Addressing Itch and Quality of Life Across Diverse Patient Populations in a 22-Year-Old Man With Seborrheic Dermatitis

This case involves a young man experiencing widespread seborrheic dermatitis, including facial and scalp involvement, with symptoms such as itching, redness, and flaking. The discomfort, especially during warmer weather, significantly disrupts his ability to focus on daily activities, particularly academic performance. Despite prior treatments with antifungal shampoo and topical corticosteroids, his disease remains uncontrolled. Notably, his condition was classified as severe, highlighting the importance of careful evaluation, particularly in patients with darker skin tones, where erythema may be underrecognized. The presence of persistent itch and quality-of-life interference underscores the need for a more effective and patient-friendly treatment.

For patients with both facial and scalp involvement, especially in visible or hair-bearing areas, treatment must consider not only efficacy but also cosmetic acceptability and ease of use. In this case, a foam-based, nonsteroidal option was selected to simplify the regimen and reduce the burden of polypharmacy. After initiating a once-daily regimen with a PDE4 inhibitor in foam form, the patient experienced complete clearance and significant itch reduction within 8 weeks. This outcome reflects findings from phase 3 trials, where the majority of patients achieved clear or almost clear skin, with more than half achieving full clearance and many reporting substantial itch relief.

In real-world settings, patients often notice symptom improvement within the first few weeks, with full benefit typically evident by the 2-month mark. Follow-ups are scheduled around this time frame to assess efficacy and adjust care if needed. The safety profile of this treatment is also reassuring, with a low incidence of adverse events and minimal treatment-related effects. Overall, the use of a targeted foam-based therapy offers a highly effective, cosmetically acceptable, and well-tolerated option for patients with chronic, visible seborrheic dermatitis impacting their quality of life.