General Notes
- Dandruff is considered a mild form of seborrhoeic dermatitis.
- Shampoos containing antimicrobial agents such as pyrithione zinc and selenium sulfide (which are widely available) may have beneficial effects.
- Ketoconazole should be considered for more persistent or severe dandruff or for seborrhoeic dermatitis of the scalp.
- Corticosteroid gels and lotions can also be used.
- Shampoos containing coal tar and salicylic acid may also be useful.
- Patients who do not respond to these treatments may need to be referred to exclude the possibility of other skin conditions.
Shampoos
| Choice | Drug | Dosage |
|---|---|---|
| 1st choice | Capasal® shampoo 250mls (coal tar 1%, coconut oil 1%, salicylic acid 0.5%) | Dose: |
| or | ||
| Polytar Scalp shampoo 150mls | Dose: Apply 1-2 times weekly as directed | |
| or | ||
| T/gel® shampoo 125mls/250mls (coal tar extract 2%) | Dose: Apply 2-3 times per week |
Shampoos with antifungal
| Choice | Drug | Dosage |
|---|---|---|
| 1st choice | Ketoconazole 2% shampoo 120mls | Dose: |
Scalp Treatments
| Choice | Drug | Dosage |
|---|---|---|
| 1st choice | Sebco® scalp ointment: (coal tar solution 12%, salicylic acid 2%, precipitated sulphur 4% in coconut oil emulsion basis) | Dose: |
Prescribing Notes
- Treatment depends on the severity of the condition. Shampoo formulations are preferred for moderate scaly scalp conditions, whereas more severe conditions may require an ointment.
- Shampoo should be left on the scalp for 20-30 minutes before washing off.
- Ketoconazole shampoo is often helpful for seborrhoeic dermatitis of the scalp.
- Eucerin® shampoo (which contains urea 5%) can be particularly useful for elderly patients with very dry scalp.
Caution
Sebco® and Capasal® contain coconut oil; caution should be used if nut allergy is a co-morbidity.
Hirsuitism-see 7.3 for further information.