頭皮的脂漏性皮膚炎, 輕微的時候不會產生過多的頭皮屑, 此時可以使用 2% ketoconazole 洗髮精. 洗頭髮的時候, 先將 10 CC 洗髮精留在頭皮上 5 分鐘之後再沖水,
ketoconazole 成分的洗髮精每周可使用 2次. 連續使用 2-4 周.
ciclopirox 成分的洗髮精則每周兩次, 連續4周
之後每周使用一次做為保養, 預防再發
洗髮精會越來越無效, 因為有些 Malassezia 菌株最終會產生抗藥性,
Seborrheic dermatitis of the scalp — For patients with mild seborrheic dermatitis of the scalp who have diffuse, fine desquamation without inflammation (dandruff), we suggest treatment with an antifungal shampoo. Antifungal shampoos include ketoconazole 2% and ciclopirox 1%, available by prescription, and zinc pyrithione 1% and selenium sulfide 2.5% shampoo, available over the counter.
Five to 10 mL of shampoo should be left on for three to five minutes before rinsing off. Ketoconazole shampoo should be used twice a week for two to four weeks in the treatment phase. The recommendations for ciclopirox shampoo call for twice-weekly use for four weeks, with a suggestion from the manufacturer not to use it more often than every three days. The Canadian monograph for ciclopirox shampoo recommends usage two to three times per week or as often as necessary.
Subsequently, the use of the medicated shampoo once a week may be helpful to prevent relapse [51]. Minor adverse effects, such as irritation and/or burning sensation, are common with antifungal shampoo [35,52].
Patients sometimes complain that their shampoo is no longer effective. Given that some strains of Malassezia eventually become resistant to azole antifungals [19], it may be wise to effectuate, every few weeks to months, a rotation among shampoos based on different molecules.
azole 的化學結構式, 抗黴菌藥物有些帶有此結構, 稱為 azole類抗黴菌藥物
對於中度至重度的病患, 頭皮產生鱗屑（Scale）, 發炎且頭皮癢, 建議用抗黴菌洗髮精, 例如 ketoconazole 2% shampoo, 加上局部塗抹強效類固醇. 外用類固醇有很多種製劑, 例如乳霜, 噴劑, 泡沫劑, 局部類固醇可每天使用, 連續 2-4 周.
For patients with moderate to severe seborrheic dermatitis of the scalp who have scale, inflammation, and pruritus, we suggest treatment with an antifungal shampoo (eg, ketoconazole 2% shampoo) in combination with a high-potency topical corticosteroid (table 1) in a formulation (lotion, spray aerosol, or foam) of patient choice. Topical corticosteroids can be used daily for two to four weeks.
鱗屑太厚的病患可使用含有水楊酸的洗髮精.
The addition of a salicylic acid shampoo to the above regimen may be helpful for patients with thick scale.
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