Anti-Yeast treatments

Overview

Anti-yeast treatments such as shampoos, creams and tablets are important in managing seborrhoeic dermatitis supressing yeasts is an important part of treatment as well as being used to keep seborrhoeic dermatitis under control.

How to treat the scalp

There are many over-the-counter anti-yeast shampoos that can be used. These include:

• Dandrazol (ketoconazole)

• Nizoral (ketoconazole) – also available on prescription

• Selsun – warning: selenium can stain cheap metals and jewellery black.

Use these shampoos as a treatment rather than as a hair wash. Leave them on for 5-10 minutes and then rinse off. Avoid using these more than twice a week as there is a risk of irritation.

For more severe seborrhoeic dermatitis affecting the scalp, a scalp application or lotion containing a steroid and salicylic acid (e.g. Diprosalic scalp application) may be prescribed. This will help control inflammation and scale.

Tar-based shampoos or Dermax (not tar-based) are good for keeping symptoms of flaking and scaling at bay, and they can be alternated with a ketoconazole shampoo. Tar-based shampoos include:

• Neutrogena T/Gel Therapeutic Shampoo

• Capasal Therapeutic Shampoo

As with the treatment shampoos above, avoid using these more than twice a week as there is a risk of irritation.

If the scalp becomes very scaly, you may need a de-scaling agent such as salicylic acid along with the shampoo. Alternatively, Capasal shampoo is a tar-based shampoo which contains a de-scaling agent.

Sometimes, healthcare professionals advise people to wash their body with an anti-yeast shampoo containing ketoconazole, as well as using it on the scalp. This can be a good way of treating large areas, such as the chest. Leave the shampoo on the body area for 5 minutes or so before rinsing it off. Since applying shampoo to the body can irritate dry skin, do this no more than twice a week.

How to apply creams

Anti-yeast creams or ointments are usually effective and can be used safely in the long-term. Examples include clotrimazole, miconazole and nystatin. They are sometimes combined with a mild steroid for a few weeks to settle inflammation.

It's best to use a cream or ointment on areas such as the face. Sometimes, anti-yeast eardrops are prescribed for the ear canals.

Oral treatments

An oral anti-yeast treatment may be needed (e.g. itraconazole or fluconazole) if the seborrhoeic dermatitis becomes severe or extensive. Oral medication is taken over several months.