Eczema

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Refer to full Ghana STG for full guidance on how to treat eczema. This section will only guide on the treatment of seborrhoiec eczema as this features the use of topical antimicrobials.

Seborrhoiec eczema presents as a scaly, flaking, dry and reddened rash of the scalp, eyebrows, nasolabial folds, perioral, periorbital and periauricular skins. Sometimes it presents as hypopigmented macules. It may be associated with Pityrosporum ovale infection. Extensive forms are associated with immunosuppressive states, particularly HIV/AIDS and diabetes mellitus.

Seborrhoiec Eczema

Evidence Rating: [C]

• Miconazole, 2% plus hydrocortisone 1% cream, topical,

Adults 

Apply 12 hourly till rash resolves 

Children 

Apply 12 hourly till rash resolves

Or

• Clotrimazole, 1% plus hydrocortisone 1% cream, topical,

Adults 

Apply 12 hourly till rash resolves 

Children 

Apply 12 hourly till rash resolves

Or

• Ketoconazole shampoo, topical, 

Adults

Apply twice weekly for 4 weeks with at least 3 days between each application 

Children 

12 -18 years (shampoo); Apply twice weekly for 4 weeks with at least 3 days between each application 

< 12 years; safety and efficacy not established 

Or

• Selenium sulphide shampoo 

Adults 

Apply whole body 2 times per week for 2 weeks initially 

Then

Once every 1-2 weeks to control symptoms.

Allow to remain on the scalp for 2-3 minutes then rinse thoroughly 

Children

5-18 years; same as adult dose

< 5 years; not recommended

Or

• Itraconazole, oral,

Adults

100 mg daily for 3 weeks 

Children

> 12 years; 100 mg daily for 3 weeks

1 month-12 years; 3-5 mg /kg daily for 3 weeks

Caution: Use of itraconazole is associated with potentially life-threatening liver-toxicity.  Monitor liver function while on long-term therapy.