Isotretinoin efficacious in seborrheic dermatitis treatment

Key takeaways:

• Seborrheic dermatitis is often treated with topical antifungals or corticosteroids, which can be cumbersome on large areas.
• This review found isotretinoin to be efficacious in improving seborrheic dermatitis.

CHICAGO — Isotretinoin can be a helpful addition to the toolbox for seborrheic dermatitis treatment, according to a study presented at the American Society for Dermatologic Surgery Annual Meeting.

“We know that seborrheic dermatitis is a chronic and relapsing disease that can have significant psychosocial impacts on patients,” Marcus G. Tan, MD, professor of dermatology at the University of Ottawa, said during his oral abstract presentation.

“Topical antifungals or topical corticosteroids are usually the first line treatment options, but these can be cumbersome to use on a daily basis on large surface areas,” Tan continued. “Isotretinoin has been used off label in seborrheic dermatitis as it reduces sebum, normalizes keratinization and is anti-inflammatory.”

Researchers conducted a systemic review of the literature that included data from seven studies encompassing 229 patients with seborrheic dermatitis.

Six of the studies evaluated low dose, or 0.5 mg/kg per day or less, of isotretinoin. All seven studies found that patients treated with isotretinoin, even at low doses, experienced significant improvements in seborrheic dermatitis and quality of life.

In three studies including 104 patients, 45% had excellent or complete response to isotretinoin, whereas 51% had partial improvement.

When compared with oral itraconazole, topical anti-fungal products and products containing salicylic acid, isotretinoin was found to be more effective.

“Isotretinoin, even at very low doses, was found to be effective for moderate to severe seborrheic dermatitis with good safety and tolerability,” Tan said. “I hope that this presentation helps you to consider adding isotretinoin to your armamentarium when managing patients with recalcitrant seborrheic dermatitis.”