Efficacy of 1% clotrimazole cream versus 2% sertaconazole cream in the management of seborrheic dermatitis: A randomized controlled trial

Background : Antifungals are regarded as one of the first line agents in the management of seborrheic dermatitis (SD). However, the data on head to head comparison among various antifungal agents is deplete and is required to broaden the number of first line agents that can be used in SD treatment. Aim : To compare the efficacy of 1% clotrimazole cream with 2% sertaconazole cream in the management of SD. Methods : 60 patients of SD were included and divided into 2 groups. The first group (n = 30) received topical 2% sertoconazole cream for twice a day application for four weeks. The other group (n = 30) received 1% clotrimazole cream applied similarly for 4 weeks. The patients were assessed by an independent dermatologist for response or any side effects due to the medications used at 0 (baseline), 2 and 4 weeks. Subjective sebum production, Scalp and/or facial pruritus, scaling, erythema, SD severity index (SI), and patient satisfaction were used in the final efficacy outcome. Results : Out of the total 60 patients, 65% (39/60) and 35% (21/60) were females and males respectively with age ranging from 6–58 years (mean age: 32.88 ± 12.68 years). 45% (27/60) had generalized and 55% (33/60) had localized disease. The severity of SD changed from moderate to mild in many patients after 4 weeks in both the groups, however, the difference was statistically significant only in the sertaconazole group (p = 0.007). 90% (27/30) and 53.4% (16/30) patients had good level of satisfaction in the sertaconazole and clotrimazole group on 28TH day. The relation was statistically significant only in the seratconazole group (p = 0.006). Subjective sebum production, pruritus, scaling and erythema reduced in both the groups. The follow-up period of 1-month post completion of therapy didn’t show any relapse in either of the groups. Conclusion : Both topical 1% clotrimazole cream and topical 2% sertaconazole cream may be regarded as effective therapies in SD with topical 2% seratconazole cream performing better as compared to topical 1% clotrimazole cream in terms of patient efficacy and acceptability by the patients.