Table 1.

Recommended Pharmacological Topical Agents for Scalp Seborrheic Dermatitis in Adults

Agent	Dose/Formulation	Schedule	Comments
Ketoconazole	1–2% shampoo	Twice weekly for 4 weeks	Ketoconazole 2% shampoo once weekly for 6 months has been shown to be effective in preventing relapse31
	2% foam	Twice daily for 4 weeks	Twice daily continuative use (for up to 12 months) has demonstrated high safety profile29
	2% gel	Twice weekly for 4 weeks	Fast efficacy and low rate of recurrences after discontinuation30
	2% foaming gel	Twice weekly for 1 month → once weekly for 3 months	Significant reduction of erythema and P. orbiculare count by microbiological evaluation vs 0.005% betamethasone dipropionate lotion31
Ciclopirox	1–1.5% shampoo	3 times a week for 4 weeks	No statistically significant difference in clinical response for higher vs lower concentrations28
	0.77% gel	Twice daily for 4 weeks
Miconazole	2% solution	Once daily for 3 weeks	Miconazole 2% solution + 1% hydrocortisone solution more effective than 2% miconazole as monotherapy35
Betamethasone valerate	0.12% foam	Twice daily for 4 weeks	Prolonged use not recommended, due to possible side effects24
Clobetasol propionate	0.05% shampoo	Twice weekly for up to 2 weeks	It can be used alone or in combination with antifungal agents; prolonged use should be avoided to prevent side effects36
Propylene glycol	15% solution	Once daily for 3 weeks	Significant reduction of P. orbiculare count by microbiological evaluation38