What are the potential side effects of topical treatments for seborrhoeic dermatitis that I should discuss with my patients?

When discussing topical treatments for seborrhoeic dermatitis with patients, it is important to highlight potential side effects, particularly concerning topical corticosteroids ¹.

• Thinning of the skin (skin atrophy): This is a potential adverse effect of topical corticosteroids, especially with prolonged use ¹. Strong topical corticosteroid scalp applications are not suitable for application to the beard area due to the risk of skin thinning on the face ¹.
• Striae: Continuous use of potent or very potent corticosteroids may cause irreversible skin atrophy and striae ².
• Systemic side effects: These can occur when potent or very potent corticosteroids are applied continuously to extensive areas of the body (e.g., more than 10% of body surface area) ².

Patients should be advised that topical corticosteroids are generally for short-term use, typically up to 2 weeks for flares, to help settle inflammation ¹. For antifungals like ketoconazole, treatment has been shown to have a lower rate of adverse effects compared to steroids [Okokon, 2015].