Flaky Red Patches by Your Nose and Brows: Seborrheic Dermatitis Treatment Options

Seborrheic dermatitis causes red or discolored patches with greasy flakes, often beside the nose, in the eyebrows, behind the ears or along the scalp. It can overlap with psoriasis, so a dermatologist may need to tell them apart.¹ Our guide to an itchy, flaky scalp covers the scalp side.

Step 1: everyday care

• Zinc soap for washing affected skin is often recommended.¹
• Dandruff shampoo works for mild to moderate scalp involvement, and dermatologists may have you lather it on your face or other affected skin too.¹ Leave it on as long as directed so the medicine can work.¹
• Keep it up once a week after things calm down to help prevent flares, and rotate shampoos if one stops working.¹

Our guide to dandruff shampoo ingredients explains the options.

Step 2: prescription creams and foams

Antifungals. Ketoconazole cream, gel or foam is often prescribed; it may sting or irritate.¹

Short courses of steroid cream. Added if antifungals or shampoos aren’t enough, or to calm a flare.¹ Our article on topical steroid details covers safe use.

Calcineurin inhibitors. Pimecrolimus cream and tacrolimus ointment can be prescribed short term.¹

Roflumilast 0.3% foam. A nonsteroid foam approved for seborrheic dermatitis, applied once daily in a thin layer to dry skin.² It can be used on the nose, eyebrows, ears, eyelid skin and scalp, per the AAD, though the label says not to put it in the eyes or mouth.¹²

In two 8-week trials with 683 people, more improved on the foam than on an inactive foam (79.5% vs. 58.0% in one trial, 73.1% vs. 40.8% in the other, by the trials’ success measure).² The most common side effects were cold symptoms, nausea and headache.²

Label cautions: the foam is flammable, so avoid flames and smoking while applying, and it isn’t for people with moderate to severe liver disease.²

Questions to ask

1. Is this seborrheic dermatitis, rosacea or psoriasis? See our rosacea guide.
2. What should I use daily, and what only for flares?
3. Will my plan cover the newer foam, or should I try older options first?

Try: “I keep getting flaky red patches by my nose and eyebrows. Could this be seborrheic dermatitis, and what’s a good plan for flares and maintenance?”

Skin, Head to Toe includes a short-shelf planner and a 12-week SkinLog. Use them to track which products you use and how the patches respond each week. See the book.