Topical antifungals for seborrhoeic dermatitis
meta-analysis Grade A 2015 n=9052 Open access
Authors: Okokon, Enembe O., Verbeek, Jos H., Ruotsalainen, Jani H., Ojo, Olumuyiwa A., Bakhoya, Victor Nyange
Journal: Cochrane Database of Systematic Reviews (Issue 4, Art. No.: CD008138)
Key Findings
- Cochrane systematic review and meta-analysis of 51 RCTs (9,052 participants) evaluating topical antifungals for seborrhoeic dermatitis of the face and scalp
- Ketoconazole 2% vs. placebo: 31% lower risk of treatment failure at 4 weeks (low-quality evidence)
- Ketoconazole vs. topical steroids: similar remission rates, but 44% fewer side effects with ketoconazole — establishing its favorable safety profile relative to steroids
- Ciclopirox 1% vs. placebo: 21% lower failure rate (moderate-quality evidence)
- Malassezia yeast overgrowth is strongly implicated as causal — antifungal efficacy itself is cited as supporting evidence for the yeast-driven disease model
- Overall evidence quality across comparisons graded low-to-moderate, chiefly due to unclear or high risk of bias in most included trials
A large Cochrane meta-analysis of pharmaceutical topical antifungals for seborrhoeic dermatitis — not peat-specific, and doesn’t test any peat-derived substance. It’s included as a standing benchmark reference rather than attached to any claim: it documents what conventional treatment actually achieves (ketoconazole roughly 31% better than placebo, with a materially better side-effect profile than topical steroids), which is the bar any future peat-vs-standard-care comparison would need to be read against.
No claim on this site currently cites this paper directly, since it doesn’t involve peat. It’s kept on file for when a genuine peat-vs-antifungal comparison study is identified.
seborrheic-dermatitisketoconazoleantifungalCochranemeta-analysisbenchmark