Efficacy of Topical Rosemary Extract Lotion versus Topical 2% Ketoconazole Lotion in the Treatment of Seborrheic Dermatitis: A Double-Blind Randomized Controlled Clinical Trial.

Introduction: Seborrheic dermatitis manifests as greasy itchy lesions commonly affecting sebum-rich areas like the scalp and face. Its prevalence is 11.6% in the general population, with various internal and environmental factors contributing to its development.

Objectives: This study aimed to compare the efficacy of rosemary extract lotion in the treatment of seborrheic dermatitis in comparison with topical 2% ketoconazole lotion.

Methods: This double-blind randomized controlled clinical trial included 42 patients with scalp seborrheic dermatitis, divided into rosemary lotion and ketoconazole lotion groups. Both lotions were applied twice daily for two months. The severity of scalp dandruff was assessed using the Adherent Scalp Flaking Score (ASFS). The itchiness of the scalp and quality of life were assessed using itchy quant and the Dermatology Life Quality Index (DLQI), respectively. Stata software version 14.2 was applied for statistical analysis.

Results: The reduction in ASFS score was statistically significant in patients in the ketoconazole group in comparison with the patients in the rosemary group (P = 0.011). However, the reduction in itching score was statistically significant more in the rosemary group at the end of the first and second months in comparison with the ketoconazole group (P < 0.001). The statistical analysis demonstrated no significant difference in the reduction of DLQI scores between the rosemary and ketoconazole groups at the end of one and two months after stating the treatment in both crude and adjustment with base-line score analysis.

Conclusion: Both rosemary and ketoconazole lotions were effective in treating scalp seborrheic dermatitis and in decreasing patients' DLQI score.