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Chan CS, Smith T, He Z, Garter C. The Sequelae and Moderators of Influence of Dandruff on Mental Health Among Mainland Chinese Adults. Clin Cosmet Investig Dermatol 2024; 17:1333-1346. [PMID: 38881702 PMCID: PMC11179641 DOI: 10.2147/ccid.s459498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Accepted: 05/26/2024] [Indexed: 06/18/2024]
Abstract
Introduction The psychological impact of dandruff has been largely understudied. Methods In this cross-sectional study (N = 2116), we examined the consequences of self-perception of dandruff severity on mental health, quality of life, and sleep quality among Chinese adults. Additionally, we examined the moderating factors that influence these associations. Results Bivariate analyses revealed that greater self-perceived dandruff severity was associated with poorer mental health, lower quality of life, and reduced sleep quality. Furthermore, dandruff severity was positively correlated with appearance anxiety, feelings of helplessness, and perceived stigma. Individuals with more severe dandruff experienced increased teasing and ostracism and, subsequently, heightened psychological distress. Moderation analyses demonstrated that females were more adversely affected by dandruff than males, and those with comorbid skin conditions or a history of being teased and ostracized during adolescence due to dandruff experienced exacerbated negative outcomes. Discussion This study highlights the need for further research on the psychological consequences of self-perceived severity of dandruff and potential interventions to mitigate its impact.
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Affiliation(s)
- Christian S Chan
- Department of Psychology, The University of Hong Kong, Hong Kong SAR, People's Republic of China
- Department of Psychology and Linguistics, International Christian University, 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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Vysochanska V, Koval G. MALASSEZIA COLONIZATION CORRELATES WITH THE SEVERITY OF SEBORRHEIC DERMATITIS. WIADOMOSCI LEKARSKIE (WARSAW, POLAND : 1960) 2023; 76:1371-1377. [PMID: 37463370 DOI: 10.36740/wlek202306107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/20/2023]
Abstract
OBJECTIVE The aim: To compare the number of fungi of the genus Malassezia on inflated and healthy areas of the skin and to correlate them with the severity of seborrheic dermatitis. PATIENTS AND METHODS Materials and methods: 168 patients with typical manifestations of seborrheic dermatitis on the scalp and face and 30 healthy individuals were recruited. SD severity was assessed by SEDASI. Samples from lesions on scalp, face and intact chest skin were cultivated and/or stained with methylene blue or cotton and inoculated onto Malassezia Leeming & Notman Agar Modified (MLNA). RESULTS Results: A statistical difference in colonization intensity between all body zones (Dwass-Steel-Critchlow-Flinger pairwise comparisons p≤0,001). Face zone with lesions of SD patients was two times more colonized with funguses than in the control group (38,5 vs 16,5 p=0,003). The sternal area with no skin lesions was more colonized in the SD group (25,0 vs 9,0 p=0,013). The SEDASI was positively correlated with the amount of CFU on the face (Spearman's rho 0,849; p≤0,001) and trunk (0,714; p≤0,001). CONCLUSION Conclusions: Our results demonstrate that inflamed seborrheic areas are more colonized with Malassezia fungi than intact areas. The intensity of Malassezia growth is correlated with the severity of the symptoms of seborrheic dermatitis. The level of colonization may be a potential biomarker to indicate the efficiency of new treatment approaches.
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Affiliation(s)
| | - Galina Koval
- UZHHGOROD NATIONAL UNIVERSITY, UZHHGOROD, UKRAINE
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Martin E, Zhang A, Campiche R. Saccharide isomerate ameliorates cosmetic scalp conditions in a Chinese study population. J Cosmet Dermatol 2023; 22:262-266. [PMID: 35279940 PMCID: PMC10083904 DOI: 10.1111/jocd.14913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 02/21/2022] [Accepted: 03/01/2022] [Indexed: 01/24/2023]
Abstract
BACKGROUND Scalp conditions such as flaky or oily scalp affect people across ethnicities and age groups. In addition to flaking, increased sebum secretion, itching, and compromised scalp barrier function were described. Scalp conditions are aesthetically disturbing and may cause psychological distress in affected individuals who are looking for mild and effective treatment at the same time. Saccharide isomerate has a long history as a skin moisturizer, and it was found to improve skin barrier function, also suggesting possible beneficial effects on scalp. AIMS To provide relevant claim substantiation to introduce saccharide isomerate as a new scalp care active against scalp flaking condition. MATERIAL AND METHODS We conducted a placebo-controlled clinical study in an adult Chinese population affected by dandruff scalp as assessed by an adherent scalp flaking score. We monitored transepidermal water loss (TEWL), sebum secretion, and scalp flaking during 28 days. RESULTS Formulations containing Saccharide isomerate significantly improved all parameters both over time as well as compared to the placebo formulation. CONCLUSION We propose Saccharide isomerate for cosmetic formulations directed toward improving scalp conditions such as dandruff or oily scalp.
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Affiliation(s)
- Emmanuel Martin
- DSM Nutritional Products, Personal Care & Aroma, Kaiseraugst, Switzerland
| | - Anson Zhang
- DSM Nutritional Products, Personal Care & Aroma, Singapore City, Singapore
| | - Remo Campiche
- DSM Nutritional Products, Personal Care & Aroma, Kaiseraugst, Switzerland
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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: 11] [Impact Index Per Article: 3.7] [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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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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