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Ergin Ç, Kurt Ö, Türkoğlu M, Sevinç H, Akbaba G. Evaluation of novel cosmetic shampoo formulations against Malassezia species: Preliminary results of anti-dandruff shampoo formulations. J Cosmet Dermatol 2024; 23:2078-2083. [PMID: 38544350 DOI: 10.1111/jocd.16219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 12/11/2023] [Accepted: 01/16/2024] [Indexed: 05/19/2024]
Abstract
OBJECTIVES Malassezia species are common, clinically relevant, and lipid-dependent yeasts of humans. They are also the leading causes of the dandruff problem of humans, and the azoles are used primarily in their topical and systemic treatment. Resistance to azoles is an emerging problem among Malassezia sp., which indicates the need of new drug assessments that will be effective against dandruff and limit the use of azoles and other agents in treatment. Among them, the efficacy of various combinations of piroctone olamine and climbazole against Malassezia sp. is highly important. Here, we assessed the efficacies of various piroctone olamine and climbazole formulations against Malassezia sp. in comparison with ketoconazole. METHODS A total of nine formulations were included in the study, where each formulation was prepared from different concentrations of piroctone olamine and climbazole and both. All formulations contained the same ingredients as water, surfactants, hair conditioning agents, and preservatives. Malassezia furfur CBS1878, Malassezia globosa CBS7874, and Malassezia sympodialis CBS9570 were tested for antifungal susceptibility of each formulation by agar diffusion method. Sizes of the inhibition zones were compared with standard medical shampoo containing 2% ketoconazole, and the data were analyzed by Dunnett's multiple-comparison test. RESULTS For all Malassezia sp. strains, climbazole 0.5% and piroctone olamine/climbazole (0.1%/0.1% and 0.1%/0.5%) combinations were found to have the same effect as the medical shampoo containing 2% ketoconazole. Piroctone olamine/climbazole 1.0%/0.1% formulation showed the same efficacy as 2% ketoconazole on M. furfur and M. sympodialis, while 0.1%/0.5% formulation to only M. furfur. For M. globosa, none of the formulations tested were as effective as ketoconazole. CONCLUSION The species distribution of Malassezia sp. varies depending on the anatomical location on the host. According to the results of this study, climbazole and piroctone olamine combinations seem to be promising options against the dandruff problem with their high antifungal/anti dandruff efficacy.
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Affiliation(s)
- Çağrı Ergin
- Department of Medical Microbiology, Pamukkale University School of Medicine, Denizli, Turkey
| | - Özgür Kurt
- Department of Medical Microbiology, Acibadem University School of Medicine, Istanbul, Turkey
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Fajuyigbe D, Sewraj P, Connétable S, Molamodi K, Clavaud C, Dufour O, Matthews N, Dlova NC. Weekly hair washing: The recommended solution for women with afro-textured hair to alleviate dandruff and scalp discomfort. J Dermatol 2024; 51:518-525. [PMID: 38217001 DOI: 10.1111/1346-8138.17102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 12/07/2023] [Accepted: 12/23/2023] [Indexed: 01/14/2024]
Abstract
Dandruff and scalp discomfort are common concerns for women and men in Africa. Moreover, women with afro-textured hair are prone to scalp discomfort owing to irregular hair washing, frequent use of oil-based products on their scalp, and harsh chemical treatments. Current literature does not, however, provide data on the pathophysiological mechanisms of these conditions in this population. In this study, we investigated the mechanisms behind scalp discomfort and dandruff in women of African descent before and after hair washing. We conducted the in Durban, South Africa, over a 3-week period with 60 women of African descent aged 20-40 years. The respondents were equally divided into a "dandruff" and a "no dandruff" group, based on clinical grading of adherent dandruff by a dermatologist. Malassezia spp. and bacterial loads were quantified by quantitative polymerase chain reaction. Evaluations of scalp condition and sample collection were performed at five time points during the 3 weeks. Data on discomfort symptoms were collected via a self-assessment questionnaire. We observed that the dandruff severity peaked at the end of the first week after hair washing and plateaued from thereon in both groups. Dandruff was associated with higher Malassezia and bacterial load counts and there was a direct correlation between the Malassezia spp. load and dandruff score. Via self-assessment questionnaire responses submitted by participants, we observed that itching was the most pronounced scalp discomfort, compared with the sensation of tingling and burning at baseline, while an improvement of the scalp symptoms of dandruff and itch was observed in both groups after one hair wash. The study also showed that higher colonization with Malassezia spp. and bacteria is associated with dandruff independently of the time point, confirming a scalp microbiome contribution to the dandruff pathophysiology in the study population. The benefits of washing were, however, not sustained after 1 week and we thus recommend weekly hair washing for long-term management of dandruff and scalp itchiness in this population.
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Affiliation(s)
| | - Poonam Sewraj
- L'Oréal Research & Innovation, Johannesburg, South Africa
| | | | | | | | - Olivia Dufour
- L'Oréal Research & Innovation, Aulnay-sous-bois, France
| | | | - Ncoza Cordelia Dlova
- Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
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Chang CH, Chovatiya R. More yeast, more problems?: reevaluating the role of Malassezia in seborrheic dermatitis. Arch Dermatol Res 2024; 316:100. [PMID: 38472524 DOI: 10.1007/s00403-024-02830-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 11/13/2023] [Accepted: 01/29/2024] [Indexed: 03/14/2024]
Abstract
Seborrheic dermatitis (SD) is an inflammatory skin disorder and eczema subtype increasingly recognized to be associated with significant physical, psychosocial, and financial burden. The full spectrum of SD, including dandruff localized to the scalp, is estimated to affect half of the world's population. Despite such high prevalence, the exact etiopathogenesis of SD remains unclear. Historically, many researchers have theorized a central, causative role of Malassezia spp. based on prior studies including the proliferation of Malassezia yeast on lesional skin of some SD patients and empiric clinical response to antifungal therapy. However, upon closer examination, many of these findings have not been reproducible nor consistent. Emerging data from novel, targeted anti-inflammatory therapeutics, as well as evidence from genome-wide association studies and murine models, should prompt a reevaluation of the popular yeast-centered hypothesis. Here, through focused review of the literature, including laboratory studies, clinical trials, and expert consensus, we examine and synthesize the data arguing for and against a primary role for Malassezia in SD. We propose an expansion of SD pathogenesis and suggest reframing our view of SD to be based primarily on dysregulation of the host immune system and skin epidermal barrier, like other eczemas.
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Affiliation(s)
- Christy H Chang
- College of Medicine, University of Illinois Chicago, Chicago, IL, USA
| | - Raj Chovatiya
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
- Chicago Medical School, Rosalind Franklin University, North Chicago, IL, USA.
- Center for Medical Dermatology and Immunology Research, Chicago, IL, USA.
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Fukuda R, Pak K, Kiuchi M, Hirata N, Tanaka R, Mochimaru N, Mitsui M, Ohya Y, Yoshida K. Association of lipid abnormalities in the stratum corneum and TGF-ß1 and 2 in colostrum and the development of infantile seborrheic dermatitis: A prospective birth cohort study. J Dermatol Sci 2023; 112:39-42. [PMID: 37604710 DOI: 10.1016/j.jdermsci.2023.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 07/15/2023] [Accepted: 08/07/2023] [Indexed: 08/23/2023]
Affiliation(s)
- Risa Fukuda
- Division of Dermatology, National Center for Child Health and Development, Tokyo, Japan
| | - Kyongsun Pak
- Division of Biostatistics, Department of Data Management, Center of Clinical Research and Development, National Center for Child Health and Development, Tokyo, Japan
| | - Megumi Kiuchi
- Division of Research and Development, Pigeon Corporation, Ibaraki, Japan
| | - Naoko Hirata
- Division of Research and Development, Pigeon Corporation, Ibaraki, Japan
| | - Ryo Tanaka
- Division of Dermatology, National Center for Child Health and Development, Tokyo, Japan
| | - Naoko Mochimaru
- Division of Dermatology, National Center for Child Health and Development, Tokyo, Japan
| | - Mari Mitsui
- Center for Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, Tokyo, Japan
| | - Yukihiro Ohya
- Allergy Center, National Center for Child Health and Development, Tokyo, Japan
| | - Kazue Yoshida
- Division of Dermatology, National Center for Child Health and Development, Tokyo, Japan; Allergy Center, National Center for Child Health and Development, Tokyo, Japan.
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Mangion SE, Mackenzie L, Roberts MS, Holmes AM. Seborrheic dermatitis: topical therapeutics and formulation design. Eur J Pharm Biopharm 2023; 185:148-164. [PMID: 36842718 DOI: 10.1016/j.ejpb.2023.01.023] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 09/27/2022] [Accepted: 01/27/2023] [Indexed: 02/28/2023]
Abstract
Seborrheic dermatitis (SD) is a common dermatological disorder with symptoms that include skin flaking, erythema and pruritus. This review discusses the topical products available for treating SD, which target several aspects of disease pathobiology, including cutaneous microbial dysbiosis (driven by Malassezia yeast), inflammation, sebum production and skin barrier disruption. Among the various treatments available, zinc pyrithione (ZnPT) based products that exhibit anti-fungal action are the market leaders. A skin compartment approach is presented here for combining ZnPT exposure information with threshold levels for anti-fungal efficacy and toxicity, overall providing a comprehensive picture of ZnPT therapeutics and safety. While Malassezia yeast on the surface are effectively targeted, yeast residing beyond the superficial follicle may not receive adequate ZnPT for anti-fungal effect forming the basis for skin re-colonisation. Levels entering systemic circulation from topical delivery are well below toxic thresholds, however the elevated zinc levels within the viable epidermis warrants further investigation. Strategies to improve formulation design can be broadly classified as influencing 1) topical delivery, 2) therapeutic bioactivity, 3) skin mildness, and 4) sensory attributes. Successful SD treatment ultimately requires formulations that can balance efficacy, safety, and consumer appeal.
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Affiliation(s)
- Sean E Mangion
- UniSA: Clinical and Health Sciences, University of South Australia, Adelaide 5000, South Australia, Australia; Therapeutics Research Centre, Basil Hetzel Institute for Translational Health Research, The Queen Elizabeth Hospital, Woodville South 5011, South Australia, Australia; Sydney Medical School, University of Sydney, Camperdown 2050, New South Wales, Australia
| | - Lorraine Mackenzie
- UniSA: Clinical and Health Sciences, University of South Australia, Adelaide 5000, South Australia, Australia; Therapeutics Research Centre, Basil Hetzel Institute for Translational Health Research, The Queen Elizabeth Hospital, Woodville South 5011, South Australia, Australia
| | - Michael S Roberts
- UniSA: Clinical and Health Sciences, University of South Australia, Adelaide 5000, South Australia, Australia; Therapeutics Research Centre, Basil Hetzel Institute for Translational Health Research, The Queen Elizabeth Hospital, Woodville South 5011, South Australia, Australia; Therapeutics Research Centre, Frazer Institute, University of Queensland, Woolloongabba 4102, Queensland, Australia
| | - Amy M Holmes
- UniSA: Clinical and Health Sciences, University of South Australia, Adelaide 5000, South Australia, Australia; Therapeutics Research Centre, Basil Hetzel Institute for Translational Health Research, The Queen Elizabeth Hospital, Woodville South 5011, South Australia, Australia.
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Mangion SE, Holmes AM, Roberts MS. Targeted Delivery of Zinc Pyrithione to Skin Epithelia. Int J Mol Sci 2021; 22:9730. [PMID: 34575891 PMCID: PMC8465279 DOI: 10.3390/ijms22189730] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 08/20/2021] [Accepted: 08/30/2021] [Indexed: 12/25/2022] Open
Abstract
Zinc pyrithione (ZnPT) is an anti-fungal drug delivered as a microparticle to skin epithelia. It is one of the most widely used ingredients worldwide in medicated shampoo for treating dandruff and seborrheic dermatitis (SD), a disorder with symptoms that include skin flaking, erythema and pruritus. SD is a multi-factorial disease driven by microbiol dysbiosis, primarily involving Malassezia yeast. Anti-fungal activity of ZnPT depends on the cutaneous availability of bioactive monomeric molecular species, occurring upon particle dissolution. The success of ZnPT as a topical therapeutic is underscored by the way it balances treatment efficacy with formulation safety. This review demonstrates how ZnPT achieves this balance, by integrating the current understanding of SD pathogenesis with an up-to-date analysis of ZnPT pharmacology, therapeutics and toxicology. ZnPT has anti-fungal activity with an average in vitro minimum inhibitory concentration of 10-15 ppm against the most abundant scalp skin Malassezia species (Malassezia globosa and Malassezia restrica). Efficacy is dependent on the targeted delivery of ZnPT to the skin sites where these yeasts reside, including the scalp surface and hair follicle infundibulum. Imaging and quantitative analysis tools have been fundamental for critically evaluating the therapeutic performance and safety of topical ZnPT formulations. Toxicologic investigations have focused on understanding the risk of local and systemic adverse effects following exposure from percutaneous penetration. Future research is expected to yield further advances in ZnPT formulations for SD and also include re-purposing towards a range of other dermatologic applications, which is likely to have significant clinical impact.
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Affiliation(s)
- Sean E. Mangion
- Therapeutics Research Centre, Basil Hetzel Institute for Translational Health Research, The Queen Elizabeth Hospital, Woodville, SA 5011, Australia; (S.E.M.); (A.M.H.)
- UniSA: Clinical and Health Sciences, University of South Australia, Adelaide, SA 5000, Australia
- Sydney Medical School, University of Sydney, Camperdown, NSW 2050, Australia
| | - Amy M. Holmes
- Therapeutics Research Centre, Basil Hetzel Institute for Translational Health Research, The Queen Elizabeth Hospital, Woodville, SA 5011, Australia; (S.E.M.); (A.M.H.)
- UniSA: Clinical and Health Sciences, University of South Australia, Adelaide, SA 5000, Australia
| | - Michael S. Roberts
- Therapeutics Research Centre, Basil Hetzel Institute for Translational Health Research, The Queen Elizabeth Hospital, Woodville, SA 5011, Australia; (S.E.M.); (A.M.H.)
- Sydney Medical School, University of Sydney, Camperdown, NSW 2050, Australia
- Therapeutics Research Centre, Diamantina Institute, Translational Research Institute, University of Queensland, Woolloongabba, QLD 4102, Australia
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Limbu SL, Purba TS, Harries M, Wikramanayake TC, Miteva M, Bhogal RK, O'Neill CA, Paus R. A folliculocentric perspective of dandruff pathogenesis: Could a troublesome condition be caused by changes to a natural secretory mechanism? Bioessays 2021; 43:e2100005. [PMID: 34486144 DOI: 10.1002/bies.202100005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 07/30/2021] [Accepted: 08/03/2021] [Indexed: 01/19/2023]
Abstract
Dandruff is a common scalp condition, which frequently causes psychological distress in those affected. Dandruff is considered to be caused by an interplay of several factors. However, the pathogenesis of dandruff remains under-investigated, especially with respect to the contribution of the hair follicle. As the hair follicle exhibits unique immune-modulatory properties, including the creation of an immunoinhibitory, immune-privileged milieu, we propose a novel hypothesis taking into account the role of the hair follicle. We hypothesize that the changes and imbalance of yeast and bacterial species, along with increasing proinflammatory sebum by-products, leads to the activation of immune response and inflammation. Hair follicle keratinocytes may then detect these changes in scalp microbiota resulting in the recruitment of leukocytes to the inflammation site. These changes in the scalp skin immune-microenvironment may impact hair follicle immune privilege status, which opens new avenues into exploring the role of the hair follicle in dandruff pathogenesis. Also see the video abstract here: https://youtu.be/mEZEznCYtNs.
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Affiliation(s)
- Susan L Limbu
- Centre for Dermatology Research, University of Manchester & NIHR Biomedical Research Centre, Manchester, UK
| | - Talveen S Purba
- Centre for Dermatology Research, University of Manchester & NIHR Biomedical Research Centre, Manchester, UK
| | - Matthew Harries
- Centre for Dermatology Research, University of Manchester & NIHR Biomedical Research Centre, Manchester, UK.,Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - Tongyu C Wikramanayake
- Dr. Phillip Frost Department of Dermatology & Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Mariya Miteva
- Dr. Phillip Frost Department of Dermatology & Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Ranjit K Bhogal
- Unilever R&D Colworth, Colworth Science Park, Sharnbrook, UK
| | - Catherine A O'Neill
- Centre for Dermatology Research, University of Manchester & NIHR Biomedical Research Centre, Manchester, UK
| | - Ralf Paus
- Centre for Dermatology Research, University of Manchester & NIHR Biomedical Research Centre, Manchester, UK.,Dr. Phillip Frost Department of Dermatology & Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA.,Monasterium Laboratory, Münster, Germany
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Jain S, Arora P, Nainwal LM. Essential oils as Potential Source of Anti-dandruff Agents: A Review. Comb Chem High Throughput Screen 2021; 25:1411-1426. [PMID: 34254910 DOI: 10.2174/1386207324666210712094148] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 05/14/2021] [Accepted: 05/21/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Dandruff is a frequently occurring scalp problem that causes significant discomfort to approximately 50% population at some stage of life, especially post-puberty and pre-adult age. OBJECTIVE This review aims to summarize the recent findings regarding the anti-fungal properties of herbal essential oils against pathogens involved in dandruff prognosis. METHODS A literature search of studies published between 2000 and 2020 was conducted over databases: PubMed, Google Scholar, Scopus, and Science direct. Literature was explored using the guidelines given in Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). RESULTS Dandruff, characterized by clinical symptoms of dryness, pruritis, scaly, and flaky scalp, is considered a pri-mary manifestation of seborrheic dermatitis. Amongst various etiological and pathophysiological factors, a significant role of yeasts, primarily species of Malassezia, Candida, has been strongly correlated with dandruff. At the same time, incidences of M. furfur, M. restricta, and M. globosa are high compared to others. Due to relapse of symptoms with the withdrawal of conventional anti-dandruff products. Essential oils of herbal origin, such as tea tree oil, lime oil, rose-mary oil, have gained global importance in dermatology. These oils are rich in secondary aromatic metabolites, espe-cially terpenes and phenolic components that impart substantial antimicrobial properties and resisting biofilm production. CONCLUSION Based on the available information, we can conclude that essential oils have tremendous potential to be developed as anti-dandruff products; however, further studies are warranted to establish their efficacy in dandruff cures.
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Affiliation(s)
- Shagun Jain
- Department of Pharmacognosy and Phytochemistry, School of Pharmaceutical Sciences, Delhi Pharmaceutical Sci-ences and Research University, New Delhi, India
| | - Poonam Arora
- Department of Pharmacognosy and Phytochemistry, School of Pharmaceutical Sciences, Delhi Pharmaceutical Sci-ences and Research University, New Delhi, India
| | - Lalit Mohan Nainwal
- Department of Pharmaceutical Chemistry, HIMT College of Pharmacy, Harlal Institute of Management and Technol-ogy, Greater Noida, U.P, India
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Diao Y, Matheson JR, Pi Y, Baines FL, Zhang S, Li Y. Comparison of whole-head and split-head design for the clinical evaluation of anti-dandruff shampoo efficacy. Int J Cosmet Sci 2021; 43:510-517. [PMID: 34058011 PMCID: PMC9290732 DOI: 10.1111/ics.12718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Revised: 05/12/2021] [Accepted: 05/16/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Dandruff is a common scalp condition that can be improved by regular use of shampoos containing anti-fungal actives. The efficacy of anti-dandruff shampoos can be assessed by measuring scalp flaking, one of the important dandruff symptoms. A randomized, double-blind trial is often used with one of two clinical designs: whole-head parallel design and split-head paired design. We aimed to explore the difference in product differentiation between these two designs using the same two test shampoos and the same scalp flaking assessment method (Total Weighted Head Score Adhered Flakes-TWHS AF). METHODS A clinical study was conducted with a 2- to 3-week wash-out phase and a 4-week test phase, consisting of 2 cells: 120 subjects with whole-head parallel design, divided into 2 subgroups (1:1) using on-site controlled washing method (either wash their own hair at a study site, under the instruction of a study supervisor or wash their own hair at home, as per instructions, but without supervision) and 35 subjects with split-head paired design using salon-staff washing method. Both cells employed hair washing at frequency of three times a week and TWHS AF measurement once a week from the baseline assessment. RESULTS Both designs gave similar differences in TWHS AF between products: 5.6 units (95% CI: 4.1-7.0 units) in whole-head design and 5.9 units (95% CI: 4.9-6.9 units) in split-head design. CONCLUSION Split-head paired design shows a similar ability of detecting product difference as whole-head parallel design, whereas it is a choice of more efficient and more cost-effective, as only a quarter of the subjects are required to demonstrate the efficacy between anti-dandruff shampoos.
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Affiliation(s)
- Yuanyuan Diao
- Unilever Research and Development Centre, Shanghai, China
| | - Jane R Matheson
- Unilever Research and Development Port Sunlight Laboratory, Bebington, Merseyside, UK
| | - Yingying Pi
- Unilever Research and Development Centre, Shanghai, China
| | - Fiona L Baines
- Unilever Research and Development Port Sunlight Laboratory, Bebington, Merseyside, UK
| | - Shuliang Zhang
- Unilever Research and Development Centre, Shanghai, China
| | - Yuanpei Li
- Unilever Research and Development Centre, Shanghai, China
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Yoon JS, Shim J, Lim JM, Park SG. Biophysical characteristics of dandruff-affected scalp categorized on the basis of sebum levels. J Cosmet Dermatol 2020; 20:1002-1008. [PMID: 32757243 DOI: 10.1111/jocd.13626] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 05/20/2020] [Accepted: 07/08/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Various sebum levels can be detected in dandruff-affected scalps. However, few studies have compared the biophysical characteristics of dandruff scalps categorized based on sebum levels. AIMS To investigate and compare the biophysical characteristics of dandruff-affected scalps categorized based on sebum levels. METHODS Fifty-four Korean women with dandruff and 30 healthy Korean women underwent physiological measurements, including evaluation of sebum and hydration levels, pH, and transepidermal water loss (TEWL) in the scalp. The levels of the biomarkers of interleukin-8 (IL-8) and kallikrein 5 (KLK5) and corneodesmosomes were investigated in the stratum corneum (SC) of the scalp. RESULTS Dandruff was categorized as dry (low-sebum, n = 25) or oily (high-sebum, n = 29) based on a sebum cutoff level of 97.82 μg/cm2 . Both dry and oily dandruff-affected scalps showed significantly decreased hydration levels and increased pH and TEWL compared with healthy subjects, with hydration levels being lower in dry dandruff-affected scalps. IL-8 expression was significantly increased in the oily dandruff-affected scalp. In addition, both dry and oily dandruff-affected scalps showed significantly increased KLK5 levels in the SC, with the levels being higher in oily dandruff-affected scalps. Altered distribution of corneodesmosomes, present on the entire surface area of the corneocytes, was notable in oily dandruff-affected scalps. CONCLUSION The biophysical characteristics of the two types of dandruff represent the influence of different characteristics, including hydration levels, expression of IL-8 and KLK5, and corneodesmosome distribution. Thus, strategies to reduce dandruff levels should differ according to sebum levels.
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Sheth U, Dande P. Pityriasis capitis: Causes, pathophysiology, current modalities, and future approach. J Cosmet Dermatol 2020; 20:35-47. [PMID: 32416039 DOI: 10.1111/jocd.13488] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Accepted: 05/07/2020] [Indexed: 01/09/2023]
Abstract
BACKGROUND Pityriasis capitis commonly known as dandruff is one of the most common and widely seen dermatological disease that affects majority of the world population. It is more than superficial flaking, as it leads to significant structural changes in the stratum corneum and inflammatory biomarkers. Various intrinsic and extrinsic factors, such as Malassezia yeast, host epidermal conditions, sebaceous secretion, and abnormal immune responses, are found to contribute to the pathogenesis. Regardless of wide research, detail understanding, and treatment modalities, it still remains to be a cause of concern due to its recurring nature. AIMS The objective of this study is to enhance the understanding of its wide causes, pathophysiology, current treatment, and future approach. METHODS The article also aims at evaluating various promising anti-dandruff agents that can be further researched to become the leads in anti-dandruff therapy. RESULTS & CONCLUSION The article summarizes the current knowledge on dandruff and present new facts and evidences in order to spread awareness, create potential for new herbal treatment options, and effectively control the most commercially exploited scalp disorder.
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Affiliation(s)
- Umang Sheth
- SVKM's NMIMS, School of Pharmacy & Technology Management, Shirpur Campus, Shirpur, India
| | - Payal Dande
- SVKM's NMIMS, School of Pharmacy & Technology Management, Shirpur Campus, Shirpur, India
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Leermakers FAM, Luengo GS, Baghdadli N, Mazilier C, Potter A, Léonforte F. Turning autophobic wetting on biomimetic surfaces into complete wetting by wetting additives. SOFT MATTER 2020; 16:4823-4839. [PMID: 32412035 DOI: 10.1039/d0sm00129e] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Autophobicity or pseudo partial wetting, a phenomenon of a liquid not spreading on its own monolayer, is characterized by an energy barrier that prevents the growth of a wetting film beyond the monolayer thickness. Applying a molecularly detailed self-consistent field theory we illustrate how autophobic wetting can be overcome by wetting additives. More specifically we use an emulsifier which keeps the interfacial tension between the wetting component and the majority solvent low, and a co-solvent additive which partitions inside the film and then destroys the molecular order in it so that the barrier for film growth is cleared. An application wherein it is believed that autophobic wetting is counteracted by such a set of wetting additives is found in an antidandruff shampoo formulation. We have experimental results that show thick deposits onto hydrophobic hair surfaces by administration of the antidandruff shampoo. The complementary modeling of such a system suggests that the active ingredient plays the role of the co-solvent additive. As significant amounts of the co-solvent additives are needed to approach the completely wet state, the formulation naturally brings large amounts of active ingredient to the root of the hair where its presence is required.
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Affiliation(s)
- Frans A M Leermakers
- Physical Chemistry and Soft Matter, Wageningen University, Stippeneng 4, 6708 WE Wageningen, The Netherlands
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Adalsteinsson JA, Kaushik S, Muzumdar S, Guttman-Yassky E, Ungar J. An update on the microbiology, immunology and genetics of seborrheic dermatitis. Exp Dermatol 2020; 29:481-489. [PMID: 32125725 DOI: 10.1111/exd.14091] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Revised: 02/07/2020] [Accepted: 02/27/2020] [Indexed: 12/11/2022]
Abstract
The underlying mechanism of seborrheic dermatitis (SD) is poorly understood but major scientific progress has been made in recent years related to microbiology, immunology and genetics. In light of this, the major goal of this article was to summarize the most recent articles on SD, specifically related to underlying pathophysiology. SD results from Malassezia hydrolysation of free fatty acids with activation of the immune system by the way of pattern recognition receptors, inflammasome, IL-1β and NF-kB. M. restricta and M. globosa are likely the most virulent subspecies, producing large quantities of irritating oleic acids, leading to IL-8 and IL-17 activation. IL-17 and IL-4 might play a big role in pathogenesis, but this needs to be further studied using novel biologics. No clear genetic predisposition has been established; however, recent studies implicated certain increased-risk human leucocyte antigen (HLA) alleles, such as A*32, DQB1*05 and DRB1*01 as well as possible associations with psoriasis and atopic dermatitis (AD) through the LCE3 gene cluster while SD, and SD-like syndromes, shares genetic mutations that appear to impair the ability of the immune system to restrict Malassezia growth, partially due to complement system dysfunction. A paucity of studies exists looking at the relationship between SD and systemic disease. In HIV, SD is thought to be secondary to a combination of immune dysregulation and disruption in skin microbiota with unhindered Malassezia proliferation. In Parkinson's disease, SD is most likely secondary to parasympathetic hyperactivity with increased sebum production as well as facial immobility which leads to sebum accumulation.
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Affiliation(s)
| | - Shivani Kaushik
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Sonal Muzumdar
- Department of Dermatology, University of Connecticut, Farmington, Connecticut
| | - Emma Guttman-Yassky
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Jonathan Ungar
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York
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Lin Q, Panchamukhi A, Li P, Shan W, Zhou H, Hou L, Chen W. Malassezia and Staphylococcus dominate scalp microbiome for seborrheic dermatitis. Bioprocess Biosyst Eng 2020; 44:965-975. [PMID: 32219537 DOI: 10.1007/s00449-020-02333-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Accepted: 03/12/2020] [Indexed: 11/24/2022]
Abstract
Seborrheic dermatitis (SD) is a common disease of the human scalp that causes physical damage and psychological problems for patients. Studies have indicated that dysbiosis of the scalp microbiome results in SD. However, the specific fungal and bacterial microbiome changes related to SD remain elusive. To further investigate the fungal and bacterial microbiome changes associated with SD, we recruited 57 SD patients and 53 healthy individuals and explored their scalp microbiomes using next generation sequencing and the QIIME and LEfSe bioinformatics tools. Skin pH, sebum secretion, hydration, and trans-epidermal water loss (TWEL) were also measured at the scalp. We found no statistically significant differences between the normal and lesion sites in SD patients with different subtypes of dandruff and erythema. However, the fungal and bacterial microbiome could differentiate SD patients from healthy controls. The presence of Malassezia and Aspergillus was both found to be potential fungal biomarkers for SD, while Staphylococcus and Pseudomonas were found to be potential bacterial biomarkers. The fungal and bacterial microbiome were divided into three clusters through co-abundance analysis and their correlations with host factors indicated the interactions and potential cooperation and resistance between microbe communities and host. Our research showed the skin microbe dysbiosis of SD and highlighted specific microorganisms that may serve as potential biomarkers of SD. The etiology of SD is multi-pathogenetic-dependent on the linkage of several microbes with host. Scalp microbiome homeostasis could be a promising new target in the risk assessment, prevention, and treatment of SD disease.
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Affiliation(s)
- Qingbin Lin
- Beijing Institute of Biotechnology, Beijing, 10071, China
| | - Ananth Panchamukhi
- Ben May Department for Cancer Research, The University of Chicago, Chicago, IL, 60637, USA
| | - Pan Li
- Division of Laboratory Medicine, Microbiome Medicine Center, Zhujiang Hospital, Southern Medical University, Guangzhou, 510280, Guangdong, China
| | - Wang Shan
- Division of Laboratory Medicine, Microbiome Medicine Center, Zhujiang Hospital, Southern Medical University, Guangzhou, 510280, Guangdong, China
| | - Hongwei Zhou
- Division of Laboratory Medicine, Microbiome Medicine Center, Zhujiang Hospital, Southern Medical University, Guangzhou, 510280, Guangdong, China
| | - Lihua Hou
- Beijing Institute of Biotechnology, Beijing, 10071, China
| | - Wei Chen
- Beijing Institute of Biotechnology, Beijing, 10071, China.
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Sadhasivam S, Garkhal K, Singh H, Yadav V, Chawrai S, Ramnane M, Jain S, Sardana K, Ghosh S. Newly Developed Anti-Dandruff Regimen, VB-3222, Delivers Enhanced Sensorial and Effective Therapeutic Benefits Against Moderate Adherent Dandruff. Clin Cosmet Investig Dermatol 2020; 13:187-195. [PMID: 32110083 PMCID: PMC7041436 DOI: 10.2147/ccid.s219109] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Accepted: 12/04/2019] [Indexed: 11/23/2022]
Abstract
Background Uninhibited proliferation of Malassezia spp., enhanced sebaceous gland activity and individual sensitivity are three prime etiological factors behind dandruff. For many dandruff sufferers, existing anti-dandruff products start yielding unsatisfactory results after a few cycles of use. This observation made us explore the physical and biological environment of the host and exploit the specific type of lipid dependence of Malassezia spp. for their survival. A shampoo formulation (product code VB-3222) was developed to address the shortcomings of existing therapy. Purpose Evaluating efficacy of VB-3222 in comparison to marketed products through in vitro assays and subsequently demonstrating its advantages in a clinical study. Methods VB-3222 was developed with a derivative of medium chain fatty acid (MCFA) and zinc pyrithione and compared against marketed comparators by in vitro time kill assay. Subsequently, VB-3222 shampoo was tested in a 21-day clinical trial on 25 moderate dandruff subjects to evaluate local safety and efficacy. Results VB-3222 in all in vitro cases demonstrated significantly better fungicidal activity than its marketed comparators. In the clinical trial, VB-3222 was well tolerated in all subjects and imparted consistent reduction of the ASFS (adherent scalp flaking score) and the pruritus score. At days 7 and 21, 55% and 90% reduction in the ASFS in comparison to treatment initiation and 50% and 95.5% reduction in the pruritus score were observed. Conclusion The increased efficacy of VB-3222 over comparator products in vitro, and the dramatic reduction (>90%) in ASFS and pruritis in subjects within 21 days of use with excellent tolerability and sensorial profile, positions VB-3222 as the new generation treatment for adherent dandruff. Clinical Trial Registration No CTRI/2018/05/013567.
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Affiliation(s)
| | | | | | - Vishal Yadav
- Vyome Therapeutics Limited, New Delhi 110092, India
| | | | - Mukesh Ramnane
- MS Clinical Research Pvt. Ltd, Ulsoor, Bangalore 560008, India
| | - Shilpi Jain
- Vyome Therapeutics Limited, New Delhi 110092, India
| | - Kabir Sardana
- Department of Dermatology, Dr RML Hospital and PGIMER, New Delhi 110001, India
| | - Shamik Ghosh
- Vyome Therapeutics Limited, New Delhi 110092, India
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Grimshaw SG, Smith AM, Arnold DS, Xu E, Hoptroff M, Murphy B. The diversity and abundance of fungi and bacteria on the healthy and dandruff affected human scalp. PLoS One 2019; 14:e0225796. [PMID: 31851674 PMCID: PMC6919596 DOI: 10.1371/journal.pone.0225796] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Accepted: 11/12/2019] [Indexed: 12/22/2022] Open
Abstract
Dandruff is a skin condition that affects the scalp of up to half the world's population, it is characterised by an itchy, flaky scalp and is associated with colonisation of the skin by Malassezia spp. Management of this condition is typically via antifungal therapies, however the precise role of microbes in the aggravation of the condition are incompletely characterised. Here, a combination of 454 sequencing and qPCR techniques were used to compare the scalp microbiota of dandruff and non-dandruff affected Chinese subjects. Based on 454 sequencing of the scalp microbiome, the two most abundant bacterial genera found on the scalp surface were Cutibacterium (formerly Propionibacterium) and Staphylococcus, while Malassezia was the main fungal inhabitant. Quantitative PCR (qPCR) analysis of four scalp taxa (M. restricta, M. globosa, C. acnes and Staphylococcus spp.) believed to represent the bulk of the overall population was additionally carried out. Metataxonomic and qPCR analyses were performed on healthy and lesional buffer scrub samples to facilitate assessment of whether the scalp condition is associated with differential microbial communities on the sampled skin. Dandruff was associated with greater frequencies of M. restricta and Staphylococcus spp. compared with the healthy population (p<0.05). Analysis also revealed the presence of an unclassified fungal taxon that could represent a novel Malassezia species.
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Affiliation(s)
- Sally G. Grimshaw
- Unilever Research & Development, Port Sunlight, England, United Kingdom
| | - Adrian M. Smith
- Unilever Research & Development, Colworth, England, United Kingdom
| | - David S. Arnold
- Unilever Research & Development, Port Sunlight, England, United Kingdom
| | - Elaine Xu
- Unilever Research & Development, Shanghai, China
| | - Michael Hoptroff
- Unilever Research & Development, Port Sunlight, England, United Kingdom
| | - Barry Murphy
- Unilever Research & Development, Port Sunlight, England, United Kingdom
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17
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Wikramanayake TC, Borda LJ, Miteva M, Paus R. Seborrheic dermatitis—Looking beyondMalassezia. Exp Dermatol 2019; 28:991-1001. [DOI: 10.1111/exd.14006] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2019] [Revised: 06/30/2019] [Accepted: 07/09/2019] [Indexed: 12/12/2022]
Affiliation(s)
- Tongyu C. Wikramanayake
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery University of Miami Miller School of Medicine Miami FL USA
| | - Luis J. Borda
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery University of Miami Miller School of Medicine Miami FL USA
| | - Mariya Miteva
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery University of Miami Miller School of Medicine Miami FL USA
| | - Ralf Paus
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery University of Miami Miller School of Medicine Miami FL USA
- Centre for Dermatology Research University of Manchester Manchester UK
- NIHR Biomedical Research Centre Manchester UK
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18
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Pople JE, Bhogal RK, Moore AE, Jenkins G. Changes in epidermal morphology associated with dandruff. Int J Cosmet Sci 2019; 41:357-363. [PMID: 31087801 DOI: 10.1111/ics.12539] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Accepted: 05/09/2019] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Dandruff is a very common scalp condition characterized by flaking and pruritus usually with no visible signs of inflammation, such as redness and erythema. Dandruff is considered a multifactorial condition with both microbial colonization and host factors such as sebum production thought to play a role. There is evidence of changes in epidermal morphology in the scalp skin of dandruff sufferers, with reports of an increase in mean thickness and more nucleated cell layers. The underlying mechanisms driving these morphological changes are currently unclear. The objective of this study was to fully characterize epidermal morphology in dandruff compared to healthy scalp skin and to evaluate potential mechanisms underlying any changes observed. METHODS Scalp skin biopsies were taken from 22 healthy female subjects and 21 dandruff sufferers, from both lesional and non-lesional sites. Samples were processed, sectioned and stained using haematoxylin and eosin (H&E). To fully characterize epidermal morphology, measurements were taken of epidermal thickness, the convolution of the dermal-epidermal junction and the depth of epidermal rete ridges. To analyse changes in epidermal proliferation immunohistochemical staining was performed using Ki67, a well-established marker of cell proliferation, and quantified using image analysis. RESULTS Histochemical analysis of skin sections revealed that in dandruff lesional samples, the epidermis was thicker, had a more convoluted dermal epidermal junction and the rete ridges were elongated, compared to healthy scalp skin. Similar directional changes in epidermal morphology, were observed in non-lesional dandruff samples, albeit to a lesser extent. Image analysis of Ki67 expression in the epidermis revealed dandruff lesional skin contained significantly more Ki67-positive proliferating keratinocytes than healthy controls samples. This suggests dandruff scalp skin epidermal keratinocytes are in a hyper-proliferative state. CONCLUSION There were significant changes in epidermal morphology in dandruff lesional skin compared to healthy scalp skin including increased epidermal thickness, a more convoluted dermal-epidermal junction and elongation of rete ridges. Interestingly, we found there was evidence of an increase in the percentage of epidermal Ki67-positive cells, which has not been reported previously, and demonstrates dandruff is a condition displaying epidermal hyper-proliferation.
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Affiliation(s)
- J E Pople
- Unilever R&D Colworth, Colworth Science Park, Sharnbrook, Bedfordshire, MK44 1LQ, UK
| | - R K Bhogal
- Unilever R&D Colworth, Colworth Science Park, Sharnbrook, Bedfordshire, MK44 1LQ, UK
| | - A E Moore
- Unilever R&D Colworth, Colworth Science Park, Sharnbrook, Bedfordshire, MK44 1LQ, UK
| | - G Jenkins
- Unilever R&D Colworth, Colworth Science Park, Sharnbrook, Bedfordshire, MK44 1LQ, UK
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Collins LZ, Baines FL, Matheson JR, Turner GA, Diao Y, Li Y, Pi Y. Sex-related differences in response to zinc pyrithione shampoo vs. non-anti-dandruff shampoo. Int J Cosmet Sci 2018; 40:583-588. [PMID: 30447108 DOI: 10.1111/ics.12501] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Accepted: 11/11/2018] [Indexed: 12/01/2022]
Abstract
OBJECTIVE Sex-related differences in skin properties may be expected to impact dandruff formation and treatment. A meta-analysis approach was undertaken to investigate potential differences between males and females in response to zinc pyrithione (ZnPT) treatment vs. non-anti-dandruff (AD) shampoo. A separate pooled statistical analysis of ceramide and total protein loss endpoints was also undertaken to assess potential sex-related differences in stratum corneum properties that might influence response to ZnPT vs. non-AD shampoo in subjects with dandruff. METHODS The meta-analysis approach included data from 17 half-head, double-blind, randomized studies (N = 2088) undertaken in Asia to assess the effectiveness of 1% ZnPT shampoo and/or non-AD shampoo in reducing dandruff severity, as assessed by Total Weighted Head Score Adherent Flake (TWHS-AF) methodology. Treatment duration was 4 weeks, with TWHS-AF measured at weekly intervals. Data from an additional three studies (N = 143) conducted in Asia were included in the pooled analysis of ceramide levels and protein loss from scalp skin of subjects with dandruff. RESULTS Response to 1% ZnPT vs. non-AD shampoo was greater in males than in females at all time points; after 4 weeks, the between-treatment difference in TWHS-AF was -17.5 (95% confidence interval [CI] -19.5, -15.5) in males and -11.1 (-13.2, -8.9) in females. Sex-related differences were observed between males and females in response to both 1% ZnPT and non-AD shampoos. Males had a stronger response than females to treatment with 1% ZnPT shampoo, while dandruff decreased to a greater extent in females than in males when using non-AD shampoo. Statistically significant sex-related differences in ceramide levels and total protein loss were observed (both P < 0.01). Ceramide levels were 0.76 times lower (95% CI 0.60, 0.97) in males than in females, while total protein loss was 1.4 times greater (95% CI 1.1, 1.9) in males than in females. CONCLUSION Males show a greater response than females to 1% ZnPT shampoo, while females show a greater response than males to non-AD shampoo. These findings may in part be explained by the sex-related differences observed in stratum corneum properties, which may make males more prone to dandruff than females.
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Affiliation(s)
- L Z Collins
- Unilever Research and Development Port Sunlight Laboratory, Bebington, Merseyside, CH63 3JW, U.K
| | - F L Baines
- Unilever Research and Development Port Sunlight Laboratory, Bebington, Merseyside, CH63 3JW, U.K
| | - J R Matheson
- Unilever Research and Development Port Sunlight Laboratory, Bebington, Merseyside, CH63 3JW, U.K
| | - G A Turner
- Unilever Research and Development Port Sunlight Laboratory, Bebington, Merseyside, CH63 3JW, U.K
| | - Y Diao
- Unilever Research and Development Centre Shanghai, 66 LinXin Road, Changning District, 200335, Shanghai, China
| | - Y Li
- Unilever Research and Development Port Sunlight Laboratory, Bebington, Merseyside, CH63 3JW, U.K
| | - Y Pi
- Unilever Research and Development Centre Shanghai, 66 LinXin Road, Changning District, 200335, Shanghai, China
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20
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Takagi Y, Ning X, Takahashi A, Ishizaki C, Nishizaka T, Kaizu K, Miyaki M, Yamamuro H, Kawashima M. The efficacy of a pseudo-ceramide and eucalyptus extract containing lotion on dry scalp skin. Clin Cosmet Investig Dermatol 2018; 11:141-148. [PMID: 29670385 PMCID: PMC5896640 DOI: 10.2147/ccid.s158428] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Objective Dry and scaly conditions on the scalp are often observed in patients with atopic dermatitis, seborrheic dermatitis and/or pityriasis capitis. Those scalp lesions often exhibit low barrier function and reduced ceramide levels. Therefore, a clinical study was conducted to evaluate the efficacy of topical application of a pseudo-ceramide and eucalyptus extract-containing lotion on the scalps of patients with skin diseases. Methods Thirty-four subjects participated in this study (atopic dermatitis: 19 subjects; seborrheic dermatitis: 6 subjects; pityriasis capitis: 9 subjects). After 4 weeks of daily treatment with a pseudo-ceramide and eucalyptus extract-containing lotion, the skin symptoms had significantly improved in all patients with those skin diseases. Results Skin dryness, scaling, and erythema were significantly improved by treatment with the lotion. The moisture-retention ability of the scalp was significantly increased and itchiness, evaluated using a visual analog scale, decreased significantly. Accompanying those improvements was a significant improvement in the quality of life of the subjects, evaluated by the Skindex-16®. Conclusion From these results, we conclude that this pseudo-ceramide and eucalyptus extract-containing lotion effectively improved the dry and scaly conditions of the scalp as well as the quality of life of subjects with atopic dermatitis, seborrheic dermatitis, or pityriasis capitis.
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Affiliation(s)
- Yutaka Takagi
- Skin Care Product Research, Kao Corporation, Tokyo, Japan
| | - Xuanhe Ning
- Skin Care Product Research, Kao Corporation, Tokyo, Japan
| | | | | | | | - Kazuhiro Kaizu
- Skin Care Product Research, Kao Corporation, Tokyo, Japan
| | | | | | - Makoto Kawashima
- Department of Dermatology, Tokyo Women's Medical University, Tokyo, Japan
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An Q, Sun M, Qi RQ, Zhang L, Zhai JL, Hong YX, Song B, Chen HD, Gao XH. High Staphylococcus epidermidis Colonization and Impaired Permeability Barrier in Facial Seborrheic Dermatitis. Chin Med J (Engl) 2018; 130:1662-1669. [PMID: 28685715 PMCID: PMC5520552 DOI: 10.4103/0366-6999.209895] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Seborrheic dermatitis (SD) is a common inflammatory skin condition. The etiology is unclear, although overgrowth of Malassezia on the skin has been suggested to cause SD. This study investigated whether colonization with Staphylococcus plays a role in facial SD, which was not well addressed previously. METHODS The study was conducted from September 1, 2011 to February 20, 2012 in the First Hospital of China Medical University. In the first phase, the study evaluated the level of transepidermal water loss (TEWL) and the number of colony-forming units (CFU) of Staphylococcus in defined skin areas of SD patients who were human immunodeficiency virus (HIV) seropositive (HIV [+] SD [+] group, n = 13), classical SD (HIV [-] SD [+] group, n = 24) patients, HIV seropositive-non-SD (HIV [+] SD [-] group, n = 16) patients, and healthy volunteers (HIV [-] SD [-] group, n = 16). In the second phase, we enrolled another cohort of HIV (-) SD (+) patients who applied topical fusidic acid (n = 15), tacrolimus (n = 16), or moisturizer (n = 12). Changes in the Seborrheic Dermatitis Area Severity Index (SDASI), TEWL, and Staphylococcus density were evaluated 2 weeks later. Comparisons of each index were performed using analysis of variance (ANOVA) and least significant difference method. RESULTS The level of TEWL was greater through lesional sites in the HIV (+) SD (+) group than that in HIV (+) SD (-) and HIV (-) SD (-) groups (95% confidence interval [CI]: 18.873-47.071, P < 0.001 and 95% CI: 28.755-55.936, P < 0.001, respectively). The number of CFU of Staphylococcus was greater in the HIV (+) SD (+) group than that in HIV (+) SD (-) and HIV (-) SD (-) groups (95% CI: 37.487-142.744, P = 0.001 and 95% CI: 54.936-156.400, P < 0.001, respectively). TEWL was significantly more improved in patients treated with tacrolimus and fusidic acid than that in those treated with moisturizers (95% CI: 7.560-38.987, P = 0.004 and 95% CI: 4.659-37.619, P = 0.011, respectively). Topical tacrolimus and fusidic acid were significantly associated with decreased SDASI as compared with moisturizer (95% CI: 0.03-0.432, P = 0.025 and 95% CI: 0.033-0.44, P = 0.024, respectively). CONCLUSIONS High colonization with Staphylococcus epidermidis, along with impaired skin permeability barrier function, contributes to the occurrence of SD.
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Affiliation(s)
- Qian An
- Department of Dermatology, The First Hospital of China Medical University, Shenyang, Liaoning 110001, China
| | - Meng Sun
- Department of Dermatology, Shenyang Children's Hospital, Shenyang, Liaoning 110032, China
| | - Rui-Qun Qi
- Department of Dermatology, The First Hospital of China Medical University, Shenyang, Liaoning 110001, China
| | - Li Zhang
- Department of Dermatology, The First Hospital of China Medical University, Shenyang, Liaoning 110001, China
| | - Jin-Long Zhai
- Department of Dermatology, The First Hospital of China Medical University, Shenyang, Liaoning 110001, China
| | - Yu-Xiao Hong
- Department of Dermatology, The First Hospital of China Medical University, Shenyang, Liaoning 110001, China
| | - Bing Song
- Department of Regenerative Medicine, Cardiff Institute of Tissue Engineering and Repair, School of Dentistry, Cardiff University, CF10 3AT, UK
| | - Hong-Duo Chen
- Department of Dermatology, The First Hospital of China Medical University, Shenyang, Liaoning 110001, China
| | - Xing-Hua Gao
- Department of Dermatology, The First Hospital of China Medical University, Shenyang, Liaoning 110001, China
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22
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Purnamawati S, Indrastuti N, Danarti R, Saefudin T. The Role of Moisturizers in Addressing Various Kinds of Dermatitis: A Review. Clin Med Res 2017; 15:75-87. [PMID: 29229630 PMCID: PMC5849435 DOI: 10.3121/cmr.2017.1363] [Citation(s) in RCA: 84] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Revised: 10/23/2017] [Accepted: 11/13/2017] [Indexed: 01/14/2023]
Abstract
Moisturizer is a major component of basic daily skin care, particularly in presence of epidermal barrier alteration and reduced epidermal water content. It is an important part of a dermatologist's strategy to maintain skin health as well as treating various dermatoses which co-exist with skin dryness and are linked to impaired skin barrier function, such as in atopic disorders as well as other types of dermatitis. Mastering the knowledge regarding mechanism of action, application, dosage, adverse effects as well as specific clinical usage of moisturizers is a must for a dermatologist in order to support their use, particularly for evidence-based, therapeutic purposes. This review discusses the use of moisturizer both for skin health maintenance as well as a definitive or adjuvant therapy for many kinds of dermatitis.
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Affiliation(s)
- Schandra Purnamawati
- Department of Dermatology and Venereology, Faculty of Medicine, Universitas Gadjah Mada/ Dr. Sardjito Hospital, Yogyakarta, Indonesia
- Faculty of Medicine, Universitas Jenderal Soedirman, Purwokerto, Indonesia
| | - Niken Indrastuti
- Department of Dermatology and Venereology, Faculty of Medicine, Universitas Gadjah Mada/ Dr. Sardjito Hospital, Yogyakarta, Indonesia
| | - Retno Danarti
- Department of Dermatology and Venereology, Faculty of Medicine, Universitas Gadjah Mada/ Dr. Sardjito Hospital, Yogyakarta, Indonesia
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23
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Chen G, Ji C, Miao M, Yang K, Luo Y, Hoptroff M, Collins LZ, Janssen HG. Ex-vivo measurement of scalp follicular infundibulum delivery of zinc pyrithione and climbazole from an anti-dandruff shampoo. J Pharm Biomed Anal 2017; 143:26-31. [DOI: 10.1016/j.jpba.2017.05.031] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Accepted: 05/16/2017] [Indexed: 10/19/2022]
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24
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Falcone D, Uzunbajakava N, Richters R, van de Kerkhof PC, van Erp PE. Histamine Iontophoresis as in vivo Model to Study Human Skin Inflammation with Minimal Barrier Impairment: Pilot Study Results of Application of the Model to a Sensitive Skin Panel. Skin Pharmacol Physiol 2017; 30:246-259. [DOI: 10.1159/000477416] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Accepted: 05/09/2017] [Indexed: 11/19/2022]
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25
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Moore DJ, Rawlings AV. The chemistry, function and (patho)physiology of stratum corneum barrier ceramides. Int J Cosmet Sci 2017; 39:366-372. [DOI: 10.1111/ics.12399] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2017] [Accepted: 03/19/2017] [Indexed: 11/28/2022]
Affiliation(s)
- D. J. Moore
- GSK Consumer Healthcare; Skin Health R&D; 184 Liberty Corner Road Warren NJ 07059 USA
| | - A. V. Rawlings
- AVR Consulting Ltd; 26 Shavington Way Kingsmead Northwich Cheshire CW9 8FH UK
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Bhattacharyya A, Jain N, Prasad S, Jain S, Yadav V, Ghosh S, Sengupta S. Evaluation of therapeutic potential of VB-001, a leave-on formulation, for the treatment of moderate adherent dandruff. BMC DERMATOLOGY 2017; 17:5. [PMID: 28468620 PMCID: PMC5415814 DOI: 10.1186/s12895-017-0058-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Accepted: 04/25/2017] [Indexed: 12/02/2022]
Abstract
Background Dandruff is a common scalp condition characterized by excessive scaling and itch. Aberrant colonization of the scalp by commensal Malassezia spp. is a major contributor in the multifactorial etiology of dandruff. Literature based understanding of Malassezia linked pathophysiology of dandruff allowed us to comprehend a strategy to potentiate the efficacy of a known antifungal agent used in dandruff therapy. The aim of this study was to determine the efficacy and skin safety of VB-001 antidandruff leave-on formulation in comparison with marketed antidandruff ZPTO shampoo in patients with moderate adherent dandruff of the scalp. Methods Healthy males or females aged ≥ 15 years and ≤ 65 with a clinical diagnosis of moderate adherent dandruff of the scalp were recruited for the study to monitor the effects of topical VB-001 versus those of marketed antidandruff ZPTO shampoo. Results 168 subjects were randomized to the treatment (VB-001, n = 84) and control (ZPTO shampoo, n = 84) groups. The efficacy of each product was evaluated by comparing proportion of subjects who have shown reduction in flaking by ASFS (adherent scalp flaking score) and pruritus by IGA (investigator global assessment) score. VB-001 imparted consistently better reduction in ASFS and enabled early reduction of pruritus in comparison to marketed ZPTO shampoo. Conclusion VB-001, a leave-on formulation with ingredients chosen to selectively disturb the Malassezia niche on dandruff scalp by denying extra nutritional benefits to the microbe, provides unique advantages over existing best in class ZPTO shampoo therapy. It has the potential to emerge as an attractive novel treatment for moderate adherent dandruff. Trial registration CTRI Registration number: CTRI/2013/01/003283. Registered on: 02/01/2013
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Affiliation(s)
- Anamika Bhattacharyya
- Vyome Biosciences Pvt. Ltd, Plot# 465, F.I.E., Patparganj Industrial Area, Delhi, 110092, India
| | - Nilu Jain
- Vyome Biosciences Pvt. Ltd, Plot# 465, F.I.E., Patparganj Industrial Area, Delhi, 110092, India
| | - Sudhanand Prasad
- Vyome Biosciences Pvt. Ltd, Plot# 465, F.I.E., Patparganj Industrial Area, Delhi, 110092, India
| | - Shilpi Jain
- Vyome Biosciences Pvt. Ltd, Plot# 465, F.I.E., Patparganj Industrial Area, Delhi, 110092, India
| | - Vishal Yadav
- Vyome Biosciences Pvt. Ltd, Plot# 465, F.I.E., Patparganj Industrial Area, Delhi, 110092, India
| | - Shamik Ghosh
- Vyome Biosciences Pvt. Ltd, Plot# 465, F.I.E., Patparganj Industrial Area, Delhi, 110092, India.
| | - Shiladitya Sengupta
- Medicine & HST, Brigham and Women's Hospital, Harvard Medical School, Room 317, 65 Landsdowne Street, Cambridge, MA, 02139, USA.
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Sommer B, Overy DP, Haltli B, Kerr RG. Secreted lipases from Malassezia globosa: recombinant expression and determination of their substrate specificities. Microbiology (Reading) 2016; 162:1069-1079. [DOI: 10.1099/mic.0.000299] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Affiliation(s)
- Bettina Sommer
- Department of Chemistry, University of Prince Edward Island, 550 University Avenue, Charlottetown, PE, Canada, C1A 4P3
- Nautilus Biosciences Canada, Duffy Research Center, University of Prince Edward Island, 550 University Avenue, Charlottetown, PE, Canada, C1A 4P3
| | - David P. Overy
- Department of Chemistry, University of Prince Edward Island, 550 University Avenue, Charlottetown, PE, Canada, C1A 4P3
- Nautilus Biosciences Canada, Duffy Research Center, University of Prince Edward Island, 550 University Avenue, Charlottetown, PE, Canada, C1A 4P3
- Department of Pathology and Microbiology, Atlantic Veterinary College, University of Prince Edward Island, 550 University Avenue, Charlottetown, PE, Canada, C1A 4P3
| | - Bradley Haltli
- Department of Chemistry, University of Prince Edward Island, 550 University Avenue, Charlottetown, PE, Canada, C1A 4P3
- Nautilus Biosciences Canada, Duffy Research Center, University of Prince Edward Island, 550 University Avenue, Charlottetown, PE, Canada, C1A 4P3
- Department of Biomedical Sciences, Atlantic Veterinary College, University of Prince Edward Island, 550 University Avenue, Charlottetown, PE, Canada, C1A 4P3
| | - Russell G. Kerr
- Department of Biomedical Sciences, Atlantic Veterinary College, University of Prince Edward Island, 550 University Avenue, Charlottetown, PE, Canada, C1A 4P3
- Department of Chemistry, University of Prince Edward Island, 550 University Avenue, Charlottetown, PE, Canada, C1A 4P3
- Nautilus Biosciences Canada, Duffy Research Center, University of Prince Edward Island, 550 University Avenue, Charlottetown, PE, Canada, C1A 4P3
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Abstract
Seborrheic Dermatitis (SD) and dandruff are of a continuous spectrum of the same disease that affects the seborrheic areas of the body. Dandruff is restricted to the scalp, and involves itchy, flaking skin without visible inflammation. SD can affect the scalp as well as other seborrheic areas, and involves itchy and flaking or scaling skin, inflammation and pruritus. Various intrinsic and environmental factors, such as sebaceous secretions, skin surface fungal colonization, individual susceptibility, and interactions between these factors, all contribute to the pathogenesis of SD and dandruff. In this review, we summarize the current knowledge on SD and dandruff, including epidemiology, burden of disease, clinical presentations and diagnosis, treatment, genetic studies in humans and animal models, and predisposing factors. Genetic and biochemical studies and investigations in animal models provide further insight on the pathophysiology and strategies for better treatment.
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Affiliation(s)
- Luis J Borda
- Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, 1600 NW 10th Avenue, RMSB 2023A, Miami, Florida 33136, USA
| | - Tongyu C Wikramanayake
- Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, 1600 NW 10th Avenue, RMSB 2023A, Miami, Florida 33136, USA
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Chen G, Miao M, Hoptroff M, Fei X, Collins LZ, Jones A, Janssen HG. Sensitive and simultaneous quantification of zinc pyrithione and climbazole deposition from anti-dandruff shampoos onto human scalp. J Chromatogr B Analyt Technol Biomed Life Sci 2015; 1003:22-6. [DOI: 10.1016/j.jchromb.2015.09.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Revised: 09/07/2015] [Accepted: 09/09/2015] [Indexed: 11/15/2022]
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Falcone D, Uzunbajakava NE, Varghese B, de Aquino Santos GR, Richters RJH, van de Kerkhof PCM, van Erp PEJ. Microspectroscopic Confocal Raman and Macroscopic Biophysical Measurements in the in vivo Assessment of the Skin Barrier: Perspective for Dermatology and Cosmetic Sciences. Skin Pharmacol Physiol 2015; 28:307-17. [PMID: 26406586 DOI: 10.1159/000439031] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2015] [Accepted: 07/27/2015] [Indexed: 11/19/2022]
Abstract
Skin barrier function, confined to the stratum corneum, is traditionally evaluated using established, noninvasive biophysical methods like transepidermal water loss, capacitance and conductance. However, these methods neither measure skin molecular composition nor its structure, hindering the actual causes of skin barrier change or impairment. At the same time, confocal Raman microspectroscopy (CRS) can directly measure skin molecular composition and structure and has proven itself to be a powerful technique for biomolecular analysis. The aims of this literature review were to evaluate noninvasive biophysical methods in view of CRS and to outline a direction towards more specific and informative skin measurement methods. We address this by investigating, for the first time, the relation between in vivo assessment of the skin barrier using indirect biophysical methods and the actual skin composition and structure as given by CRS, and emphasize the high potential of CRS for dermatology and cosmetic sciences. CRS acceptance in these fields will require close collaboration between dermatologists, skin scientists and spectroscopy experts towards simplifying the technology and creating robust, rapid, easy-to-use and less expensive CRS applications.
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Affiliation(s)
- Denise Falcone
- Department of Dermatology, Radboud University Medical Center, Nijmegen, The Netherlands
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Singh B, Haftek M, Harding CR. Retention of corneodesmosomes and increased expression of protease inhibitors in dandruff. Br J Dermatol 2014; 171:760-70. [PMID: 24815089 DOI: 10.1111/bjd.13111] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/05/2014] [Indexed: 12/22/2022]
Abstract
BACKGROUND Dandruff is a common, relapsing and uncomfortable scalp condition affecting a large proportion of the global population. The appearance of flakes on the scalp and in the hair line, and associated itch are thought to be consequences of a damaged skin barrier, altered corneocyte cohesion and abnormal desquamation in dandruff. The balance between skin proteases and protease inhibitors is essential for driving the key events, including corneodesmosome degradation, in the desquamation process and to maintain stratum corneum (SC) barrier integrity. OBJECTIVES To investigate the distribution of corneodesmosomes, the key component of the SC cohesivity and barrier function, and the protease inhibitors lympho-epithelial Kazal-type-related inhibitor (LEKTI-1) and squamous cell carcinoma antigen (SCCA1) in the scalp of dandruff-affected participants. METHODS The methods utilized were immunohistochemistry, scanning immunoelectron microscopy, phase-contrast microscopy, Western blotting and serine protease activity assay on tape-stripped SC or scalp skin biopsies. RESULTS In SC samples from healthy subjects, corneodesmosomes were peripherally located in the corneocytes. In samples of dandruff lesions, corneodesmosomes were located both peripherally and on the entire surface area of the corneocytes. LEKTI-1 and SCCA1 protein levels and parakeratosis were found to be highly elevated in the lesional samples. CONCLUSIONS The persistence of nonperipheral corneodesmosomes is a characteristic feature of the perturbed desquamation seen in dandruff. The increased expression levels of LEKTI-1 and SCCA1 are consistent with the view that the dandruff condition is characterized by an imbalance in protease-protease inhibitor interaction in the SC.
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Affiliation(s)
- B Singh
- Unilever Research & Development, Port Sunlight, Bebington, U.K
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Pople JE, Moore AE, Talbot DCS, Barrett KE, Jones DA, Lim FL. Climbazole increases expression of cornified envelope proteins in primary keratinocytes. Int J Cosmet Sci 2014; 36:419-26. [DOI: 10.1111/ics.12137] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2014] [Accepted: 04/27/2014] [Indexed: 11/27/2022]
Affiliation(s)
- J. E. Pople
- Unilever R&D Colworth; Colworth Science Park; Sharnbrook Bedfordshire UK
| | - A. E. Moore
- Unilever R&D Colworth; Colworth Science Park; Sharnbrook Bedfordshire UK
| | - D. C. S. Talbot
- Unilever R&D Colworth; Colworth Science Park; Sharnbrook Bedfordshire UK
| | - K. E. Barrett
- Unilever R&D Colworth; Colworth Science Park; Sharnbrook Bedfordshire UK
| | - D. A. Jones
- Unilever R&D Port Sunlight; Quarry Road East; Bebington Wirral UK
| | - F. L. Lim
- Unilever R&D Colworth; Colworth Science Park; Sharnbrook Bedfordshire UK
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Bonnist EYM, Pudney PDA, Weddell LA, Campbell J, Baines FL, Paterson SE, Matheson JR. Understanding the dandruff scalp before and after treatment: anin vivoRaman spectroscopic study. Int J Cosmet Sci 2014; 36:347-54. [DOI: 10.1111/ics.12132] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2014] [Accepted: 03/29/2014] [Indexed: 11/29/2022]
Affiliation(s)
- E. Y. M. Bonnist
- Unilever R&D Colworth; Colworth Science Park, Sharnbrook Bedfordshire MK44 1LQ U.K
| | - P. D. A. Pudney
- Unilever R&D Colworth; Colworth Science Park, Sharnbrook Bedfordshire MK44 1LQ U.K
| | - L. A. Weddell
- Unilever R&D Port Sunlight; Quarry Rd East Bebington Wirral CH63 3JW U.K
| | - J. Campbell
- Unilever R&D Port Sunlight; Quarry Rd East Bebington Wirral CH63 3JW U.K
| | - F. L. Baines
- Unilever R&D Port Sunlight; Quarry Rd East Bebington Wirral CH63 3JW U.K
| | - S. E. Paterson
- Unilever R&D Port Sunlight; Quarry Rd East Bebington Wirral CH63 3JW U.K
| | - J. R. Matheson
- Unilever R&D Port Sunlight; Quarry Rd East Bebington Wirral CH63 3JW U.K
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Belousova TA, Goryachkina MV, Katranova DG. Seborrheic scalp dermatitis: current concepts of its etiology, pathogenesis and therapy. VESTNIK DERMATOLOGII I VENEROLOGII 2013. [DOI: 10.25208/vdv637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
The authors provide a review of current concepts of the epidemiology, etiology, pathogenesis and treatment principles for seborrheic scalp dermatitis. They also describe the results of multiple national and foreign studies confirming high clinical efficacy of ketoconazole 2% shampoo in the therapy of seborrheic dermatitis.
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Schommer NN, Gallo RL. Structure and function of the human skin microbiome. Trends Microbiol 2013; 21:660-8. [PMID: 24238601 DOI: 10.1016/j.tim.2013.10.001] [Citation(s) in RCA: 226] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2013] [Revised: 10/07/2013] [Accepted: 10/11/2013] [Indexed: 01/22/2023]
Abstract
An abundant and diverse collection of bacteria, fungi, and viruses inhabits the human skin. These microorganisms vary between individuals and between different sites on the skin. The factors responsible for the unique variability of the skin microbiome are only partly understood, but results suggest that host genetic and environmental influences play a major role. Today, the steady accumulation of data describing the skin microbiome, combined with experiments designed to test the biological functions of surface microbes, has provided new insights into links between human physiology and skin microbiota. This review describes some of the current information regarding the skin microbiome and its impact on human health. Specifically, we summarize the present understanding of the function of microbe-host interactions on the skin and highlight some unique features that distinguish skin commensal organisms from pathogenic microbes.
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Affiliation(s)
- Nina N Schommer
- Division of Dermatology, University of California, San Diego, La Jolla, CA, USA
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37
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Chen G, Hoptroff M, Fei X, Su Y, Janssen HG. Ultra-high-performance liquid chromatography–tandem mass spectrometry measurement of climbazole deposition from hair care products onto artificial skin and human scalp. J Chromatogr A 2013; 1317:155-8. [DOI: 10.1016/j.chroma.2013.08.032] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2013] [Revised: 07/01/2013] [Accepted: 08/08/2013] [Indexed: 10/26/2022]
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Schwartz JR, Bacon RA, Shah R, Mizoguchi H, Tosti A. Therapeutic efficacy of anti-dandruff shampoos: A randomized clinical trial comparing products based on potentiated zinc pyrithione and zinc pyrithione/climbazole. Int J Cosmet Sci 2013; 35:381-7. [DOI: 10.1111/ics.12055] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2013] [Accepted: 04/20/2013] [Indexed: 11/27/2022]
Affiliation(s)
- J. R. Schwartz
- The Procter & Gamble Company, 11511 Reed Hartman Hwy.; Cincinnati OH 45241 U.S.A
| | - R. A. Bacon
- The Procter & Gamble Company, 11511 Reed Hartman Hwy.; Cincinnati OH 45241 U.S.A
| | - R. Shah
- The Procter & Gamble Company, 11511 Reed Hartman Hwy.; Cincinnati OH 45241 U.S.A
| | - H. Mizoguchi
- The Procter & Gamble Company, 11511 Reed Hartman Hwy.; Cincinnati OH 45241 U.S.A
| | - A. Tosti
- Department of Dermatology & Cutaneous Surgery; Miller School of Medicine, University of Miami; 1295 NW 14th St; South Bldg, Sites K, L & M Miami FL 33136 U.S.A
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Gordon James A, Abraham KH, Cox DS, Moore AE, Pople JE. Metabolic analysis of the cutaneous fungiMalassezia globosaandM. restrictafor insights on scalp condition and dandruff. Int J Cosmet Sci 2012; 35:169-75. [DOI: 10.1111/ics.12022] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2012] [Accepted: 10/19/2012] [Indexed: 11/27/2022]
Affiliation(s)
- A. Gordon James
- Unilever Discover; Colworth Science Park; Sharnbrook; Bedford; MK44 1LQ; UK
| | - Karen H. Abraham
- Unilever Discover; Colworth Science Park; Sharnbrook; Bedford; MK44 1LQ; UK
| | - Diana S. Cox
- Unilever Discover; Colworth Science Park; Sharnbrook; Bedford; MK44 1LQ; UK
| | - Alison E. Moore
- Unilever Discover; Colworth Science Park; Sharnbrook; Bedford; MK44 1LQ; UK
| | - Jennifer E. Pople
- Unilever Discover; Colworth Science Park; Sharnbrook; Bedford; MK44 1LQ; UK
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Turner GA, Matheson JR, Li GZ, Fei XQ, Zhu D, Baines FL. Enhanced efficacy and sensory properties of an anti-dandruff shampoo containing zinc pyrithione and climbazole. Int J Cosmet Sci 2012; 35:78-83. [DOI: 10.1111/ics.12007] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2012] [Accepted: 09/07/2012] [Indexed: 12/19/2022]
Affiliation(s)
- G. A. Turner
- Unilever Research & Development Port Sunlight; Quarry Road East; Bebington; Merseyside; CH63 3JW; U.K
| | - J. R. Matheson
- Unilever Research & Development Port Sunlight; Quarry Road East; Bebington; Merseyside; CH63 3JW; U.K
| | - G.-Z. Li
- Unilever Research & Development Centre Shanghai; 66 Linxin Road; Linkong Economic Development Zone; Changning District; Shanghai; 200335; China
| | - X.-Q. Fei
- Unilever Research & Development Centre Shanghai; 66 Linxin Road; Linkong Economic Development Zone; Changning District; Shanghai; 200335; China
| | - D. Zhu
- Unilever Research & Development Centre Shanghai; 66 Linxin Road; Linkong Economic Development Zone; Changning District; Shanghai; 200335; China
| | - F. L. Baines
- Unilever Research & Development Port Sunlight; Quarry Road East; Bebington; Merseyside; CH63 3JW; U.K
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Bacon RA, Mizoguchi H, Schwartz JR. Assessing therapeutic effectiveness of scalp treatments for dandruff and seborrheic dermatitis, part 2: the impact of gender and ethnicity on efficacy. J DERMATOL TREAT 2012; 25:237-40. [DOI: 10.3109/09546634.2012.719077] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Mills KJ, Hu P, Henry J, Tamura M, Tiesman JP, Xu J. Dandruff/seborrhoeic dermatitis is characterized by an inflammatory genomic signature and possible immune dysfunction: transcriptional analysis of the condition and treatment effects of zinc pyrithione. Br J Dermatol 2012; 166 Suppl 2:33-40. [PMID: 22670617 DOI: 10.1111/j.1365-2133.2012.10863.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Dandruff/seborrhoeic dermatitis is a common scalp condition that is characterized by flakes, pruritus and sometimes mild erythema. These symptoms reflect tissue level events that are poorly understood at the molecular level. OBJECTIVES The purpose of this work was: (i) to compare gene expression profiles in subjects with dandruff vs. those of subjects without dandruff to determine the key physiological disruptions manifest in the condition; and (ii) to determine the effect on this profile of treatment with a shampoo containing potentiated zinc pyrithione (ZPT). METHODS In study 1, scalp biopsies were taken from 16 normal subjects and from involved and uninvolved sites in 15 subjects with dandruff. In study 2, 30 subjects with dandruff were treated for 3 weeks with a commercial ZPT shampoo (n = 15) or a vehicle (n = 15), and scalp lesional biopsies were collected at baseline and end of study for transcriptomic analysis. RNA was extracted from all biopsies and Affymetrix gene chips were used to analyse transcriptomic profiles, followed by bioinformatic analysis. RESULTS Analysis of study 1 biopsies revealed more than 7000 individual probes differentially regulated in dandruff lesional skin relative to normal. Enriched Gene Ontology categories included: lipid metabolism, immune response, response to stimulus, apoptosis, cell proliferation, and epidermal development. The most striking feature of lesional skin relative to normal was the reciprocal expression of induced inflammatory genes and repressed lipid metabolism genes. Induced inflammatory genes were also enriched in dandruff uninvolved skin, suggesting the existence of predisposing factors associated with inflammation. Many genes increased in lesional skin were increased at the level of protein in stratum corneum samples (e.g. IL-1RA, S100A8, S100A9, S100A11, IL-8). Under conditions known to improve overall scalp condition, the ZPT shampoo treatment in study 2 produced a transcriptomic profile resembling that of normal scalp skin. CONCLUSIONS These data provide novel insights into the nature of dandruff and the therapeutic action of potentiated ZPT-containing shampoo, and provide a basis to explore many new mechanistic questions related to these topics.
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Affiliation(s)
- K J Mills
- The Procter and Gamble Company, Miami Valley Innovation Center, 11810 East Miami River Road, Cincinnati, OH 45252, USA.
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Bacon RA, Mizoguchi H, Schwartz JR. Assessing therapeutic effectiveness of scalp treatments for dandruff and seborrheic dermatitis, part 1: a reliable and relevant method based on the adherent scalp flaking score (ASFS). J DERMATOL TREAT 2012; 25:232-6. [DOI: 10.3109/09546634.2012.687089] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Abstract
Synopsis Dandruff is characterized by a flaky, pruritic scalp and affects up to half the world’s population post-puberty. The aetiology of dandruff is multifactorial, influenced by Malassezia, sebum production and individual susceptibility. The commensal yeast Malassezia is a strong contributory factor to dandruff formation, but the presence of Malassezia on healthy scalps indicates that Malassezia alone is not a sufficient cause. A healthy stratum corneum (SC) forms a protective barrier to prevent water loss and maintain hydration of the scalp. It also protects against external insults such as microorganisms, including Malassezia, and toxic materials. Severe or chronic barrier damage can impair proper hydration, leading to atypical epidermal proliferation, keratinocyte differentiation and SC maturation, which may underlie some dandruff symptoms. The depleted and disorganized structural lipids of the dandruff SC are consistent with the weakened barrier indicated by elevated transepidermal water loss. Further evidence of a weakened barrier in dandruff includes subclinical inflammation and higher susceptibility to topical irritants. We are proposing that disruption of the SC of the scalp may facilitate dandruff generation, in part by affecting susceptibility to metabolites from Malassezia. Treatment of dandruff with cosmetic products to directly improve SC integrity while providing effective antifungal activity may thus be beneficial. Résumé Les pellicules se caractérisent par un cuir chevelu prurigineux, squameux, et affectent jusqu’à la moitié de la population post-pubertaire du monde. L’étiologie des pellicules est multifactorielle, influencée par Malassezia, par la production de sébum, et par la susceptibilité individuelle. La levure commensale Malassezia est un facteur fortement contributif à la formation de pellicules, mais la présence de Malassezia aussi sur les cuirs chevelus sains indique que Malassezia seule n’est pas une cause suffisante. Un stratum corneum (SC) sain forme une barrière protectrice pour empêcher la perte d’eau et maintenir l’hydratation du cuir chevelu. Il protège également contre les agressions externes tels les micro-organismes, y compris Malassezia, ou des substances toxiques. Des dommages aigus ou chroniques au niveau de la barrière peuvent nuire à une bonne hydratation, conduisant à des effets atypiques de la prolifération épidermique, de la différenciation des kératinocytes, et de la maturation du SC, ce qui peut expliquer une partie des symptômes des pellicules. L’appauvrissement et la désorganisation des lipides structurels d’un stratum corneum sujet aux pellicules sont compatibles avec la notion d’une barrière affaiblie telle qu’indiquée par une perte d’eau transépidermique élevée. Une preuve supplémentaire d’une barrière affaiblie dans les cas des pellicules est fournie par un niveau d’inflammation infraclinique et une plus grande susceptibilité aux irritants topiques. Nous proposons que la perturbation du SC du cuir chevelu facilite la production de pellicules, en partie en augmentant la sensibilité aux métabolites de Malassezia. Le traitement des pellicules avec des produits cosmétiques pour améliorer directement l’intégrité du SC, tout en offrant une activité antifongique efficace peut donc être bénéfique.
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Affiliation(s)
- G A Turner
- Unilever Research & Development Port Sunlight, Bebington, Merseyside, UK.
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Manuel F, Ranganathan S. A new postulate on two stages of dandruff: a clinical perspective. Int J Trichology 2011; 3:3-6. [PMID: 21769228 PMCID: PMC3129121 DOI: 10.4103/0974-7753.82117] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Dandruff (pityriasis capitis, seborrheic dermatitis confined to the scalp) is a disease that has been around for centuries despite several treatment options. Almost every day new players are entering the market with various antidandruff products, perhaps due to an increase in the incidence of dandruff all over the world. Interestingly, clinicians, especially dermatologists, gave little attention to this problem. At the end, the dandruff sufferer is puzzled by the array of antidandruff products with varied claims entering the market day by day. Why have we not achieved complete treatment success against dandruff? Is dandruff a disease or disorder? It seems that our understanding about dandruff perfectly fits into the famous saying of Albert Einstein, “as the area of light increases, so does the circumferences of darkness.” Have dermatologists left dandruff unattended, only to be exploited by the personal care industry?
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Affiliation(s)
- Frederick Manuel
- Deparment of Dermatology, Skin Clinic, 22, Paper Mills Road, Perambur, Chennai, Tamil Nadu, India
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Kerr K, Darcy T, Henry J, Mizoguchi H, Schwartz JR, Morrall S, Filloon T, Wimalasena R, Fadayel G, Mills KJ. Epidermal changes associated with symptomatic resolution of dandruff: biomarkers of scalp health. Int J Dermatol 2011; 50:102-13. [PMID: 21182510 DOI: 10.1111/j.1365-4632.2010.04629.x] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Dandruff is a common scalp condition characterized by flakes, pruritus and sometimes mild erythema. These symptoms reflect underlying histopathologic and biochemical events that must be reversed if treatment is to be effective. OBJECTIVES This study aimed to better characterize the state of the epidermis in dandruff and to determine how a defined set of skin surface biomarkers of this state change during a successful course of treatment with a potentiated zinc pyrithione (ZPT) shampoo. METHODS A population of dandruff sufferers was treated for 3 weeks with a commercial ZPT shampoo or a non-medicated product, and the effect of treatment on adherent scalp flake (ASF) scores was evaluated. Biopsies were taken from lesional sites at baseline and at the end of the study for histomorphometric and histopathologic analysis. Stratum corneum (SC) samples were likewise obtained for evaluation of biochemical markers of inflammation (IL-1α, IL-1RA, IL-8) and barrier integrity (keratin 1, 10, 11; involucrin; SC lipids; human serum albumin). The biomarker profile was evaluated first by comparison with that in non-dandruff subjects at baseline, and then to determine whether any treatment-induced changes were correlated with reductions in flaking in dandruff sufferers. RESULTS Taken together, our studies showed that treatment with the ZPT shampoo led to an improvement in the overall scalp condition as assessed by the resolution of flaking, reduction in epidermal thickness and inflammatory biomarkers, and a dramatic improvement in biomarkers of epidermal barrier integrity. CONCLUSIONS The combination of biomarkers examined appears to be a good overall descriptor of the health of the scalp in dandruff, and changes in these biomarkers track with tissue-level events that underlie clinical efficacy in the treatment of dandruff by ZPT shampoo. For the first time, we demonstrate a set of tools that extend beyond flaking scores to provide insight into specific biological changes occurring on the scalp to enable an objective assessment of scalp health.
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Affiliation(s)
- Kathy Kerr
- The Procter & Gamble Company, Cincinnati, OH 45252, USA
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Bailey P, Arrowsmith C, Darling K, Dexter J, Eklund J, Lane A, Little C, Murray B, Scott A, Williams A, Wilson D. A double-blind randomized vehicle-controlled clinical trial investigating the effect of ZnPTO dose on the scalp vs. antidandruff efficacy and antimycotic activity. Int J Cosmet Sci 2010; 25:183-8. [PMID: 18494899 DOI: 10.1046/j.1467-2494.2003.00183.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Dandruff is a common problem in approximately 30% of the world's population. Reports in the literature regarding treatment of this condition with various antidandruff shampoos usually report the level of active ingredient within the formulation. However, we propose that a more important parameter relating to antidandruff efficacy is the amount of active ingredient delivered to the scalp from the shampoo. This report describes the results from two studies designed to investigate the relationship between the level of zinc pyrithione (ZnPTO) deposited onto the scalp and the resultant scalp condition. A double-blind randomized vehicle-controlled clinical study comparing three shampoos - a vehicle, a low-depositing ZnPTO shampoo and a high-depositing ZnPTO shampoo - was carried out in the U.K. with 53 panelists with dandruff or mild-to-moderate seborrheic dermatitis of the scalp. Both shampoos containing ZnPTO were significantly superior in antidandruff efficacy to the vehicle. Furthermore, the high-depositing ZnPTO shampoo was significantly superior compared with the low-depositing ZnPTO shampoo in terms of both antidandruff efficacy and antimycotic activity. Antidandruff performance and antimycotic activity of ZnPTO-containing shampoos is highly dependent on the amount of active ingredient delivered to the scalp. Furthermore, careful manipulation of the formulation parameters of an antidandruff shampoo can result in enhanced levels of delivery of the active ingredient without having to increase the level of active ingredient within the formulation.
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Affiliation(s)
- P Bailey
- Unilever Research & Development Laboratory, Port Sunlight, UK.
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Abstract
Dandruff is a common scalp disorder affecting almost half of the postpubertal population of any ethnicity and both genders. It may, however, represent a stubborn esthetical disturbance often source of pruritus. Skin biocenosis, in particular the Malassezia spp. flora, plays a key aetiologic role, in combination with the unusual capacity of some corneocytes to be coated by these yeasts. Substantial evidence indicates that keratinocytes play an active role in the generation and expression of immunopathological reactions. This is probably the case in dandruff. Upon stimulation of a critical colonization of corneocytes by Malassezia yeasts, the release of pro-inflammatory mediators is increased. This could lead to the subclinical microinflammation present in dandruff. In seborrheic dermatitis, local deposits of immunoglobulins and the release of lymphokines are responsible for the recruitment and local activation of leukocytes leading to the eventual amplification of the inflammatory reaction. Some ancillary non-microbial causes of dandruff may operate through physical or chemical irritants. Many methods have been described for rating dandruff. Our favourite tools are clinical examination and squamometry. Dandruff can precipitate telogen effluvium and exacerbate androgenic alopecia. Antidandruff formulations exhibiting some direct or indirect anti-inflammatory activity can improve both dandruff and its subsequent hair cycle disturbance.
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Cook BA, Warshaw EM. Role of topical calcineurin inhibitors in the treatment of seborrheic dermatitis: a review of pathophysiology, safety, and efficacy. Am J Clin Dermatol 2009; 10:103-18. [PMID: 19222250 DOI: 10.2165/00128071-200910020-00003] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Seborrheic dermatitis (SD) is characterized by erythematous pruritic patches and plaques with greasy scale that occur in sebaceous areas. It is common, affecting up to 3% of the population. Past treatments have relied on a wide variety of anti-inflammatory and antifungal agents, but corticosteroids have limited use because of long-term adverse effects. Topical calcineurin inhibitors provide a safe alternative for the treatment of SD, as these drugs block the inflammatory cascade involved in the disease process and pose no risk of skin atrophy. Studies of topical pimecrolimus and tacrolimus in the treatment of SD have found that improvement occurred within 2 weeks, and if SD recurred after stopping treatment, it was significantly less severe. There have been no studies of the comparative efficacy of pimecrolimus versus tacrolimus for the treatment of SD. Common adverse effects of mild burning and irritation have been associated with the use of both of these agents. Safety profile studies are limited to studies of atopic dermatitis, which show no increase in infection rate, photocarcinogenicity, or signs of immunosuppression in patients using topical calcineurin inhibitors for long-term treatment. This article reviews the clinical trials of pimecrolimus and tacrolimus in the treatment of SD, focusing on efficacy and safety.
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Affiliation(s)
- Bethany A Cook
- University of Minnesota School of Medicine, Minneapolis, Minnesota, USA
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Thomas DS, Ingham E, Bojar RA, Holland KT. In vitromodulation of human keratinocyte pro- and anti-inflammatory cytokine production by the capsule ofMalasseziaspecies. ACTA ACUST UNITED AC 2008; 54:203-14. [DOI: 10.1111/j.1574-695x.2008.00468.x] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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