Beyond Efficacy: 0.6% Selenium Disulfide Shampoo Matches 2% Ketoconazole for Seborrheic Dermatitis with Superior Cosmesis

Seborrheic dermatitis (SD) is a chronic, relapsing inflammatory condition. SD affects areas that are rich in sebaceous glands, most commonly the scalp (SSD).¹ In adults, SD occurs in approximately 1-3% of the general population, affecting men more often than women.² There is a spectrum of disease in SD that ranges from mild to severe.³ Mild cases are sometimes referred to as dandruff or pityriasis sicca. This form of SD is characterized by dry flaking, often likened to snowflakes, which is noticeable on the scalp, hair shafts, and clothing. In more severe cases of SD, the inflammation may be more clinically evident with thick, greasy, yellowish flakes adherent to an erythematous scalp. The face is the second most affected area with similar appearing patches located symmetrically on the central face, nasolabial folds, alar creases, and eyebrows. SD can also affect the ear canals, post-auricular area, neck creases, central chest, axillae, and inguinal folds. In melanin-rich skin, pink or hypopigmented annular coalescing ring-like scaling lesions, referred to as Petaloid SD, may be seen in and along the hairline and on the central face.⁴ The primary symptom associated with all forms of SD is intense itching, although some patients note burning, stinging, and/or cosmetic product intolerance.⁵ The burden of SD is significant, with sufferers experiencing not only physical signs and symptoms, but the embarrassment associated with unsightly visible flaking that can affect self-esteem.

The pathogenesis of SD is complex, and our understanding is still evolving. There appears to be an interplay between microbial colonization, altered lipid composition, and epidermal barrier dysfunction. In SD, there is an increased abundance of Malassezia spp. on the scalp that is related to disease