Real-World Efficacy and Safety of a Topical Salvia fruticosa Leaf Extract Rich in Carnosic Acid and Carnosol for Mild to Very Severe Facial Seborrheic Dermatitis: A 12-Year Retrospective Study.

Objective We aimed to evaluate the safety and efficacy of a cream (SDπ) containing S. fruticosa leaf extract rich in carnosic acid and carnosol in the treatment of facial seborrheic dermatitis (SD). Methods In this 12-year retrospective study, 10 patients (eight males, two females; age range, 40-78 years) with mild to very severe facial seborrheic dermatitis (mean baseline Seborrheic Dermatitis Area and Severity Index (SEDASI) score: 19; range, 10-60) applied SDπ cream once nightly as monotherapy. Follow-up ranged from 6 months to 5 years. Results All patients achieved complete disease clearance (SEDASI=0) within a mean of 7.7 days (range 3-15 days) with marked reduction in erythema, scaling, and rapid relief of pruritus. Remission persisted from 20 days to 10 months. Subsequent episodes responded to re-treatment in a shorter period (mean 4.8 days), while no relapses were observed during long-term maintenance therapy with nightly or alternate-night application. No local or systemic safety concerns were documented throughout treatment and the longitudinal follow-up period. Conclusions In this retrospective observational study, SDπ cream was associated with favorable clinical outcomes and good tolerability, suggesting that it may represent a promising natural topical monotherapy for facial seborrheic dermatitis. Although these findings are encouraging, prospective randomized controlled studies are required to confirm efficacy and long-term safety. To our knowledge, this work represents the first full-length retrospective report in the literature documenting the therapeutic role of S. fruticosa leaf extract rich in carnosic acid and carnosol in seborrheic dermatitis.