The myrtus communis L. solution versus ketoconazole shampoo in treatment of dandruff: A double blinded randomized clinical trial.

OBJECTIVE: To evaluate the efficacy and safety of myrtus communis L. solution in the treatment of dandruff and to compare it with ketoconazole. METHODS: This double-blind randomised clinical trial was conducted at Shiraz University of Medical Sciences, Shiraz, Iran, from December 2015 to August 2016, and comprised patients with dandruff aged 18-60 years visiting the dermatology out-patient clinic. The subjects were randomised into two equal groups. The treatment group received myrtus communis L. solution and a placebo shampoo, while the control group received ketoconazole shampoo and a placebo solution. The total duration of the study for each subject was one month and subjects in both groups used their respective interventions 8 times during that period. The parameters studied were pruritus, erythema, severity of scaling, and the extent of scalp involvement. All subjects underwent scalp scaling tests at the beginning, after 10 days and at the end of the 30th day. SPSS 21 was used for data analysis. RESULTS: Of the 90 individuals, there were 45(50%) in each of the two groups. However, 74(82%) subjects completed the third visit and, of them, there were 37(50%) in each group. Both groups showed significant improvement in all outcome measures (p<0.001). There were no significant differences between the groups in terms of efficacy, satisfaction rate and side effects (p>0.05 for each outcome). CONCLUSIONS: Myrtus solution was found to be effective in the treatment of dandruff.

Cathepsin S, a new pruritus biomarker in clinical dandruff/seborrhoeic dermatitis evaluation.

Dandruff/seborrhoeic dermatitis (D/SD) is characterized by Malassezia colonization, impaired barrier function with subsequent inflammation, resulting in dandruff and itching. Histamine is one of the biomarkers of pruritus now widely used in treatment efficacy trials. The exact mechanism leading to histamine release and pruritus is not yet clear. However, it could involve cathepsin S, an activator of proteinase-activated receptor 2 (PAR2). The purpose of this study was to evaluate the levels of cathepsin S, PAR2 and histamine in patients with D/SD compared with healthy subjects through non-invasive sampling of the scalp and to correlate those markers with D/SD clinical parameters. A significant increase in the three biological markers was observed in the D/SD group versus healthy subjects, and those markers were correlated with clinical parameters. In conclusion, cathepsin S could be a potential marker of pruritus in D/SD and could help assessing the effect of treatments.