Narrative review evaluates contemporary topical, systemic, and procedural therapies for seborrheic dermatitis, highlighting roflumilast foam as a promising first-line intervention.
INTRODUCTION: Seborrheic dermatitis (SD) is a common, chronic inflammatory skin condition affecting sebaceous gland-rich areas of the skin. The multifactorial etiology of SD involves sebocyte activity, skin microbiome dysbiosis, and immune factors. Various treatment options exist for management of SD. METHODS: A PubMed search conducted on November 1, 2024 using the terms "seborrheic dermatitis" and "treatment" (restricted to 2019-2024) yielded 389 results, from which relevant papers and additional references were included in this review. DISCUSSION: Topical antifungals, topical corticosteroids, and topical calcineurin inhibitors are first-line treatments for SD; however, long-term use of each of these may be limited by varying side effects. Roflumilast foam is a newly approved topical with potential to become a first-line treatment. Myriad systemic treatments exist as second- and third-line treatments for cases of moderate-to-severe and/or recalcitrant SD. Procedural interventions of varying efficacy exist. CONCLUSIONS: The treatment of SD requires an individualized approach, utilizing a range of topical, systemic, and procedural interventions. The advent of new treatments like roflumilast foam offers novel, well-tolerated, and safer options than what has been available in the past.
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