Clinical efficacies of topical agents for the treatment of seborrheic dermatitis of the scalp: a comparative study

J Dermatol. 2009 Mar;36(3):131-7. doi: 10.1111/j.1346-8138.2009.00607.x.


Previous studies have shown that topical steroid and shampoo containing zinc pyrithione provide clinical benefits for treatment of scalp seborrheic dermatitis. But the clinical efficacy of topical tacrolimus, a newly developed calcineurin inhibitor on seborrheic dermatitis, is not well investigated yet. We wanted to compare the clinical efficacy of topical tacrolimus with that of conventional treatment (zinc pyrithione shampoo and topical betamethasone) for treatment of seborrheic dermatitis of the scalp. Patients with seborrheic dermatitis of the scalp were randomly allocated to receive topical betamethasone, topical tacrolimus or zinc pyrithione shampoo. Some patients were instructed to continue the treatments for 8 weeks and the others to discontinue the treatments at week 4. We evaluated the efficacy using a clinical severity score, dandruff score and sebum secretion at baseline, week 4 and week 8. All treatment groups showed significant improvements in clinical assessment after 4 weeks. While the patients treated by zinc pyrithione improved continuously even after cessation of the treatment, the patients treated by betamethasone lotion or tacrolimus ointment were aggravated clinically. Topical tacrolimus was as effective as topical betamethasone, and showed more prolonged remission than topical betamethasone. To treat seborrheic dermatitis of the scalp, we think that the combination therapy of topical steroid or topical tacrolimus, and zinc pyrithione is recommended.

Publication types

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

MeSH terms

  • Administration, Topical
  • Adult
  • Antifungal Agents / administration & dosage
  • Betamethasone Valerate / administration & dosage
  • Calcineurin Inhibitors
  • Dermatitis, Seborrheic / drug therapy*
  • Female
  • Glucocorticoids / administration & dosage
  • Humans
  • Male
  • Middle Aged
  • Organometallic Compounds / administration & dosage
  • Pyridines / administration & dosage
  • Recurrence
  • Scalp Dermatoses / drug therapy*
  • Tacrolimus / administration & dosage
  • Time Factors
  • Young Adult


  • Antifungal Agents
  • Calcineurin Inhibitors
  • Glucocorticoids
  • Organometallic Compounds
  • Pyridines
  • Betamethasone Valerate
  • pyrithione zinc
  • Tacrolimus