Early treatment of flares is encouraged. Behavior modification techniques in reducing excoriations are especially helpful with scalp involvement. Pharmacologic agents that may be used include the following: Topical corticosteroids (discouraged except for short-term use) For skin involvement, ketoconazole, naftifine, or ciclopirox creams and gels alternatively, calcineurin inhibitors (ie, pimecrolimus, tacrolimus),  sulfur or sulfonamide combinations, or propylene glycol  For acute flares, class IV or lower corticosteroid creams, lotions, or solutions For severe or unresponsive lesions, systemic ketoconazole or fluconazole  Treatment of dandruff may involve the following: More frequent shampooing or longer lathering Discontinuance of hair spray or hair pomades Use of shampoos containing salicylic acid, tar, selenium, sulfur, or zinc selenium sulfide (2.5%), ketoconazole, and ciclopirox shampoos may help by reducing Malassezia yeast scalp reservoirs  Overnight application of tar, bath oil, or Baker’s  consult dermatologist for assessment and prescription