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Concurrent twice-weekly applications of topical selenium sulfide for 2 weeks will decrease the fungal spore counts on the scalp and decrease infectivity.
BACKGROUND Current topical treatments of seborrheic dermatitis include steroids, selenium sulfide, pyrithione zinc, coal tar preparations, terbinafine, ketoconazole, and ultraviolet phototherapy.
Traditional topical agents such as selenium sulfide are effective, but recurrence following treatment with these agents is likely and often rapid.
5% selenium sulfide shampoo applied once a day, usually after showering, over the entire affected area.
TABLE Treatment Approaches for Tinea Versicolor Agent Suggested Dosing Topical Ciclopirox olamine 1% cream(1) Twice daily for 2 weeks Ketoconazole 2% cream(1) Twice daily until clinical improvement Miconazole 2% cream(1) Once daily for 2 weeks Oxiconazole nitrate 1% cream Once to twice daily until clinical improvement Selenium sulfide 2.
In a direct comparative test of oral itraconazole and selenium sulfide shampoo,(18) 20 patients took itraconazole 200 mg/day for 5 days, and another 20 patients used the shampoo daily for 7 days.
Topicals such as selenium sulfide employ keratolytics, which mechanically remove the keratinized layer of skin and the infection therein.