Evaluation of a new-formula shampoo containing 6% glycyrrhetinic acid complex for scalp seborrheic dermatitis: A pilot study

SSA-ZP on Scalp Seborrheic Dermatitis: Regulating Sebum Levels and Scalp Barrier

BACKGROUND

The occurrence of scalp seborrheic dermatitis (SD) is closely related to the production of sebum and scalp barrier function. Supramolecular salicylic acid has the keratolytic and anti-inflammatory properties, and zinc pyrithione is an antifungal drug delivered as a microparticle to skin epithelia.

OBJECTIVE

This study aimed to assess the efficacy and safety of 2% supramolecular salicylic acid (SSA) combined with 0.8% zinc pyrithione conditioner (SSA-ZP) in treating scalp SD focusing on key outcome measures including sebum levels and scalp barrier function.

METHODS

Five patients with mild to moderate scalp SD were included in the 2-week self-controlled prospective study, receiving daily SSA-ZP treatment. Evaluation on days 0, 7, and 14 included dermoscopy, the adherent scalp flaking scale (ASFS), sebum level, transepidermal water loss (TEWL), pH, and stratum corneum hydration. We also performed the fungal count across specific scalp regions, such as the left and right sides of the forehead, the top of the head, and the occiput.

RESULTS

Five patients with mild to moderate scalp SD participated in this study. After 2 weeks of SSA-ZP treatment, significant reductions in ASFS scores, sebum levels, and fungal count were observed, alongside improvements in TEWL and pH values across multiple scalp regions. Moreover, there was no difference in the hydration of stratum corneum.

CONCLUSION

SSA-ZP demonstrated efficacy in treating scalp SD without adverse effects, suggesting its potential as a first-line treatment option. Further research with larger sample sizes and longer follow-up periods is warranted to validate these findings.

Evaluation of novel cosmetic shampoo formulations against Malassezia species: Preliminary results of anti-dandruff shampoo formulations

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.

Methodology Validation: Correlating Adherent Scalp Flaking Score (ASFS) With Phototrichogram for Scalp Dandruff Evaluation in Adult Subjects

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.

Efficacy of probiotics in hair growth and dandruff control: A systematic review and meta-analysis

Background

Probiotics are intellectually rewarding for the discovery of their potential as a source of functional food. Investigating the economic and beauty sector dynamics, this study conducted a comprehensive review of scholarly articles to evaluate the capacity of probiotics to promote hair growth and manage dandruff.

Methods

We used the PRISMA 2020 with Embase, Pubmed, ClinicalTrials.gov, Scopus, and ICTRP databases to investigate studies till May 2023. Meta-analyses utilizing the random effects model were used with odds ratios (OR) and standardized mean differences (SMD).

Result

Meta-analysis comprised eight randomized clinical trials and preclinical studies. Hair growth analysis found a non-significant improvement in hair count (SMD = 0.32, 95 % CI -0.10 to 0.75) and a significant effect on thickness (SMD = 0.92, 95 % CI 0.47 to 1.36). In preclinical studies, probiotics significantly induced hair follicle count (SMD = 3.24, 95 % CI 0.65 to 5.82) and skin thickness (SMD = 2.32, 95 % CI 0.47 to 4.17). VEGF levels increased significantly (SMD = 2.97, 95 % CI 0.80 to 5.13), while IGF-1 showed a non-significant inducement (SMD = 0.53, 95 % CI -4.40 to 5.45). For dandruff control, two studies demonstrated non-significant improvement in adherent dandruff (OR = 1.31, 95 % CI 0.13-13.65) and a significant increase in free dandruff (OR = 5.39, 95 % CI 1.50-19.43). Hair follicle count, VEGF, IGF-1, and adherent dandruff parameters were recorded with high heterogeneity. For the systematic review, probiotics have shown potential in improving hair growth and controlling dandruff through modulation of the immune pathway and gut-hair axis. The Wnt/β-catenin pathway, IGF-1 pathway, and VEGF are key molecular pathways in regulating hair follicle growth and maintenance.

Conclusions

This review found significant aspects exemplified by the properties of probiotics related to promoting hair growth and anti-dandruff effect, which serve as a roadmap for further in-depth studies to make it into pilot scales.

Scalp Seborrheic Dermatitis: What We Know So Far

Scalp seborrheic dermatitis (SSD) is a prevalent chronic, relapsing inflammatory skin disease. The etiology is related to sebum production, bacterial proliferation - Staphylococcus sp., Streptococcus, and M. restricta - and host immunity factors - NK1+, CD16+ cells, IL-1, and IL-8. Trichoscopy features include mostly arborizing vessels and yellowish scales. New trichoscopic findings were described to guide the diagnosis as dandelion vascular conglomerate, "cherry blossom" vascular pattern, and intrafollicular oily material. Antifungals and corticosteroids constitute the essential therapy, but new treatments have been described. This article aims to review and discuss the etiology, pathophysiology, trichoscopy, histopathologic findings, main differential diagnoses, and therapeutic options of SSD.

Effects of natural products on skin inflammation caused by abnormal hormones secreted by the adrenal gland

The cortex of adrenal gland produces glucocorticoid, mineralocorticoid, and androgen. The medulla of adrenal gland secrets catecholamines. These hormones play an important role in regulating blood pressure, metabolism, and homeostasis of glucose or electrolytes. Hypersecretion or hyposecretion by the adrenal gland will cause a complex cascade of hormone effects and lead to diseases, including Addison's disease, Cushing's syndrome, and congenital adrenal cortical hyperplasia. Skin is the largest organ of body. It provides protection and acts as a barrier against external damage factors like infectious organisms, chemicals, and allergens. Endocrinologic disorders often induce cutaneous abnormalities. According to the previous evidences, natural products have the potential properties for attenuating skin disorders and improving dermatologic symptoms by inhibiting inflammation through MAPK or PI3K/AKT-dependent NF-κB pathways. The natural products may also promote skin wound healing by inhibiting the production of matrix metalloproteinase-9. We systematically searched the relevant articles from databases, including PubMed, Embase, and Cochrane library databases, to review the effects of natural products on skin disorders. This article summarized the effects of natural products on skin inflammation caused by abnormal hormone secreted by adrenal gland. And the published papers indicated that natural products might be a potential source for treating skin diseases.

Seborrheic Dermatitis in Older Adults: Pathogenesis and Treatment Options

Seborrheic dermatitis is a common and chronic skin disease, which is particularly prevalent in older adults. While a specific cause of seborrheic dermatitis remains largely unelucidated, the currently understood pathogenesis of seborrheic dermatitis revolves around the presence of Malassezia yeast colonies and an inflammatory response in the affected individual. Keratinocyte proliferation resulting from inflammasome response in the host skin leads to the clinically relevant symptoms of seborrheic dermatitis. The increasing number of older adults as a percentage of the population in the USA will lead to an even higher prevalence of the disease in the ensuing decades. Fortunately, there are multiple treatment options based on individual patient situations and preferences. Topical treatment is the gold standard, but oral therapy may be required in certain cases. In order to maximize effectiveness and minimize adverse pharmacologic effects, effective treatment for older adults must take into account changes in lifestyle and metabolism that occur with aging.