Experts' view on the management of scalp seborrheic dermatitis in Italy

Acne vulgaris is a common skin disorder that negatively affects adolescents' quality of life. Recent evidence suggests that combining isotretinoin with desloratadine may enhance treatment outcomes.

This study aimed to develop a practical algorithm for SSD management in Italy, by gathering insights from Italian dermatology experts on diagnosis, treatment and long-term management of SSD.

According to literature review and clinical experience, accurate diagnosis of SSD requires medical history, clinical evaluation, disease severity assessment and trichoscopy. The differentiation of SSD from psoriasis, eczema, and tinea capitis is essential to guide appropriate treatment, which should counteract the main pathogenic mechanisms underlying the disease and be tailored to the severity of clinical manifestations. Topical antifungals are the first-line treatments due to their efficacy in reducing Malassezia colonization. The use of topical anti-inflammatory agents, including corticosteroids, is useful for moderate-to-severe cases, but should be limited due to potential adverse effects. Selenium disulfide may be a useful option for both acute symptom control and long-term maintenance because of its antifungal, sebostatic, keratolytic, and microbiome-restoring properties, associated with a high degree of patient satisfaction. Systemic antifungals may be considered in refractory cases.

This experts' view provides a structured approach to SSD management in Italy, integrating clinical experience and scientific evidence.