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Seborrhoeic dermatitis - Evidence
Evidence on treatments to manage seborrhoeic dermatitis of the scalp and beard
Anti-dandruff shampoos:
- CKS found no good-quality evidence on shampoos containing zinc pyrithione and other over-the-counter preparations in people with mild dandruff.
Ketoconazole scalp preparations compared with placebo:
- A systematic review (search date February 2007) found no systematic reviews comparing ketoconazole shampoo with placebo but identified five RCTs (number of participants ranged from 20 to 246) [Manriquez and Uribe, 2007].
- Compared with placebo, ketoconazole 2% shampoo showed improvement in symptoms after 4 weeks in all trials.
- An adverse effect (one case of scalp tenderness) was reported in one trial.
Selenium sulphide compared with ketoconazole:
- One RCT was found which compared selenium sulphide 2.5% shampoo with ketoconazole 2% shampoo and placebo in people with moderate-to-severe dandruff (n = 46, of whom approximately a third had seborrhoeic dermatitis) [Danby et al, 1993].
- Mean adherent dandruff scores were used to assess response. In the placebo group, 44.5% (n = 49) showed a reduction in total adherent dandruff score, compared with 73% of the ketoconazole group (n = 94) and 66.7% of the selenium sulphide group (n = 95).
- Adverse effects were only reported in the selenium sulphide group (by 14 people) and included pruritus, burning sensation, skin eruption, psoriasis, bleaching of hair, and orange staining of the scalp.
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