Control of the disease can generally be gained quickly and without recourse to potent steroids e.g. the use of hydrocortisone ointment on the face

When necessary, eg. in seborrhoeic dermatitis of the scalp and beard with severe itching (1):

• add a topical corticosteroid scalp application, such as betamethasone valerate 0.1%, hydrocortisone butyrate 0.1%, or mometasone furoate 0.1%. Betamethasone is available as a mousse as well as a cream, ointment and lotion for use on the scalp
  • try 4-6 weeks of this treatment (to the scalp, not the beard). If symptoms do not resolve during this period or if response to treatment is poor seek specialist advice (1)

For adults who are affected by face and/or body seborrhoeic dermatitis, a mild topical corticosteroid cream, such as hydrocortisone 1% (or a combined imidazole and hydrocortisone preparation) can be considered to settle inflammation more quickly (1).

If there are concerns about how much topical steroid is being used on the face consider the off-label use of topical calcineurin inhibitors eg Elidel ® cream (pimecrolimus) or Proptopic ® ointment (tacrolimus) (2)

Reference:

• (1) Clinical Knowledge Summaries (July 2008). Seborrhoeic dermatitis
• (2) Primary Care Dermatological Society. Seborrhoeic dermatitis (Accessed 30/7/14)