Managing fungal infections in seborrhoeic eczema

Topical antifungals such as Ketoconazole (cream/ shampoo) and Terbinafine are a well-established treatment, based on trial evidence (Picardo and Cameli, 2008). There is limited evidence that oral antifungals are beneficial.

For cradle cap (infant seborrhoeic dermatitis), in addition to scalp being affected, the condition may also affect other areas of the body such as behind the ears, in the creases of the neck, armpits and nappy area. It is treated by regular use of mild baby shampoos and the use of oil to soften the scales, avoiding olive oil which exacerbates the growth of the Malassezia yeast. If this is unsuccessful or the rash spreads more extensively, inflamed areas may require a medicated shampoo containing ketoconazole and hydrocortisone cream.