Dandruff (seborrheic dermatitis)
Clinical basis & sources
- Primary source
- OCP Expanding Scope of Practice
Sources used
- Minor Ailments PrescribingOntario College of Pharmacists · 2026
- Expanding Scope of Practice - Minor AilmentsOntario College of Pharmacists · 2026-05-28
- Ontario Regulation 256/24: GeneralGovernment of Ontario · 2026
- Minor Ailments: Drug Classes and Specified DrugsOntario College of Pharmacists · 2026
- Seborrhoeic dermatitisDermNet · 2024
- Diagnosis and Treatment of Seborrheic DermatitisAmerican Family Physician · 2015-02-01
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Allowable drugs under Schedule 4 (10)
Drugs an Ontario pharmacist may prescribe for Dandruff (seborrheic dermatitis) under O. Reg. 256/24, Schedule 4. Choice still depends on the assessment, contraindications, allergies, and product availability — this is the eligible list, not a recommendation.
- Betamethasone valerate
- Ciclopirox
- Coal tar
- Hydrocortisone
- Ketoconazole
- Roflumilast
- Salicylic acid
- Selenium sulfide
- Triclosan
- Zinc pyrithione
Symptoms this assessment screens
- Flaking or scale on scalp consistent with dandruff/seborrheic dermatitis
- Mild to moderate itch or irritation without severe pain, pustules, oozing, or scarring
- Limited to typical seborrheic areas and pharmacist is confident this is not tinea, psoriasis, infection, or contact dermatitis
- No patchy hair loss, broken hairs, tender boggy scalp, pustules, or lymph nodes
- Shampoo use, allergies, prior antifungal response, pregnancy/lactation if relevant, and scalp irritation risk reviewed
Red flags — any positive means refer
- Patchy hair loss, broken hairs, boggy/tender scalp, pustules, oozing, crusting, fever, or swollen lymph nodes
- Thick silvery plaques, bleeding, severe inflammation, marked pain, nail changes, or lesions on elbows/knees/body suggesting psoriasis or another dermatosis
- Infant cradle cap, immunocompromise, severe neurologic disease/frailty, extensive face/body involvement, or complex dermatologic history
- No improvement after 2 to 4 weeks of appropriate antifungal shampoo use, frequent relapse, or diagnosis uncertainty
- Needs a nonlisted/high-potency corticosteroid, calcineurin inhibitor, systemic antifungal, antibiotic, or another therapy outside Schedule 4
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