Summary of findings 3. Topical steroids compared to comparator for infantile seborrhoeic dermatitis (including cradle cap).

Topical steroids compared to comparator for infantile seborrhoeic dermatitis (including cradle cap)
Patient or population: infantile seborrhoeic dermatitis (including cradle cap) Setting: paediatric departments in Thailand (Wananukul 2012) and Israel (Shohat 1987) Intervention: topical steroids Comparison: comparator (licochalcone 0.025% lotion; eosin 2% aqueous solution)
Outcomes	Anticipated absolute effects* (95% CI)		Relative effect (95% CI)	№ of participants (studies)	Certainty of the evidence (GRADE)	Comments
	Risk with comparator	Risk with topical steroids
Change in severity	See comment	See comment	—	105 (2 RCTs) randomised; 102 included in analysis	⊕⊝⊝⊝ Very lowa	Change in severity assessed using different scales and metrics. Wananukul 2012: cleared by day 14: 97% (95% CI 91% to 99%) with licochalcone 0.025% lotion vs 96% (95% CI 89% to 99%) with hydrocortisone 1% lotion; absolute risk reduction 1.3% (95% CI –6% to 9%) (no difference between groups on day 14). Shohat 1987: < 10% of body surface in both groups on day 10 (flumethasone pivalate 0.02% ointment vs eosin 2% aqueous solution)
Adverse events	See comment	See comment	—	105 (2 RCTs)	⊕⊝⊝⊝ Very lowa	1 participant in the licochalcone group developed an adverse effect. No other adverse events observed.
Quality of life	—	—	—	—	—	Not measured.
*The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: confidence interval; RCT: randomised controlled trial.
GRADE Working Group grades of evidence High quality/certainty: we are very confident that the true effect lies close to that of the estimate of the effect. Moderate quality/certainty: we are moderately confident in the effect estimate: the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different. Low quality/certainty: our confidence in the effect estimate is limited: the true effect may be substantially different from the estimate of the effect. Very low quality/certainty: we have very little confidence in the effect estimate: the true effect is likely to be substantially different from the estimate of effect.

^aDowngraded three levels to very low because of serious risk of bias (Shohat 1987 used staining agent that precludes blinding and Wananukul 2012 split‐body design has high risk of contamination), indirectness (different products used as comparator) and imprecision (small studies).