Comparing the Efficacy of Topical Terbinafine 1% Cream with Topical Ketoconazole 2% Cream and Placebo in the Treatment of Facial Seborrhoeic Dermatitis

Previous uncontrolled trials have suggested that topical terbinafine 1% cream could be useful in the treatment of seborrhoeic dermatitis. The aim of the present study was to evaluate the clinical efficacy of topical terbinafine 1% cream in patients with facial seborrhoeic dermatitis. Ninety outpatients with seborrheic dermatitis were randomized into three groups: topical terbinafine 1% cream (n=30), topical ketoconazole 2% cream (n=30), and placebo (n=30). The patients received one of these treatments twice daily for 4 weeks. Clinical evaluation of erythema, scaling and itching, each scored on a 0-3 scale was recorded at weeks 0, 4, and 12. At baseline, the mean total clinical score was 5.04±2.02, 5.04±1.50 and 4.97±1.71 in the terbinafine, ketoconazole and placebo groups, respectively. At week 12, the mean total clinical score was 1.78±2.47, 1.81±2.43 and 3.73±1.74 in the terbinafine, ketoconazole and placebo groups, respectively. A significant decrease in the mean total clinical score was found in the terbinafine and ketoconazole groups compared with the placebo group (P=0.003), while response to terbinafine was not significantly different from that to the ketoconazole (P>0.05). Terbinafine 1% cream had a comparable efficacy and safety profile to that of ketoconazole 2% cream in the treatment of facial seborrheic dermatitis.