Treatment and prophylaxis of seborrheic dermatitis of the scalp with antipityrosporal 1% ciclopirox shampoo

Objective: To demonstrate the efficacy, safety, and tolerance of ciclopirox shampoo for treatment and prophylaxis of seborrheic dermatitis of the scalp. Design: Multicenter, randomized, double-blind, vehicle-controlled study. After treatment with ciclopirox shampoo once or twice weekly or vehicle for 4 weeks (study, segment A), responders were randomized to a 12-week prophylactic study arm (segment B). Setting: Forty-five medical centers in Germany, (n = 19), France (n = 15), the United Kingdom (n = 8), and Austria (n = 3). Patients: A total of 1000 patients with stable or exacerbating seborrheic diermatitis of the scalp. Interventions: A total of 949 patients were randomized to receive ciclopirox treatment once or twice weekly or vehicle for 4 weeks. Thereafter, 428 responders received either ciclopirox prophylaxis once weekly or every 2 weeks or vehicle for 3 months. Main Outcome Measures: Primary and secondary: response of effectively treated and cured, with investigators and patients rating acceptability and tolerance. Results: Ciclopirox twice and once weekly produced response rates of 57.9% and 45.4%. respectively, compared with 31.6% for vehicle. Relapses occurred in 14.7% of patients using prophylactic ciclopirox once weekly, 22.1% of those in the prophylactic group shampooing once every 2 weeks. and 35.5% in the vehicle group. The few adverse events were evenly distributed among groups. Local tolerance and cosmetic acceptability were good in more than 85% of subjects. Conclusions: Seborrheic dermatitis of the scalp responds well to 1% ciclopirox shampoo once or twice weekly for 4 weeks. A low relapse rate is maintained by once-weekly shampooing or shampooing once every 2 weeks. These treatments are sale and well-tolerated.