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Abstract

Dandruff is a common complaint and is suffered by as many as 50% of the population at some time during their life and cause significant discomfort. The condition is generally characterized by the presence of flakes on the scalp and in the hair, and by itch. The symptoms can vary, and the severity can range from mild scaling, similar to dry skin, to severe scaling. Its prevalence and severity is greatest in young men, with children and older individuals suffering less frequently. It is commonly aggravated by changes in humidity, trauma (e.g., scratching), seasonal changes, and emotional stress. Dandruff responds to everyday shampooing and a longer period of lathering. Use of hair spray or hair pomades (gels) should be stopped. Salicylic acid, tar, selenium, sulfur, and zinc all are effective in shampoos and may be alternated. Overnight occlusion of salicylic or urea oil may help to soften thick, scalp plaques. The common causative agent is now accepted to be the lipohilic yeasts Malassezia spp. (previously Pityrosporum) which is increased in the scaly epidermis of both dandruff and seborrhoeic dermatitis sufferers. Selenium sulfide, imidazoles or ciclopirox olamine shampoos may help by reducing Malassezia scalp reservoirs. The wide range of antifungal shampoos available provides safe, effective and flexible treatment options for dandruff.

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... The aetiology of dandruff considers a possibility of infection with the yeast-like fungus Malassezia spp., hormonal disturbances , involvement of numerous exogenous factors and the failure of the epidermal cells renewal process71727374. Shampoos containing antifungal preparations bring about the greatest therapeutic effect [75]. Shampoos used in the treatment of dandruff should be regularly replaced with preparations of different groups because it prevents from the development of tachyphylaxis [75]. ...
... Shampoos containing antifungal preparations bring about the greatest therapeutic effect [75]. Shampoos used in the treatment of dandruff should be regularly replaced with preparations of different groups because it prevents from the development of tachyphylaxis [75]. In the treatment of dandruff, antifungal, keratolytic or cytostatic preparations are used. ...
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Puberty is a period of life between childhood and adulthood. It is characterized by many changes in morphology and appearance of the body (biological maturation), in the psyche - development of personality (psychological maturation), and in the attitude towards one's own and the opposite sex (psychosexual maturation), and in the social role (social maturation). Dermatological problems of adolescence are mainly related to fluctuations in hormone levels, mainly androgens. They include acne, hair problems and excessive sweating. Acne vulgaris is the most frequently diagnosed dermatosis in patients aged between 11 and 30 years. It is believed that it affects about 80% of persons in this age group or even, taking into account lesions of low intensity, 100% of young people. Excessive sweating is a condition characterised by excessive production of sweat, resulting from high activity of sweat glands. The sweat glands are localised in almost all areas of the body surface but on the hands, feet, armpits and around the groin they are found at the highest density. Seborrhoeic dermatitis of the scalp is a chronic, relapsing, inflammatory dermatosis, which currently affects about 5% of the population. It affects mostly young people, particularly men.
... Inflammation of varied intensity develops on the scalp skin along with the appearance of oily scales of dirty yellow colour that can form lesions. Hairfall is common; it may also exacerbate androgenetic alopecia. The most common site affected by this type of dandruff is scalp, but it can occur between eyebrows, along the side of nose, behind the ears, over the breastbone and sometimes in the armpits (Nowicki, 2006) [14] . Dandruff scale is a cluster of corneocytes, which have retained a large degree of cohesion with one another and detach as such from the surface of the stratum corneum. ...
... Inflammation of varied intensity develops on the scalp skin along with the appearance of oily scales of dirty yellow colour that can form lesions. Hairfall is common; it may also exacerbate androgenetic alopecia. The most common site affected by this type of dandruff is scalp, but it can occur between eyebrows, along the side of nose, behind the ears, over the breastbone and sometimes in the armpits (Nowicki, 2006) [14] . Dandruff scale is a cluster of corneocytes, which have retained a large degree of cohesion with one another and detach as such from the surface of the stratum corneum. ...
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Dandruff is the major problem for many people in today's world. Many anti-dandruff shampoos, whether synthetic or herbal, and lotions are marketed to combat the problem of dandruff. The present study deals with testing the effect of different synthetic and herbal shampoos on dandruff causing fungus isolate Malassezia. Isolation of Malassezia was carried out by using Dixon and Sabouraud Dextrose Agar medium. Total six synthetic and two herbal shampoos were selected to check the effectivity against Malassezia by agar cup method. Different concentrations of shampoos were taken to check the Minimum Inhibitory Concentration (MIC). All the selected shampoos were proved to be effective as they all showed the inhibition against Malassezia. Synthetic shampoos were proved to be more effective compared to herbal shampoos. The highest zone of inhibition was obtained by Cipla-8X while minimum inhibition was observed by Nature's Essence.
... These lesions can be associated with pruritis of different intensity. The most affected area of dandruff is scalp, but it also occurs between eyebrows, along the side of nose, behind the ears, over the breastbone and sometimes in the armpits [4]. ...
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creative commons attribution noncommercial License 4.0. Which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms. Abstract Anti-dandruff shampoos like synthetic or herbal are marketed to combat the problem of dandruff. To test the effect of synthetic and herbal shampoos on dandruff causing fungus to isolate the species Malassezia. The fungal species was isolated using Potato Dextrose Agar medium. Total six synthetic and herbal shampoos were selected to check the effectively against dandruff by agar cup method. Different level (0.1 ml, 0.5 ml, 1ml) of shampoos were taken to check the Zone of Inhibition. The selected shampoos were effective as they showed inhibition against dandruff. Synthetic shampoos were more effective when compared to herbal shampoos. The highest zone of inhibition was obtained by Head &Shoulders > Pure derm > All clear and Dove. Herbal anti-dandruff shampoos were found to be an effective but their anti-dandruff activity was less compared to synthetic one. Currently, herbal hair is high demand for strengthen for negligible side effects.
... Dandruff scalps are associated with a higher abundance of Malassezia restricta and Staphylococcal species [5]. The severity of dandruff can range from mild scale formation similar to dry skin to seborrheic dermatitis [6]. The impairment of proper hydration in skin barrier can result in the typical epidermal proliferation, keratinocyte differentiation and stratum corneum maturation, which may cause dandruff [7]. ...
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Many human skin diseases, such as seborrheic dermatitis, potentially occur due to the over-growth of fungi. It remains a challenge to develop fungicides with a lower risk of generating resistant fungi and non-specifically killing commensal microbes. Our probiotic approaches using a selective fermentation initiator of skin commensal bacteria, fermentation metabolites or their derivatives provide novel therapeutics to rein in the over-growth of fungi. Staphylococcus lugdunensis (S. lugdunensis) bacteria and Candida parapsilosis (C. parapsilosis) fungi coexist in the scalp microbiome. S. lugdunensis interfered with the growth of C. parapsilosis via fermentation. A methoxy poly(ethylene glycol)-b-poly(ε-caprolactone) (mPEG-PCL) copolymer functioned as a selective fermentation initiator of S. lugdunensis, selectively triggering the S. lugdunensis fermentation to produce acetic and isovaleric acids. The acetic acid and its pro-drug diethyleneglycol diacetate (Ac-DEG-Ac) effectively suppressed the growth of C. parapsilosis in vitro and impeded the fungal expansion in the human dandruff. We demonstrate for the first time that S. lugdunensis is a skin probiotic bacterium that can exploit mPEG-PCL to yield fungicidal short-chain fatty acids (SCFAs). The concept of bacterial fermentation as a part of skin immunity to re-balance the dysbiotic microbiome warrants a novel avenue for studying the probiotic function of the skin microbiome in promoting health.
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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. Whilst the hair follicle exhibits unique immune‐modulatory properties, its role in dandruff pathogenesis is unknown. This review examines dandruff from a folliculocentric perspective, hypothesizing that hair follicle keratinocytes can detect changes in scalp microbiota, leading to the recruitment immune cells to the site of inflammation.
Article
Dandruff and seborrhoeic dermatitis (SD) are common, chronic and recurrent inflammatory skin disorders which are among the dermatological diseases most resistant to therapy. The aetiology of dandruff and seborrhoeic dermatitis is still unknown. Malassezia yeast, hormonal disorders, some genetic and environmental factors and also wrong epidermal turnover are strongly suspected of playing a role in the manifestation of dandruff. The aetiology of SD is poorly understood. Seborrhoeic dermatitis results from a few aetiological factors: sebaceous secretions, an immunological component, Malassezia fungi and superficial factors. Treatment of SD and dandruff lasts for years and very often patients are not satisfied because of temporary remission. We use mainly topical therapy for dandruff - cytostatic, keratolytics and antifungal preparations. Available specimens are designed for local treatment and have the following forms: shampoo, oils, liquids and creams. Pharmacologic treatment options for seborrhoeic dermatitis include in very severe cases some oral drugs - retinoids, antibiotics, antifungal preparations (ketoconazole, fluconazole, itraconazole) and also topical management and phototherapy. Prophylaxis is also very important.
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Background: Seborrheic dermatitis (SD) is a chronic, papulosquamous dermatosis and Malassezia yeasts are considered as causative factors. The dual antifungal and anti-inflammatory effects of oral itraconazole account for its prolonged therapeutic action in SD. Objectives: To assess the safety of oral itraconazole in the treatment of seborrheic dermatitis. Patients and methods: During a period of total 2 years from January, 2008 to December, 2009, 37 patients of SD were treated with oral itraconazole (200 mg/day for 7 days) in first month and consecutive use of 200 mg/day for the first 2 days of the following 11 months. Patients were followed up monthly for clinical side effects and biochemical derangements. Results :16 (43.2%) patients suffered from different side effects of drug i.e. nausea in 16 (76.2%) patients, followed by abdominal pain in 3 (14.3%) and diarrhea in 2 (9.5%). These were selflimiting and did not warrant discontinuation of therapy. Biochemical abnormalities were not seen in any patient. Conclusion :The study suggests that oral itraconazole is a safe treatment option of seborrheic dermatitis.
Article
To assess the knowledge, attitude and practice regarding dandruff among soldiers. Cross-sectional study. Departments of Dermatology at Combined Military Hospitals, Abbottabad, Malir and Gujranwala from January 2006 to March 2006. Serving male soldiers posted at Abbottabad, Malir and Gujranwala Cantonments were included in the study. Convenience sampling was used to distribute the questionnaire. All soldiers included in the study were asked or assisted by the trained staff to fill the close-ended questionnaire in Urdu, which included information about demographic profile and questions relevant to the objectives of the study. The ethical requirements for the study were fulfilled. SPSS-10 was used for data management. A total of 800 serving male soldiers were surveyed. Five hundred and twenty-one soldiers (65.1%) answered yes to dandruff, whereas 279 (34.9%) replied in negative. Dandruff was considered a disease by 433 (83.1%) respondents. Hair fall (n=392, 75.2%) and scalp itching (n=380, 72.9%) were the common symptoms and 330 (63.3%) respondents were embarrassed by dandruff. Bad water (n=93, 17.8%), winter (n=40, 07.6%) and lack of sleep (n=30, 05.7%) were considered the most common causes of dandruff. Majority of the individuals (n=487, 93.4%) used different hair oils and household remedies for the treatment of dandruff. One hundred and fourteen (21.9%) and 50 (09.6%) participants consulted doctors and traditional healers respectively for their dandruff. Advertisements in electronic or print media and wall hoardings etc. influenced 213 (40.9%) respondents to use various anti-dandruff shampoos, hair tonics and oils. Dandruff is a common problem and there is a need for education programmes and formulation of a policy regarding the positive role of media on health matters.
Article
Aim: To investigate the relationship the density of the yeast Malassezia with the clinical severity of dandruff and health of the scalp. Methods: Totally 120 patients and 60 healthy people were collected in this study. Samples were obtained from the scalps with adhesive tape followed by observation under a microscope and culture in rapeseed oil agar. The density of the yeast Malasseiza and the positive rate of culture were compared between the patients without dandruff and the patients with different severities of dandruff. Results: The density of the yeast Malasseiza and the positive rate of culture on healthy scalps were obviously lower than those on scalps with dandruff. And the density of the yeast Malassezia and the positive rate of culture were increased with the severity of dandruff. Conclusion: There is a positive correlation of the density and the positive rate of culture of the yeast Malassezia with the severity of dandruff.
Article
The Malassezia yeasts are members of the normal human cutaneous flora in adults but also associated with several skin diseases. In pityriasis versicolor, under the influence of predisposing factors, Malassezia changes from the round blastospore form to the mycelial form. A great problem in pityriasis versicolor is the high rate of recurrence and to avoid this a prophylactic treatment is mandatory. Malassezia folliculitis is a chronic disease characterised by pruritic follicular papules and pustules located primarily on the upper trunk, neck and upper arms. The disease responds rapidly to antimycotic therapy. There are now many studies indicating that the Malassezia yeasts play an important role in seborrhoeic dermatitis. Many of these are treatment studies showing a good effect of antimycotics paralleled by a reduction in number of organisms. Severe seborrhoeic dermatitis often difficult to treat is associated with AIDS. In skin biopsies from patients with seborrhoeic dermatitis we have found an increase in NK1+, CD16+ cells in combination with complement activation indicating that an irritant non-immunogenic stimulation of the immune system is important. However, an increase in the production of inflammatory interleukines as well as regulatory interleukins for both TH1 and TH2 cells were also present. The majority of adult patients with atopic dermatitis localised to the head, neck and scalp have both a positive skin prick test to a Malassezia extract as well as specific IgE antibodies. There are also treatment studies indicating that antifungal treatment may be beneficial in these patients.
Article
Objective The in vitro antimicrobial susceptibility of Pityrosporum ovale strains isolated from patients with seborrheic dermatitis was determined. Method Minimum inhibitory concentrations of a total of 11 agents - including true antifungal, antiseborrheic, and antipsoriatic drugs - were measured. Results Ketoconazole was the most effective of the tested antifungal agents against Pityrosporum ovale in vitro (minimum inhibitory concentration 0.1 μg/ml). The antiseborrheic agents zinc pyrithione and selenium disulfide showed a good in vitro efficacy against Pityrosporum with similar minimum inhibitory concentrations. Liquor carbonis detergens and dithranol were also able to inhibit growth of Pityrosporum ovale in vitro, but much higher concentrations were necessary. Conclusion The tested agents commonly used against seborrheic dermatitis might exert their efficacy, at least in part, due to inhibition of Pityrosporum ovale.
Article
The spectrum of disease known as dandruff/seborrhoeic dermatitis has been shown to be due to infection of the skin by the Pityrosporon species of fungus. Ketoconazole shampoo has been shown to suppress effectively both the organism's growth and the symptoms and signs of the clinical disorder.
Article
Seborrheic dermatitis is a common condition that usually appears as simple dandruff. It may affect the scalp, the central part of the face and the anterior portion of the chest, as well as flexural creases of the arms, legs and groin. It occurs most often in infants and in adults between 30 and 60 years of age. Patients with acquired immunodeficiency syndrome may have particularly resistant cases of seborrheic dermatitis. Diagnosis of this condition is generally straightforward, but the differential diagnosis includes a variety of conditions, such as psoriasis vulgaris (sebopsoriasis), atopic dermatitis, tinea capitis and candidiasis, as well as other, more rare conditions. Seborrheic dermatitis may be associated with or caused by a variety of underlying disorders. Treatment is generally topical. Steroid creams, selenium, salicylic acid and coal tar preparations, and pyrithione zinc are frequently used to treat this condition.
Article
Malassezia furfur is an anthropophilic fungus that belongs to the physiological skin flora. The fungus can grow in a yeast phase as well as in a mycelial phase; on nonaffected skin the fungus is mainly prevalent in the yeast phase. The organism has complex lipid requirements for growth, which also explains its occurrence on the skin. This also leads to the requirement for specially supplemented media for in vitro cultivation. Malassezia furfur is the causative agent of pityriasis versicolor. It also seems to be associated with seborrheic dermatitis and dandruff formation, folliculitis, confluent and reticulate papillomatosis, and the provocation of psoriatic lesions. Many substances for topical application, such as azole antimycotics, ciclopirox olamine, piroctone-olamine, zinc pyrithione, or sulfur-containing substances are effective in the treatment of these diseases. In recent years rare cases of systemic infections and fungemias caused by Malassezia have been reported.
Article
The disease commonly known as "dandruff" is caused by numerous host factors in conjunction with the normal flora yeast Malassezia furfur (Pityrosporum ovale). Indeed, clinical studies have shown that administration of antifungal agents correlates with an improved clinical condition. Almost all commercially available hair shampoos publicize that they contain some form of antifungal agent(s). However, few studies have been published in which antifungal activity of commercially available hair shampoos have been contrasted experimentally. In this study six commercially available shampoos (in the Philippines) were assessed for antifungal activity against a human (dandruff) isolate of M. furfur: (a) Head & Shoulders (Proctor & Gamble); (b) Gard Violet (Colgate-Palmolive); (c) Nizoral 1% (Janssen); (d) Nizoral 2% (Janssen); (e) Pantene Blue (Proctor & Gamble); and (f) Selsun Blue (Abbott). The results demonstrated that all six of the assayed hair shampoos have some antifungal effect on the test yeast. However, there was consider variation in potency of antifungal activity. Nizoral 1% and Nizoral 2% shampoo preparations were the most effective. The 1% Nizoral shampoo was consistently 10X better at killing yeast cells than the next closest rival shampoo. The 2% Nizoral shampoo was 10X better than the Nizoral 1% product and 100 times better than any of the other products assayed. The study demonstrated that shampoos containing a proven antifungal compound were the most effective in controlling the causative yeast.
Article
Dandruff is known to be controlled by fungistatic shampoos active against Malassezia spp. These products also remove the loosely attached scales. This study was performed to assess the effect of a 5-min residence time on the efficacy of antidandruff shampoos. Two commercially available shampoos were used in two groups of 21 panelists with severe dandruff. They contained either 1% ketoconazole or 1% piroctone olamine. In each group, intraindividual comparisons were made by a split-scalp design between the effect of a 5-min residence time versus no residence time. Both shampoos induced significant reductions in scaliness and yeast colonization. The beneficial effects were obvious immediately after one single shampooing and 3 days later as well. The improvement was greater with a 5-min residence time. The piroctone olamine treatment benefited more than the ketoconazole treatment from the extension of shampoo-exposure time. In conclusion, the benefit of a residence time in treating dandruff is documented. The level of improvement in efficacy may vary according to the nature of the shampoo.