{ "schema_version": 1, "kind": "condition", "id": "seborrhoeic-dermatitis", "name": "Seborrhoeic dermatitis (adult scalp and face)", "category": "chronic", "sources": "BAD Guidelines for Seborrhoeic Dermatitis 2019 · Hydrocortisone 1% cream SmPC section 4.2 (eMC product 13103) · Nizoral 2% Shampoo SmPC section 4.2 (eMC product 1510) · Seborrheic Dermatitis - StatPearls - NCBI Bookshelf - disease-level clinical article (seborrhoeic-dermatitis-full.txt)", "review_status": "reviewed", "verified_against": "Nizoral 2% Shampoo SmPC section 4.2 (eMC product 1510) · Hydrocortisone 1% cream SmPC section 4.2 (eMC product 13103) · Seborrheic Dermatitis - StatPearls - NCBI Bookshelf - disease-level clinical article (seborrhoeic-dermatitis-full.txt)", "verified_date": "2026-08", "treatments": [ { "id": 1605, "generic": "Ketoconazole", "line": 1, "is_adjunct": false, "form": "topical", "strength_mg": null, "adult_dose": "Wash hair twice weekly.", "adult_duration": "2-4 weeks for treatment, then once every 1-2 weeks for prophylaxis", "dose_source": "Nizoral 2% Shampoo SmPC section 4.2 (eMC product 1510)", "rationale": "Ketoconazole is a topical antifungal that targets the Malassezia yeast implicated in seborrhoeic dermatitis, reducing the scaling and inflammation of the scalp and face; it is first-line therapy for this condition.", "cautions": [ "Leave shampoo on scalp for 3-5 minutes before thoroughly rinsing.", "Avoid contact with eyes; rinse immediately if exposed.", "May cause mild local skin irritation or dry skin.", "Steroid withdrawal: gradually withdraw prior topical steroid therapy over 2 to 3 weeks while using shampoo to prevent rebound effect." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Children >12 years: apply twice weekly for 2-4 weeks", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": null, "brands": [ { "trade_name": "KONAZOLE 2% CREAM 15 GM", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ALFACURE PHARMACEUTICALS", "price_egp": 6.0, "pack_count": null, "unit_price": null, "strength_mg": 15000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "CURAZOLE 2% TOPICAL CREAM 15 GM", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EVA PHARMA", "price_egp": 7.0, "pack_count": null, "unit_price": null, "strength_mg": 15000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "KETODERM 2% TOP. CREAM 20 GM", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SEDICO", "price_egp": 7.0, "pack_count": null, "unit_price": null, "strength_mg": 20000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "KONAZOLE 2% SHAMPOO 60 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ALFACURE PHARMACEUTICALS", "price_egp": 12.0, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "KETODERM 2% GEL SHAMPOO 60 GM", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SEDICO", "price_egp": 18.0, "pack_count": null, "unit_price": null, "strength_mg": 60000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "KENZO 2% SHAMPOO 60 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "BORG", "price_egp": 27.5, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "NIZAPEX 20MG/GM SHAMPOO 80 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "APEX PHARMA", "price_egp": 68.0, "pack_count": null, "unit_price": null, "strength_mg": 20.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "NIZORAL 2% SHAMPOO 60 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MINA PHARM > JANSSEN CILAG", "price_egp": 68.0, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "seborrhoeic-dermatitis" }, { "id": 1607, "generic": "Referral & safety-netting (no drug therapy)", "line": 1, "is_adjunct": false, "form": null, "strength_mg": null, "adult_dose": null, "adult_duration": null, "dose_source": "Seborrheic Dermatitis - disease-level clinical article (seborrhoeic-dermatitis-full.txt)", "rationale": "Carries the referral criteria and warning signs for this condition, which apply whichever treatment is chosen.", "cautions": [ "RED FLAG - Sudden-onset or severe seborrhoeic dermatitis in an adult should prompt expedited HIV serology.", "In an elderly patient with seborrhoeic dermatitis, look actively for clinical features of Parkinson disease and review the medication list.", "Topical antifungals are the first-line treatment; topical corticosteroids and calcineurin inhibitors are reserved for significant symptoms and moderate-to-severe flares.", "Limit topical corticosteroid harm by using them intermittently at a potency appropriate to the site, or by switching to a steroid-sparing preparation such as topical 1% pimecrolimus.", "If oral antifungal treatment is needed for generalised or refractory disease: ketoconazole carries a Black Box warning and needs liver function monitoring, itraconazole has CYP450 interactions and can worsen heart failure, and fluconazole needs dose adjustment for renal function.", "Flexural areas and the eyelids are prone to secondary bacterial infection during acute flares, and the nappy area to Candida overgrowth.", "The commonest problem in both infant and adult seborrhoeic dermatitis is misdiagnosis - reconsider psoriasis, contact eczema, discoid lupus, rosacea, tinea and Darier disease before treating a resistant rash as seborrhoeic dermatitis.", "Erythroderma is a recognised progression, reported in immunosuppressed neonates with generalised infantile disease and more often seen in adults with HIV-AIDS.", "Topical salicylic acid, selenium and zinc lack safety and efficacy data in infants and should be used with care in that age group." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": null, "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": null, "brands": [], "condition_id": "seborrhoeic-dermatitis" }, { "id": 1608, "generic": "Selenium sulphide", "line": 1, "is_adjunct": false, "form": "topical", "strength_mg": null, "adult_dose": "Massage 5 to 10 mL of the 2.5% lotion or shampoo into the wet scalp, leave it on for 2 to 3 minutes, then rinse thoroughly", "adult_duration": "Twice a week for 2 weeks, then spaced out to hold it - once a week, or every 2 to 4 weeks", "dose_source": "Egyptian National Drug Formulary - Antimicrobial 2023, selenium sulfide monograph - verbatim, for the indication: \"Dandruff, scalp seborrhea: Treatment of dandruff and seborrheic dermatitis of the scalp\", and for the dose: \"Lotion, shampoo (2.25%): Massage ~5 to 10 mL into wet scalp; leave on scalp for 2 to 3 minutes, then rinse scalp thoroughly.\" and \"Usually 2 applications each week for 2 weeks will be effective. After this, may repeat at less frequent intervals (eg, once weekly, every 2 to 4 weeks).\" The monograph heads the same entry \"Shampoo 0.025 gm (2.5%)\"; every Egyptian product is 2.5%.", "rationale": "The scalp treatment the Egyptian formulary names for this disease, and the cheapest thing on the card - a 2.5% lotion costs about 4 EGP.", "cautions": [ "Not on broken, weeping or acutely inflamed skin, and not on mucous membranes - the formulary is explicit that it is not for use where there is acute inflammation or exudation.", "Not recommended in pregnancy, and use caution while breastfeeding.", "Rinse thoroughly. Left on, it can discolour hair or leave the scalp unusually dry or oily.", "Remove jewellery before treatment - it can damage it.", "Check the box lists selenium sulfide and nothing else. Most Egyptian anti-dandruff shampoos add zinc pyrithione, climbazole or piroctone olamine, and this dose was written for the single-agent 2.5% product - shampoo, lotion or cream alike, the formulary covers all three." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "The monograph states no paediatric dose. For a baby with cradle cap, look up infantile seborrhoeic dermatitis instead.", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": null, "brands": [ { "trade_name": "VENEER HAIR SHAMPOO 120 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EGYPTIAN COMPANY FOR COSMETICS > RAND PHARM", "price_egp": 32.95, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "SELENO CARE HAIR SHAMPOO 150 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SIGMA > INTERPHARMA", "price_egp": 98.0, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "SELENGENA ANTI-DANDRUFF SHAMPOO 120 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EGYPTIAN CO. FOR COSMETICS (E.C.C.) > PARKVILLE", "price_egp": 105.0, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "SELENGENA ANTI-DANDRUFF SHAMPOO 220 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EGYPTIAN CO. FOR COSMETICS (E.C.C.) > PARKVILLE", "price_egp": 165.0, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "TINASEL 2.5 GM CREAM 20 GM", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ALFACURE PHARMACEUTICALS", "price_egp": 5.0, "pack_count": null, "unit_price": null, "strength_mg": 2500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "seborrhoeic-dermatitis" }, { "id": 1606, "generic": "Hydrocortisone", "line": 2, "is_adjunct": true, "form": "topical", "strength_mg": null, "adult_dose": "Apply sparingly to the affected skin two or three times daily after gently cleansing the area", "adult_duration": null, "dose_source": "Hydrocortisone 1% cream SmPC section 4.2 (eMC product 13103)", "rationale": "Low-potency hydrocortisone is added to the antifungal regimen for facial seborrhoeic dermatitis to quickly settle inflammation and itching during a short course; it does not address the underlying Malassezia overgrowth on its own.", "cautions": [ "Use lowest potency (1%) on facial skin for short courses only.", "Do not apply near eyes.", "Limit a course in a child to 7-10 days, and remember the face and scalp absorb far more than limb skin.", "Contraindicated in rosacea, urticaria, ulcers, and local infection." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Infant cradle cap has its own entry - see Infantile Seborrhoeic Dermatitis (Cradle Cap). Do not apply this adult regimen to an infant.", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": null, "brands": [ { "trade_name": "NOVACORTIN 1% CREAM 15 GM", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PHAROPHARMA", "price_egp": 4.75, "pack_count": null, "unit_price": null, "strength_mg": 15000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "NOVACORTIN 1% OINT. 15 GM", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PHAROPHARMA", "price_egp": 4.75, "pack_count": null, "unit_price": null, "strength_mg": 15000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "MICORT 1% CREAM 20 GM", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MISR", "price_egp": 12.5, "pack_count": null, "unit_price": null, "strength_mg": 20000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "HYDROCORTISONE 1% OINT. 20 GM", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MISR", "price_egp": 21.0, "pack_count": null, "unit_price": null, "strength_mg": 20000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "seborrhoeic-dermatitis" } ] }