Treatment and prophylaxis of seborrheic dermatitis of the scalp with antipityrosporal 1% ciclopirox shampoo

Arch Dermatol. 2005 Jan;141(1):47-52. doi: 10.1001/archderm.141.1.47.

Abstract

Objective: To demonstrate the efficacy, safety, and tolerance of ciclopirox shampoo for treatment and prophylaxis of seborrheic dermatitis of the scalp.

Design: Multicenter, randomized, double-blind, vehicle-controlled study. After treatment with ciclopirox shampoo once or twice weekly or vehicle for 4 weeks (study segment A), responders were randomized to a 12-week prophylactic study arm (segment B).

Setting: Forty-five medical centers in Germany (n = 19), France (n = 15), the United Kingdom (n = 8), and Austria (n = 3). Patients A total of 1000 patients with stable or exacerbating seborrheic dermatitis of the scalp. Interventions A total of 949 patients were randomized to receive ciclopirox treatment once or twice weekly or vehicle for 4 weeks. Thereafter, 428 responders received either ciclopirox prophylaxis once weekly or every 2 weeks or vehicle for 3 months.

Main outcome measures: Primary and secondary: response of "effectively treated" and "cured," with investigators and patients rating acceptability and tolerance.

Results: Ciclopirox twice and once weekly produced response rates of 57.9% and 45.4%, respectively, compared with 31.6% for vehicle. Relapses occurred in 14.7% of patients using prophylactic ciclopirox once weekly, 22.1% of those in the prophylactic group shampooing once every 2 weeks, and 35.5% in the vehicle group. The few adverse events were evenly distributed among groups. Local tolerance and cosmetic acceptability were "good" in more than 85% of subjects.

Conclusions: Seborrheic dermatitis of the scalp responds well to 1% ciclopirox shampoo once or twice weekly for 4 weeks. A low relapse rate is maintained by once-weekly shampooing or shampooing once every 2 weeks. These treatments are safe and well-tolerated.

Publication types

  • Clinical Trial
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antifungal Agents / administration & dosage*
  • Antifungal Agents / adverse effects
  • Antifungal Agents / therapeutic use
  • Ciclopirox
  • Dermatitis, Seborrheic / drug therapy*
  • Dermatitis, Seborrheic / microbiology
  • Dermatitis, Seborrheic / prevention & control*
  • Double-Blind Method
  • Drug Administration Schedule
  • Esthetics
  • Female
  • Hair Preparations
  • Humans
  • Malassezia / drug effects*
  • Male
  • Middle Aged
  • Patient Satisfaction
  • Pyridones / administration & dosage*
  • Pyridones / adverse effects
  • Pyridones / therapeutic use
  • Scalp Dermatoses / drug therapy*
  • Scalp Dermatoses / microbiology
  • Scalp Dermatoses / prevention & control*

Substances

  • Antifungal Agents
  • Hair Preparations
  • Pyridones
  • Ciclopirox