Prior Treatment Options and Outcomes for SD


Experts shed light on the challenges of seborrheic dermatitis treatment, emphasizing the historical lack of treatment options and importance of patient education.


Linda Stein Gold, MD: Now, Neal, I’m going to come back to you for a minute because this is something that we haven’t talked about that much. When we look at our treatment armamentarium, where have we been?

Neal Bhatia, MD: Well, you mentioned how we all do trials. We all have to bring something to the market for some indication. Psoriasis and atopic dermatitis have been the popular flavors over the years, but to bring something truly to the market for seborrheic dermatitis has not been a goal not only of any project or product, but even [by] a lack of interest by the dermatology world. That being said, we can apply the mechanisms of action of the therapies we know work for those anti-inflammatory approaches and apply them to seborrheic dermatitis in a very similar way. But the more we have good trial data, the more we have good before and after pictures, the more patient-related outcomes, like we’ve seen with a couple of the trials that we’re going to talk about, the more we can impact that. Yes, we’ve been using ketoconazole shampoo, antifungals over the counter, hydrocortisone lotion, but again, it’s like throwing things at the mirror to see if they stick. But at the same time, we haven’t had really some dedicated treatments until a few years ago. We had a 510(k) device that had a really interesting approach. It had shea butter,…vitis vinifera, gluconic acid, and lanolin; all of that, which was in a nice green base that really did work well. But unfortunately, that product isn’t as commonly found as it was. The other part of it, again, and you touched on this, Linda, is about the patient perception. If they feel like they’re looking in the mirror and seeing dryness, they think they’re dirty, or someone looks at them as not really taking care of their hygiene, which is not fair. So we have to really get back to good counseling on fundamentals of cleansing and moisturizing, maybe going back to sulfacetamide cleansers like we used to, thinking about how long do we leave cleanser on, and how long do we leave shampoo on? These are things that patients really need some handholding to say, "Look, you need to let these shampoos sit for 5 minutes and then rinse." You’re not just treating your hair, but you’re treating your whole head. Same with cleansing. They have to think about what they are using in the shower versus what are they using in the evening. So, all these little nuances, aside from the prescription products we use, the fundamentals of skin care have to be just as important.

Transcript was AI-generated and edited for clarity.

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Jonathan Silverberg, MD, PhD, MPH | Credit: George Washington University
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