When to Initiate Referral

• Lack of response to therapy after 2 months
• Severe or widespread eruption

Treatment Basics

• Caused by the lipophilic Malassezia yeast species (part of the normal microflora of the skin)
• Tends to occur more frequently in tropical climates
• Associated with sebaceous gland activity (so more frequently seen in post- pubertal adolescents and adults)
• Recurrences are common
• Skin dyspigmentation can last months after condition treated

Treatments Include

• Ketoconazole 2% shampoo or over-the-counter selenium sulfide shampoo applied to affected areas daily until clear (left on for 5 minutes prior to rinsing)
• Topical antifungal creams such as ketoconazole 2% cream or over-the-counter clotrimazole cream once to twice daily until clear