidence and a qualitative comparison of results among and within studies.


RESULTS
A total of 32 studies were eligible for inclusion, encompassing 18 topical treatments for facial SD. Pimecrolimus, the focus of seven of the 32 eligible studies, was the most commonly studied topical treatment.


CONCLUSIONS
Promiseb®, desonide, mometasone furoate, and pimecrolimus were found to be effective topical treatments for facial SD, as they had the lowest recurrence rate, highest clearance rate, and the lowest severity scores (e.g., erythema, scaling, and pruritus), respectively. Ciclopirox olamine, ketoconazole, lithium (gluconate and succinate), and tacrolimus are also strongly recommended (level A recommendations) topical treatments for facial SD, as they are consistently effective across high-quality trials (randomized controlled trials).
Department of Medicine, University of Toronto, Toronto, ON, Canada. publications@mediproberesearch.com.|Mediprobe Research Inc., 645 Windermere Road, London, ON, Canada. publications@mediproberesearch.com.
Aditya K
AK
Gupta
Mediprobe Research Inc., 645 Windermere Road, London, ON, Canada.
Sarah G
SG
Versteeg
D000279:Administration, Cutaneous; D000893:Anti-Inflammatory Agents / Q000009:adverse effects / Q000627:therapeutic use*; D000935:Antifungal Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D065095:Calcineurin Inhibitors / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D000077768:Ciclopirox; D012628:Dermatitis, Seborrheic / Q000188:drug therapy* / Q000382:microbiology; D003879:Dermatologic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D003898:Desonide / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D005148:Facial Dermatoses / Q000188:drug therapy* / Q000382:microbiology; D006801:Humans; D007654:Ketoconazole / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D008290:Malassezia / Q000187:drug effects; D000068656:Mometasone Furoate / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D028321:Plant Preparations / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D017410:Practice Guidelines as Topic; D011728:Pyridones / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D016559:Tacrolimus / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives / Q000627:therapeutic use; D016896:Treatment Outcome; D014815:Vitamins / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use
D000893:Anti-Inflammatory Agents; D000935:Antifungal Agents; D065095:Calcineurin Inhibitors; D003879:Dermatologic Agents; D028321:Plant Preparations; D011728:Pyridones; D014815:Vitamins; D000068656:Mometasone Furoate; D000077768:Ciclopirox; C117268:pimecrolimus; D003898:Desonide; D007654:Ketoconazole; D016559:Tacrolimus