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

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Posted: 16 August 2025Updated: 16 August 2025 Guideline-Aligned (High Confidence) Clinically Reviewed
Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX

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

  • Thinning of the skin (skin atrophy): This is a potential adverse effect of topical corticosteroids, especially with prolonged use . Strong topical corticosteroid scalp applications are not suitable for application to the beard area due to the risk of skin thinning on the face .
  • Striae: Continuous use of potent or very potent corticosteroids may cause irreversible skin atrophy and striae .
  • 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) .

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

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