Calm itchy, flaky skin · 6 weeks
Seborrhoeic Dermatitis (Face & Body)
Clear flaky, itchy patches around the eyebrows, nose folds, beard, ears and chest with antifungal care proven in trials, then keep them away.
- Length
- 6 weeks
- For
- Women, Men
- Evidence A
- Strong evidence: guidelines or reviews of trials
- What to expect
- Less flaking: 1–2 weeks. Clear: 2–4 weeks. Pale or dark patches recover over weeks to months.
The goal: Clear or nearly clear skin within about 4 weeks and a simple maintenance plan (it often returns).
Cochrane review of 51 trials (A); the shampoo-as-wash format is B. Pale, petal-shaped patches are common on darker skin.
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The plan
Weeks 1–4
Clear
Antifungal cream daily; antifungal wash 2–3 times a week; gentle moisturiser.
The rash is driven by Malassezia yeast; antifungals treat the cause (Cochrane).
Morning
Gentle cleanse (or water rinse)
Lukewarm water; a 5-cent-coin amount of fragrance-free, soap-free cleanser; massage 30–60 seconds with fingertips; rinse; pat dry — never rub.
Why: Removes overnight oil and sweat without stripping the barrier lipids that keep water in.
Fragrance-free moisturiser
Apply within 3 minutes of patting dry, while skin is slightly damp: a 10-cent-coin amount for face and neck, pressed in, not rubbed hard.
Why: Humectants pull water into the outer layer; occlusives and ceramides seal it in, reducing transepidermal water loss.
Broad-spectrum SPF 30+ (tinted with iron oxides if you have dark marks)
Two-finger rule: squeeze a line along your index and middle fingers for face and neck. Apply as the last skincare step, 15 minutes before going out. Reapply every 2 hours outdoors or after sweating.
Leave on: 15 min before sun
Why: UVA, UVB and visible light all switch on pigment cells; tinted iron-oxide formulas also block visible light, which matters most in darker skin.
Evening
Ketoconazole 2% cream (or ciclopirox 1%)
Thin layer once daily on flaky patches (eyebrows, nose folds, beard, ears, chest) for 2–4 weeks. Avoid the eyes. Pregnancy: ask your pharmacist first.
Why: A Cochrane review of 51 trials found ketoconazole and ciclopirox clear seborrhoeic dermatitis better than placebo; ketoconazole works about as well as a steroid with fewer side effects.
Okokon et al. Topical antifungals for seborrhoeic dermatitis (Cochrane, 2015; CD008138)
Fragrance-free moisturiser
Apply within 3 minutes of patting dry, while skin is slightly damp: a 10-cent-coin amount for face and neck, pressed in, not rubbed hard.
Why: Humectants pull water into the outer layer; occlusives and ceramides seal it in, reducing transepidermal water loss.
Antifungal wash days
Ketoconazole 2% shampoo as a face, beard & chest wash
Lather on damp face, beard, chest and scalp; leave 3–5 minutes; rinse well; light moisturiser after.
Leave on: leave 3–5 min
Why: The antifungal treats the Malassezia yeast that drives the rash; the wash format is easy to keep up.
Habits
Mild steroid for a bad flare (only if a pharmacist or doctor advises)Doctor or pharmacist
Ask a pharmacist whether a short course of a mild steroid such as hydrocortisone suits a very red, itchy flare. Never use strong or "3-in-1" steroid creams on the face. Your doctor or pharmacist will advise the dose and how long.
Why: A short mild steroid settles inflammation while the antifungal works; long use on the face causes thinning, acne and redness.
Check every pack for a NAFDAC number
Before buying, look for the NAFDAC registration number and an intact seal. Buy from a registered pharmacy, not a market table or social-media seller.
Why: Counterfeit and mislabelled creams are common; some "plain" creams secretly contain steroids, mercury or strong bleaching agents.
Voice of Nigeria: NAFDAC warns against high-hydroquinone skin creams (2025)
Shower after sweating
Lukewarm shower soon after heavy sweating, sport or a hot day; pat dry, especially in folds.
Why: Sweat left on the skin feeds yeast and bacteria and triggers itch.
Weekly progress photo
Same place, same daylight by a window, no filter, no makeup; front, left and right.
Why: Change is slow; consistent photos show progress memory cannot.
Food
Hydration
Water with each meal and whenever thirsty; more in heat and harmattan.
Why: Supports overall health; skin hydration is mostly about the barrier, so pair water with moisturiser.
Weeks 5–6
Maintain
Antifungal wash once or twice a week, long term.
Regular antifungal use keeps the yeast down and prevents flares.
Morning
Gentle cleanse (or water rinse)
Lukewarm water; a 5-cent-coin amount of fragrance-free, soap-free cleanser; massage 30–60 seconds with fingertips; rinse; pat dry — never rub.
Why: Removes overnight oil and sweat without stripping the barrier lipids that keep water in.
Fragrance-free moisturiser
Apply within 3 minutes of patting dry, while skin is slightly damp: a 10-cent-coin amount for face and neck, pressed in, not rubbed hard.
Why: Humectants pull water into the outer layer; occlusives and ceramides seal it in, reducing transepidermal water loss.
Broad-spectrum SPF 30+ (tinted with iron oxides if you have dark marks)
Two-finger rule: squeeze a line along your index and middle fingers for face and neck. Apply as the last skincare step, 15 minutes before going out. Reapply every 2 hours outdoors or after sweating.
Leave on: 15 min before sun
Why: UVA, UVB and visible light all switch on pigment cells; tinted iron-oxide formulas also block visible light, which matters most in darker skin.
Evening
Evening cleanse
If you wore sunscreen or makeup, cleanse twice (first pass loosens, second cleans). 60 seconds total per pass, lukewarm water, pat dry.
Why: Sunscreen and makeup left overnight can clog pores; a thorough but gentle cleanse prepares skin for treatments.
Fragrance-free moisturiser
Apply within 3 minutes of patting dry, while skin is slightly damp: a 10-cent-coin amount for face and neck, pressed in, not rubbed hard.
Why: Humectants pull water into the outer layer; occlusives and ceramides seal it in, reducing transepidermal water loss.
Maintenance wash
Ketoconazole 2% shampoo as a face, beard & chest wash
Lather on damp face, beard, chest and scalp; leave 3–5 minutes; rinse well; light moisturiser after.
Leave on: leave 3–5 min
Why: The antifungal treats the Malassezia yeast that drives the rash; the wash format is easy to keep up.
Habits
Weekly progress photo
Same place, same daylight by a window, no filter, no makeup; front, left and right.
Why: Change is slow; consistent photos show progress memory cannot.
Shower after sweating
Lukewarm shower soon after heavy sweating, sport or a hot day; pat dry, especially in folds.
Why: Sweat left on the skin feeds yeast and bacteria and triggers itch.
Food
Hydration
Water with each meal and whenever thirsty; more in heat and harmattan.
Why: Supports overall health; skin hydration is mostly about the barrier, so pair water with moisturiser.
Milestones
Your weekly check-in
Ask yourself these once a week. If an answer worries you, stop and see a doctor or pharmacist.
Stop and see a doctor if
- Sudden, severe or widespread rash: see a doctor (severe adult seborrhoeic dermatitis can be linked to HIV or other immune problems; ask about testing)
- Pale patches that are numb (leprosy must be ruled out): see a doctor
- Thinning, tiny visible vessels or acne after steroid use
- Eyelid swelling
In an emergency, call 112112999911911.
Sources
- Okokon et al. Topical antifungals for seborrhoeic dermatitis (Cochrane, 2015; CD008138)
- DermNet: Seborrhoeic dermatitis
- AAD: How to treat dandruff
Education, not diagnosis. This plan cannot examine you; pending physician review where marked.
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