Scalp Seb Derm Treatment — SCE Dermatology MCQ

Correct answer: C — Topical corticosteroid scalp application (Betamethasone valerate 0.1% scalp application) for short-term use to control inflammation, followed by maintenance antifungal shampoo

For scalp seborrhoeic dermatitis not responding to antifungal shampoo (Ketoconazole 2% or Ciclopirox) alone, adding a topical corticosteroid scalp application (Betamethasone valerate 0.1% solution, Clobetasol shampoo) for 2-4 weeks controls inflammation. Once inflammation settles, maintenance with antifungal shampoo (1-2 times weekly) prevents relapse. Coal tar shampoo is an alternative anti-inflammatory option. For facial seborrhoeic dermatitis, topical Ketoconazole 2% cream, topical calcineurin inhibitors (Tacrolimus/Pimecrolimus), or short courses of mild topical corticosteroid (Hydrocortisone 1%) are used. Scalp SD is chronic and relapsing — patient education about the need for maintenance treatment and trigger management (stress, fatigue) is important.

Reference: BAD; NICE CKS Seborrhoeic Dermatitis