Seventy-two patients with seborrheic dermatitis were treated once daily with 2% ketoconazole cream (n = 36) or 1% hydrocortisone cream (n = 36) on a double-blind basis for 4 weeks. For the global evaluation, no significant difference could be seen between the two groups. The clinical response was 80.5% in the ketoconazole group and 94.4% in the hydrocortisone group. For the different symptoms combined (scaling, redness, itching, and papules), no significant difference was seen between the two groups when the total scores at week 2 and at week 4 were compared with the initial scores. The incidence of side effects in both groups was comparably low.