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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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Patel MN, Patel NK, Merja AM, Gajera DU, Purani AK, Pandya JH. Methodology Validation: Correlating Adherent Scalp Flaking Score (ASFS) With Phototrichogram for Scalp Dandruff Evaluation in Adult Subjects. Cureus 2024; 16:e63247. [PMID: 39070400 PMCID: PMC11282177 DOI: 10.7759/cureus.63247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/24/2024] [Indexed: 07/30/2024] Open
Abstract
Introduction Scalp dandruff is a common dermatological condition characterized by flaking and itching of the scalp, affecting a significant portion of the population. Effective assessment methods are crucial for evaluating treatment outcomes. This study aimed to establish the reliability and correlation of three assessment techniques: Adherent Scalp Flaking Score (ASFS), phototrichogram using CASLite Nova, and the 60-second hair combing test. Methods This open-label, single-arm, single-center, prospective clinical study enrolled 12 adult subjects with mild to moderate dandruff. Evaluations were conducted before and after a standardized hair-wash intervention using three methods: ASFS, phototrichogram using CASLite Nova, and the 60-second hair combing test. The primary objective was to establish correlations between these assessment techniques. Inter-evaluator and inter-operator reliability were assessed using Fleiss Multirater Kappa. Results Significant reductions in dandruff were observed across all methods post-hair wash. The ASFS decreased from 23.67±2.06 at baseline to 6.67±4.46, showing a mean reduction of 17.00±5.22 (71.40%, p<0.001). phototrichogram analysis revealed that 60.42% of the total (n=96) scalp zones assessed were in normal condition post-hair wash compared to none at baseline. The 60-second hair combing test showed a reduction in non-adherent flakes, with 58.33% of subjects displaying light flakes and 41.67% showing no flakes post-hair wash. The chi-squared test indicated a significant association (p<0.001) between ASFS and phototrichogram results. Inter-evaluator variability for ASFS and the hair combing test demonstrated substantial agreement (Kappa=0.692 and 0.637, respectively, p<0.0001). Inter-operator reliability for phototrichogram also showed substantial agreement (Kappa=0.746, p<0.0001). Conclusion The study confirms the reliability and consistency of ASFS, phototrichogram, and the 60-second hair combing test in assessing scalp dandruff. The significant correlations of ASFS and phototrichogram via CASLite Nova validate their use in clinical settings. Comprehensive training for evaluators and operators is essential to achieve reproducible and accurate results. These findings provide a robust framework for future studies and clinical assessments of scalp dandruff.
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Affiliation(s)
- Maheshvari N Patel
- Clinical Research, NovoBliss Research, Ahmedabad, IND
- Pharmacology, Swaminarayan University, Ahmedabad, IND
| | - Nayan K Patel
- General Medicine, NovoBliss Research, Ahmedabad, IND
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Hashem MM, Attia D, Hashem YA, Hendy MS, AbdelBasset S, Adel F, Salama MM. Rosemary and neem: an insight into their combined anti-dandruff and anti-hair loss efficacy. Sci Rep 2024; 14:7780. [PMID: 38565924 PMCID: PMC10987638 DOI: 10.1038/s41598-024-57838-w] [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: 12/15/2023] [Accepted: 03/22/2024] [Indexed: 04/04/2024] Open
Abstract
Dandruff, a common scalp disorder characterized by flaking dead skin, is often treated with conventional topical products. However, limitations exist due to potential side effects and high costs. Therefore, searching for natural, cost-effective solutions for dandruff and hair loss is crucial. Rosemary herb and neem tree, both cultivated in Egypt, possess well-documented anti-inflammatory properties derived from their rich phenolic phytoconstituents. This study formulated a standardized combined extract of rosemary and neem (RN-E 2:1) into hair gel and leave-in tonic formats. This extract demonstrated superior efficacy against Malassezia furfur (a causative agent of dandruff) and Trichophyton rubrum (associated with scalp disorders) compared to the conventional antifungal agent, ketoconazole. The combined extract (RN-E 2:1) also exhibited potent anti-inflammatory activity. Additionally, the suppression of iNOS expression is considered concentration-dependent. Quality control verified formulation stability, and ex-vivo studies confirmed effective ingredient penetration into the epidermis, the primary site of fungal presence. Remarkably, both formulations outperformed the standard treatment, minoxidil in hair growth trials. These findings highlight the potential of natural extracts for scalp and hair health.
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Affiliation(s)
- Mona M Hashem
- Department of Pharmacognosy, Faculty of Pharmacy, Cairo University, Kasr El-Aini Street, Cairo, 11562, Egypt.
| | - Dalia Attia
- Department of Pharmaceutics and Pharmaceutical Technology, Faculty of Pharmacy, The British University in Egypt, Suez Desert Road, El Sherouk City, Cairo, 11837, Egypt
| | - Yomna A Hashem
- Department of Microbiology, Faculty of Pharmacy, The British University in Egypt, Suez Desert Road, El Sherouk City, Cairo, 11837, Egypt
| | - Moataz S Hendy
- Department of Pharmaceutical Chemistry, The British University in Egypt, Suez Desert Road, El Sherouk City, Cairo, 11837, Egypt
- Health Research Centre of Excellence, Drug Research and Development, The British University in Egypt, Suez Desert Road, El Sherouk City, Cairo, 11837, Egypt
| | - Safa AbdelBasset
- Department of Pharmacognosy, Faculty of Pharmacy, The British University in Egypt, Suez Desert Road, El Sherouk City, Cairo, 11837, Egypt
| | - Farah Adel
- Department of Pharmaceutics and Pharmaceutical Technology, Faculty of Pharmacy, The British University in Egypt, Suez Desert Road, El Sherouk City, Cairo, 11837, Egypt
| | - Maha M Salama
- Department of Pharmacognosy, Faculty of Pharmacy, Cairo University, Kasr El-Aini Street, Cairo, 11562, Egypt
- Department of Pharmacognosy, Faculty of Pharmacy, The British University in Egypt, Suez Desert Road, El Sherouk City, Cairo, 11837, Egypt
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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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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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