Anti-dandruff effects of butterfly pea flowers (Clitoria ternatea)-based shampoo: A pretest-posttest control study.

Butterfly pea flower (Clitoria ternatea) may serve as an alternative anti-dandruff treatment; however, its effects on Malassezia spp. remain unexplored. The aim of this study was to explore the effects of C. ternatea as an herbal-based anti-dandruff treatment on Malassezia spp. DNA expression, plakoglobin levels, IL-8 levels, sebum levels, dandruff severity scores, adverse effects, and patient satisfaction. An experimental study with a pretest-posttest control design was conducted at the Outpatient Clinic of Dermatology and Venereology, Arifin Achmad Hospital, Pekanbaru, Indonesia, from November 2023 to January 2024. The flower of C. ternatea was used to formulate the shampoo. The study involved 70 female patients aged 18-25 with dandruff, who were divided into two groups: (a) experimental group using 20% C. ternatea shampoo and (b) control group using 2% ketoconazole shampoo. The present study found that 2% ketoconazole shampoo significantly reduced Malassezia spp. DNA expression compared to 20% C. ternatea shampooo (Clitoria ternatea: ΔCq=1.76±3.18; ketoconazole: ΔCq=3.77±2.90; p=0.008). No significant difference was observed in plakoglobin levels (C. ternatea: ΔCq=1.98±3.63; ketoconazole: ΔCq=2.50±2.36; p=0.427) or IL-8 levels (C. ternatea: ΔCq=3.46±4.00; ketoconazole: ΔCq=4.16 ± 3.62; p=0.459). C. ternatea significantly reduced sebum levels more than ketoconazole (C. ternatea: 1.16±0.98%; ketoconazole: 0.22±0.38%; p<0.001). Dandruff scores and patient satisfaction were similar for both shampoos (p=0.115 and p=0.336, respectively). Adverse effects were more common in the 2% ketoconazole shampoo group, affecting 21.2% of the patients. In conclusion, 2% ketoconazole shampoo is more effective in reducing Malassezia spp. DNA expression, while 20% C. ternatea shampoo offers better sebum control. Both shampoos are similarly effective in ameliorating dandruff severity and are well-tolerated, with fewer adverse effects reported for C. ternatea.

Scalp microbiome: a guide to better understanding scalp diseases and treatments.

The scalp microbiome represents an array of microorganisms important in maintaining scalp homeostasis and mediating inflammation. Scalp microbial dysregulation has been implicated in dermatologic conditions including alopecia areata (AA), dandruff/seborrheic dermatitis (D/SD), scalp psoriasis (SP) and folliculitis decalvans (FD). Understanding the impact of scalp microbial dysbiosis gives insight on disease pathophysiology and guides therapeutic decision making. Herein we review the scalp microbiome and its functional role in scalp conditions by analysis of metagenomic medical literature in alopecia, D/SD, SP, and other dermatologic disease.Increased abundance of Malassezia, Staphylococcus, and Brevibacterium was associated with SD compared to healthy controls. A higher proportion of Corynebacterium, actinobacteria, and firmicutes are present in AA patients, and lower proportions of Staphylococcus caprae are associated with worse clinical outcomes. Decreased prevalence of actinobacteria and Propionibacterium and increased firmicutes, staphylococcus, and streptococcus are associated with scalp psoriasis. Studies of central centrifugal cicatricial alopecia (CCCA) suggest scalp microbial composition contributes to CCCA's pro-inflammatory status. The most common organisms associated with FD include methicillin-resistant S. aureus and S. lugdunensis. Antifungals have been a mainstay treatment for these diseases, while other alternatives including coconut oils and shampoos with heat-killed probiotics have shown considerable potential efficacy by replenishing the scalp microbiome.

Rosemary and neem: an insight into their combined anti-dandruff and anti-hair loss efficacy.

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.

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.

Scalp microbiome composition changes and pathway evaluations due to effective treatment with Piroctone Olamine shampoo.

OBJECTIVE: To characterize the scalp microbial composition, function, and connection to dandruff severity using a metagenomics approach and to understand the impact of a Piroctone Olamine containing anti-dandruff shampoo on the scalp microbiome. METHODS: Shotgun metagenomics was used to characterize the composition of the scalp microbiomes from 94 subjects with and without clinically defined dandruff. Furthermore, the microbiome of the scalps of 100 dandruff sufferers before and after 3 weeks of treatment with either control or anti-dandruff shampoo containing 0.5% Piroctone Olamine (PO) was characterized and compared to identify microorganisms associated with the dandruff condition and the associated pathways and processes that may contribute to PO's effect on scalp microbiome. RESULTS: A higher relative abundance of Malassezia restricta and Staphylococcus capitis and a lower abundance of Cutibacterium acnes were associated with the dandruff scalps relative to the no-dandruff scalps. A 3-week PO shampoo treatment reduced the relative abundance of Malassezia species and Staphylococcus capitis and increased the relative abundance of Cutibacterium acnes. This change to the scalp microbiome composition is consistent with a return to a healthy no-dandruff microbiome and improved clinical signs and symptoms as measured by adherent scalp flaking score (ASFS) compared with the control shampoo. Functional genomics analysis showed that the PO shampoo treatment reduced oxidative stress-associated genes and decreased the abundance of protease, urease, and lipase genes. These changes correlated positively to improvements in dandruff severity. PO treatment favourably shifted scalp microbiomes in dandruff subjects toward the no-dandruff state. CONCLUSION: Our results suggest that part of the aetiology of dandruff can be attributed to dysbiosis of the scalp microbiome. PO treatment can restore a healthier microbiome, reducing oxidative stress and promoting better scalp health.

OBJECTIF: Caractériser la composition microbienne du cuir chevelu, sa fonction et son lien avec la sévérité des pellicules à l'aide d'une approche métagénomique. Comprendre l'impact d'un shampooing antipelliculaire à base de piroctone olamine sur le microbiome du cuir chevelu. MÉTHODES: La métagénomique shotgun a été utilisée pour caractériser la composition des microbiomes du cuir chevelu de 94 sujets avec et sans pellicules définies cliniquement. Par ailleurs, le microbiome des cuirs chevelus de 100 personnes ayant des pellicules avant et après trois semaines de traitement par un shampooing témoin ou un shampooing antipelliculaire contenant 0,5 % de piroctone olamine (PO) a été caractérisé et comparé pour identifier les micro­organismes associés à l'état pelliculaire, et les voies et processus associés pouvant contribuer à l'effet de la PO sur le microbiome du cuir chevelu. RÉSULTATS: Une abondance relative plus élevée de Malassezia restricta et de Staphylococcus capitis, et une abondance plus faible de Cutibacterium acnes étaient associées aux cuirs chevelus avec des pellicules par rapport aux cuirs chevelus sans pellicules. Un traitement avec un shampooing contenant de la PO de 3 semaines a réduit l'abondance relative des espèces Malassezia et Staphylococcus capitis, et a augmenté l'abondance relative de Cutibacterium acnes. Cette modification de la composition du microbiome du cuir chevelu est cohérente avec un retour à un microbiome sain sans pellicules, et une amélioration des signes et symptômes cliniques mesurés par le score de desquamation du cuir chevelu adhérent (Adherent Scalp Flaking Score, ASFS) par rapport au shampooing témoin. L'analyse génomique fonctionnelle a montré que le traitement avec un shampooing contenant de la PO réduisait les gènes associés au stress oxydatif et diminuait l'abondance des gènes de la protéase, de l'uréase et de la lipase. Ces modifications étaient corrélées positivement à des améliorations de la sévérité des pellicules. Le traitement avec la PO a favorisé l'évolution des microbiomes du cuir chevelu des sujets ayant des pellicules vers un état sans pellicules. CONCLUSION: Nos résultats suggèrent qu'une partie de l'étiologie des pellicules peut être attribuée à la dysbiose du microbiome du cuir chevelu. Le traitement avec la PO peut rétablir un microbiome plus sain, en réduisant le stress oxydatif et en favorisant une meilleure santé du cuir chevelu.

Novel anti-dandruff shampoo incorporated with ketoconazole-coated zinc oxide nanoparticles using green tea extract.

BACKGROUND: Dandruff caused by Malassezia furfur is a prevailing fungal infection. Although ketoconazole (KTZ) is widely intended for anti-dandruff treatment, poor solubility, and epidermal permeability limits its use and the marketed KTZ shampoo adversely effects scalp and hair. OBJECTIVE: To prepare a novel shampoo loaded with KTZ-coated zinc oxide nanoparticles using green tea extract and evaluate its antifungal activity. METHODS: The KTZ-coated zinc oxide nanoparticles was prepared by green synthesis and was characterized by UV, FTIR, XRD, and the drug entrapment efficiency was investigated. The antifungal activity of the nanoparticles with respect to standard drug, KTZ was tested against Malassezia furfur. Further, a novel antidandruff shampoo was developed by incorporating the prepared nanoparticles into the shampoo base. RESULTS: The formation of KTZ-coated ZnO nanoparticles was confirmed by UV and FTIR analysis. XRD analysis confirmed the amorphous phase of KTZ in nanoparticles. The drug entrapment efficiency was found to be 91.84%. The prepared nanoparticles showed enhanced activity against Malassezia furfur compared to drug of choice, KTZ (1%). The evaluation of shampoo showed an ideal result. CONCLUSION: KTZ-coated ZnO nanoparticles loaded novel shampoo in comparison to marketed anti-dandruff shampoo could be an effective alternate for the treatment of dandruff.

Clinical efficacy of a gentle anti-dandruff itch-relieving shampoo formulation.

Dandruff is a common scalp condition affecting almost half of the world's population. Despite its high prevalence, the exact pathophysiology is not well established and is understood to be multifactorial, with factors such as fungal colonization, sebaceous gland activity and individual factors being implicated. There is a need for an effective and safe shampoo that can target the above factors. Hence, we have developed a shampoo formulation with properties of oil control, moisturizing, non-irritative, anti-fungal, anti-microbial and itch-relieving. In this interventional, open-label study, we evaluated the efficacy and safety of this shampoo in reducing the clinical signs of dandruff and pruritus in patients with pre-existing mild-to-moderate dandruff over a course of 21-day treatment duration through self-assessment and objective clinical evaluations. After continued use of the shampoo, there was a significant decrease in the adherent and loose scalp flaking scores. Mean pruritus scores also decreased significantly across the 21-day time points. There were also no adverse events or skin intolerances reported. This study showed that our shampoo formulation has led to a significant reduction in both adherent and loose scalp flaking and pruritus when used in individuals suffering from mild to moderate dandruff. As such, it is an ideal shampoo, which can be used to effectively control dandruff.

Les pellicules sont une affection courante du cuir chevelu qui touche près de la moitié de la population mondiale. Malgré sa prévalence élevée, la physiopathologie exacte n'est pas bien établie et est comprise comme étant multifactorielle, avec des facteurs impliqués tels que la colonisation fongique, l'activité des glandes sébacées et des facteurs individuels. Un shampooing sûr et efficace pouvant cibler les facteurs évoqués ci-dessus est nécessaire. Par conséquent, nous avons développé une formulation de shampooing présentant des propriétés de contrôle du sébum, d'hydratation, non irritante, antifongique, antimicrobienne et de soulagement des démangeaisons. Dans cette essaie interventionnelle ouvert, nous avons évalué l'efficacité et la sécurité d'emploi de ce shampooing dans la réduction des signes cliniques de pellicules et de prurit chez des patients présentant des pellicules préexistantes légères à modérées sur une durée de traitement de 21 jours par le biais d'auto-évaluations et d'évaluations cliniques objectives. Après une utilisation continue du shampooing, une diminution significative des scores de squames adhérents et d'excoriation du cuir chevelu a été observée. Les scores de prurit moyens ont également significativement diminué tout au long de la période de 21 jours. De même, aucun événement indésirable ou intolérance cutanée n'a été rapporté. Cette étude a montré que notre formulation de shampooing a entraîné une réduction significative des squames adhérents, de l'excoriation du cuir chevelu et du prurit lorsqu'elle est utilisée chez des personnes souffrant de pellicules légères ou modérées. Il s'agit donc d'un shampooing idéal qui peut être utilisé pour contrôler efficacement les pellicules.

Selenium disulfide: a key ingredient to rebalance the scalp microbiome and sebum quality in the management of dandruff.

BACKGROUND: Dandruff is a chronic and relapsing scalp condition characterized by flaky scalp. Environmental and host factors (exposome) may alter the sebaceous gland activity, sebum composition, epidermal barrier function, and scalp microbiome balance, resulting in dandruff. Selenium disulfide (SeS2) improves the clinical signs of dandruff. OBJECTIVES: To investigate the mode of action of SeS2 shampoo during treatment and relapse phases. MATERIALS & METHODS: Two single-center studies assessed dandruff severity, subjective efficacy perception, microbial balance, microbiota diversity and sebum lipids. RESULTS: SeS2 significantly (p≤0.01) reduced scaling and led to a significant decrease of Malassezia and Staphylococcus spp. counts in both lesional and non-lesional areas, compared to the vehicle at D28 returning to baseline levels at D56. Cutibacterium spp. levels were not different between the SeS2 and the vehicle treatment groups but had significantly increased with SeS2 (p<0.001) in the lesional zone at D56. The ratio Malassezia spp./Cutibacterium spp. decreased significantly in lesional zones compared to baseline levels, at both D28 and D35 (p<0.001). The total squalene content significantly increased (p<0.05), whereas peroxided squalene had significantly decreased by almost 50% at D31. The ratio triglycerides/free fatty acids significantly (p<0.0001) increased, almost 5-fold, between D0 and D31. SeS2 shampoo was very well tolerated. CONCLUSION: SeS2 is beneficial in scalp dandruff, even after treatment interruption. It is well tolerated, rebalances the equilibrium between the main bacterial and fungal populations, and improves sebum quality.

Clinical evaluation of paraprobiotic-associated Bifidobacterium lactis CCT 7858 anti-dandruff shampoo efficacy: A randomized placebo-controlled clinical trial.

OBJECTIVE: The microbiome plays an important role in a wide variety of skin disorders. Hence, dysbiosis in the skin and/or gut microbiome is associated with an altered immune response, promoting the development of skin diseases, such as atopic dermatitis, psoriasis, acne vulgaris and dandruff. Studies have shown that paraprobiotics may be promising for the treatment of skin disorders through microbiota modulation and immunomodulation. So, the objective is to develop an anti-dandruff formulation using a paraprobiotic (Neoimuno) as active ingredient. METHODS: Randomized, double-blind, placebo-controlled clinical trial was performed in patients who had any degree of dandruff. A total of 33 volunteers were recruited and randomly divided into two groups: placebo or treated. (1% Neoimuno). The ingredient used was Neoimuno (Bifidobacterium lactis strain CCT 7858). Combability analysis and perception questionnaire were applied before and after treatment. Statistical analyses were performed. RESULTS: No adverse effects were reported by patients throughout the study. Through the combability analysis, a significant decrease in the number of particles was verified after 28 days of shampoo use. Regarding perception, there was a significant difference for the cleaning variables and improvement of the general appearance 28 days after the intervention. There were no significant differences for the itching and scaling parameters, as well as the perception parameters at 14 days. DISCUSSION: Topical application of the paraprobiotic shampoo containing 1% Neoimuno was able to significantly improve the feeling of cleanliness and general aspects of dandruff, in addition to reducing scalp flakiness. Thus, with the results obtained through the clinical trial, Neoimuno presents itself as a natural, safe and effective ingredient in the treatment of dandruff. The efficacy of Neoimuno in dandruff was visible within 4 weeks.

OBJECTIF: Le microbiome joue un rôle important dans une grande variété de troubles cutanés. Ainsi, la dysbiose du microbiome cutané et/ou intestinal est associée à une réponse immunitaire altérée, favorisant le développement de maladies cutanées, telles que la dermatite atopique, le psoriasis, l'acné vulgaire et les pellicules. Des études ont montré que les paraprobiotiques peuvent être prometteurs pour le traitement des troubles cutanés par la modulation du microbiote et l'immunomodulation. Ainsi, l'objectif est de développer une formulation antipelliculaire utilisant un paraprobiotique (Neoimuno) comme principe actif. MÉTHODES: Un essai clinique randomisé, en double aveugle et contrôlé par placebo a été réalisé chez des patients présentant des pellicules de n'importe quel degré. Au total, 33 volontaires ont été recrutés et divisés au hasard en deux groupes: placebo ou traité. (1% Neoimuno). L'ingrédient utilisé était le Neoimuno (souche Bifidobacterium lactis CCT 7858). Une analyse de combabilité et un questionnaire de perception ont été appliqués avant et après le traitement. Des analyses statistiques ont été effectuées. RÉSULTATS: Aucun effet indésirable n'a été signalé par les patients tout au long de l'étude. Grâce à l'analyse de combabilité, une diminution significative du nombre de particules a été vérifiée après 28 jours d'utilization du shampooing. Concernant la perception, il y avait une différence significative pour les variables de nettoyage et d'amélioration de l'aspect général 28 jours après l'intervention. Il n'y avait pas de différences significatives pour les paramètres de démangeaison et de desquamation, ainsi que les paramètres de perception à 14 jours. DISCUSSION: L'application topique du shampooing paraprobiotique contenant 1% de Neoimuno a pu améliorer significativement la sensation de propreté et les aspects généraux des pellicules, en plus de réduire la desquamation du cuir chevelu. Ainsi, avec les résultats obtenus grâce à l'essai clinique, Neoimuno se présente comme un ingrédient naturel, sûr et efficace dans le traitement des pellicules. L'efficacité de Neoimuno sur les pellicules a été visible en 4 semaines.

Characterization of piroctone olamine for topical delivery to the skin.

OBJECTIVE: Dandruff and its more severe related condition, seborrheic dermatitis affects a high proportion of the population at some point in their life. Piroctone olamine, also known as Octopirox® (OPX) is the monoethanolamine salt of piroctone and is an antifungal agent widely used for the management of dandruff. The aim of the present work was to characterize the physicochemical properties of piroctone olamine and to conduct pre-formulation studies for the development of novel topical formulations of this active. METHODS: An HPLC method was developed and validated for the analysis of OPX. The melting point was determined using the DSC Q2000 (TA Instruments, USA). The distribution coefficient (logD(O/PBS) ) and partition coefficient (log Po/w ) was determined in phosphate-buffered saline (PBS) AND deionized (DI) water using the shake flask method. All experiments were performed at room temperature. The solubility was determined experimentally by adding amount of active to a solvent. The samples were kept at 32° ± 1°C for 48 h in a water bath. The stability of the compound was determined in a range of solvents by preparing solutions of 1 mg mL-1 in the relevant solvents. These solutions were kept and stirred throughout the experiment at 32 ± 1°C, and aliquots were taken at 24, 48 and 96 h. RESULTS: The HPLC method was developed successfully; however, samples at the lower end of the calibration curve showed lower degrees of precision and accuracy. Based on experiments with DSC, the melting point was observed at an onset temperature of 132.4°C. The LogD was determined to be 1.84. The compound had the highest solubility in methanol (278.4 mg mL-1 ) and propylene glycol (PG), with a value of 248.8 mg mL-1 . The lowest solubility for OPX was in dimethyl isosorbide (9.9 mg mL-1 ), Labrafac™ (3.6 mg mL-1 ) and isostearyl isostearate (0.5 mg mL-1 ). Over the 4 days, OPX showed stability in ethanol and PG, while a notable decrease in OPX was observed in PBS and DI water at 32 ± 1°C. CONCLUSION: The physicochemical properties of OPX were characterized to find suitable excipients able to target the epidermis for topical delivery. Building on these findings, future work will focus on the development of novel topical formulation of OPX.

OBJECTIF: la production de pellicules et la maladie plus grave qui y est apparentée, la dermatite séborrhéique, touchent une grande partie des personnes à un moment donné de leur vie. La piroctone olamine, également connue sous le nom d'Octopirox® (OPX), est le sel de monoéthanolamine de la piroctone. Il s'agit d'un agent antifongique largement utilisé pour le traitement des pellicules. L'objectif de ce travail était de caractériser les propriétés physicochimiques de la piroctone olamine et de mener des études de préformulation pour le développement de nouvelles formulations topiques de ce principe actif. MÉTHODES: une méthode de chromatographie liquide à haute performance (CLHP) a été développée et validée pour l'analyse de l'OPX. Le point de fusion a été déterminé à l'aide du calorimètre à balayage différentiel (Differential Scanning Calorimetry, DSC) Q2000 (TA Instruments, États-Unis). Le coefficient de distribution (logD(Octanol/PBS) ) et le coefficient de partage (log Poctanol/eau , ou log Poe ) ont été déterminés dans le tampon phosphate salin (phosphate buffered saline, PBS) et dans l'eau désionisée (deionised, DI) à l'aide de la méthode par agitation en flacon. Toutes les expériences ont été réalisées à température ambiante. La solubilité a été déterminée de manière expérimentale. Une certaine quantité du principe actif a été ajoutée au solvant. Les échantillons ont été conservés à une température de 32 °C ± 1 °C pendant 48 h dans un bain-marie. La stabilité du composé a été déterminée à l'aide d'une gamme de solvants. Des solutions de 1 mg mL−1 ont été préparées dans les solvants correspondants. Les solutions ont été conservées et agitées tout au long de l'expérience à une température de 32°C ± 1°C. Des aliquotes ont été prélevées après 24, 48 et 96 h. RÉSULTATS: la méthode CLHP a été développée avec succès. Toutefois, les échantillons situés dans la partie inférieure de la courbe d'étalonnage ont montré des degrés inférieurs de précision et d'exactitude. Sur la base des expériences avec le DSC, le point de fusion a été observé à une température initiale de 132,4°C. Le LogD a été déterminé à 1,84. Le composé présentait la solubilité la plus élevée dans le méthanol (278,4 mg mL−1 ) et le propylène glycol (PG), avec une valeur de 248,8 mg mL−1 . L'OPX présentait la solubilité la plus faible dans l'isosorbide de diméthyle (9,9 mg.mL−1 ), le LabrafacTM (3,6 mg mL−1 ) et l'isostéarate d'isostéaryle (0,5 mg mL−1 ). Sur les 4 jours, l'OPX a montré une stabilité dans l'éthanol et le PG, tandis qu'il a diminué de manière notable dans le PBS et l'eau désionisée à une température de 32°C ± 1°C. CONCLUSION: les propriétés physicochimiques de l'OPX ont été caractérisées afin de trouver des excipients appropriés capables de cibler l'épiderme dans le cadre d'une administration topique. En s'appuyant sur ces résultats, les travaux futurs se concentreront sur le développement d'une nouvelle formulation topique de l'OPX.

Malassezia restricta-mediated Lipoperoxidation: A Novel Trigger in Dandruff.

Dandruff is a common scalp disorder with multiple microbial and host-related factors contributing to its aetiology, including alterations in scalp sebum. Despite existing evidence that the yeast Malassezia restricta plays a key role in the onset of dandruff, the interplay of these factors is poorly understood. Recently, squalene monohydroperoxide and malondialdehyde were established as biomarkers of dandruff-afflicted scalp, highlighting the role of sebum lipoperoxidation in the triggering and maintenance of dandruff, although its mechanism of action is unknown. The current study provides evidence that M. restricta mediates sebum peroxidation, leading to production of squalene monohydroperoxide and malondialdehyde. Furthermore, in vitro data show that these lipoperoxidation products act on epidermal cells and alter the skin barrier. These results support the role of Malassezia restricta-induced lipoperoxides as triggers of dandruff, which suggests that blocking their production could be a novel anti-dandruff treatment approach.

Enhanced piroctone olamine retention from shampoo for superior anti-dandruff efficacy.

BACKGROUND: Dandruff is a pervasive chronic condition which negatively impacts quality of life. Effective treatment requires efficient delivery of scalp benefit agents that control commensal scalp Malassezia levels. Delivery of benefit agents from shampoos requires balancing many technical parameters to achieve the desired outcome without sacrificing secondary parameters, such as cosmetic attributes. AIM: To develop formulation technologies that increase the shampoo delivery efficiency of the scalp benefit agent piroctone olamine (PO). Increased delivery should result in increased anti-dandruff efficacy. METHODS: Micellar Stability and Association parameters were quantified via dynamic surface tension and nuclear magnetic resonance (NMR) diffusion parameters, respectively. PO delivery has been assessed in vivo both on the scalp surface and follicular infindibula using extraction procedures and analytical analysis. Clinical anti-dandruff efficacy was assessed for an advanced delivery technology prototype in comparison to standard delivery technology. RESULTS: Shampoo prototypes have been developed that increase the delivery efficiency of PO. Both surfactant and polymer coacervate-based approaches have been developed. Decreased micellar stability results in weaker association between PO and micelles, resulting in more efficient PO retention on the scalp surface and delivery to the infundibula. Increased charge density of cationic polymers optimizes coacervation enabling improved PO delivery as well. Increased PO delivery has been shown clinically to result in higher anti-dandruff efficacy as measured by both visible flakes and underlying biomarkers. CONCLUSION: Increased efficiency PO delivery shampoos have been developed by optimization of both surfactant and coacervate parameters. The increased deposition efficiency results in significantly more products with significantly greater anti-dandruff efficacy.

CONTEXTE: Les pellicules sont une maladie chronique omniprésente qui a un impact négatif sur la qualité de vie. Un traitement efficace nécessite une administration efficace d'agents bénéfiques pour le cuir chevelu qui contrôlent les niveaux commensaux de Malassezia. L'administration d'agents bénéfiques à partir de shampooings nécessite d'équilibrer de nombreux paramètres techniques pour obtenir le résultat souhaité sans sacrifier des paramètres secondaires tels que les attributs cosmétiques. BUT: Développer des technologies de formulation qui augmentent l'efficacité d'administration du shampooing de l'agent bénéfique pour le cuir chevelu piroctone olamine (PO). Une livraison accrue devrait entraîner une efficacité antipelliculaire accrue. MÉTHODES: La stabilité micellaire et les paramètres d'association ont été quantifiés via les paramètres de tension superficielle dynamique et de diffusion RMN, respectivement. L'administration de PO a été évaluée in vivo à la fois sur la surface du cuir chevelu et sur l'indibula folliculaire à l'aide de procédures d'extraction et d'analyses analytiques. L'efficacité antipelliculaire clinique a été évaluée pour un prototype de technologie d'administration avancée par rapport à la technologie d'administration standard. RÉSULTATS: Des prototypes de shampooing ont été développés pour augmenter l'efficacité de livraison des PO. Des approches à base de tensioactifs et de coacervats polymères ont été développées. Une diminution de la stabilité micellaire entraîne une association plus faible entre le PO et les micelles, ce qui entraîne une rétention plus efficace du PO sur la surface du cuir chevelu et une livraison à l'infundibula. L'augmentation de la densité de charge des polymères cationiques optimise la coacervation, permettant également une meilleure administration de PO. Il a été démontré cliniquement que l'augmentation de l'administration de PO entraîne une efficacité antipelliculaire plus élevée, mesurée à la fois par les squames visibles et les biomarqueurs sous-jacents. CONCLUSION: Des shampooings à libération de PO à efficacité accrue ont été développés en optimisant à la fois les paramètres du tensioactif et du coacervat. L'efficacité de dépôt accrue se traduit par beaucoup plus de produits avec une efficacité antipelliculaire nettement supérieure.

Promising Essential Oils/Plant Extracts in the Prevention and Treatment of Dandruff Pathogenesis.

BACKGROUND: Dandruff is a scalp disorder affecting the male populace predominantly. Topical agents and synthetic drugs used for dandruff treatment have specific side effects including burning at the application site, depression, dizziness, headache, itching or skin rash, nausea, stomach pain, vision change, vomiting, discoloration of hair, dryness or oiliness of the scalp and increased loss of hair. Thus, essential oils and extracts from plants could be valuable in the treatment and prevention of dandruff. AIMS & OBJECTIVES: This review aims to highlight current findings in dandruff occurrence, its etiology, promising plant essential oils/extracts, and novel treatment strategies. The main emphasis has been given on the anti-dandruff effect of essential oils and plant extracts to disrupt microbial growth. The proposed mechanism(s) of action, novel approaches used to perk up its biopharmaceutical properties, and topical application have been discussed. RESULTS: The literature survey was done, and bibliographic sources and research papers were retrieved from different search engines and databases, including SciFinder, PubMed, NCBI, Scopus, and Google Scholar. The selection of papers was accomplished based on exclusion and inclusion criteria. The scalp of diverse populations revealed an association of dandruff with microbial symbiosis, including Staphylococcus, Propionibacterium, Malassezia, and Candida as the pathogens responsible for the cause of dandruff. Topical antifungals are considered the first line of treatment for dandruff including azoles, with clotrimazole (1%), ketoconazole (2%), and miconazole (2%). Other commonly used therapies integrate benzoyl peroxide, coal tar, glycerin, zinc pyrithione, lithium succinate/gluconate, salicylic acid, selenium disulfide/sulfide, sodium sulfacetamide, etc. However, these medicaments and chemicals are known to cause specific side effects. Alternative therapies, including tea tree oil, thyme, Aloe vera, Mentha have been reported to demonstrate anti-dandruff activity by disrupting the microbial growth associated with dandruff formation. CONCLUSION: Overall, this review explains the occurrence of dandruff, its pathogenesis, and the potential applicability of promising plant essential oils/extracts and their novel treatment strategies. Further studies based on pre-clinical and clinical research are essential before making any conclusion about its efficacy in humans.

Effect of oral administration of Triphala, a polyphenol-rich prebiotic, on scalp sebum in patients with scalp seborrhea a randomized clinical trial.

BACKGROUND: Although there are various therapeutic options to control oily skin, they have potential side effects and limitations especially in long-term use. Pre/probiotics may have beneficial effects in atopic dermatitis' acne, dandruff, and seborrhea, demonstrated by some clinical trials. This trial conducted to determine whether the herbal prebiotic Triphala is effective in reducing scalp sebum secretion in patients with scalp seborrhea. METHODS: In this 8 week patient and outcome assessor-blinded, placebo-controlled trial participants with scalp seborrhea aged 14-50 years were randomized to Triphala or placebo groups. 1 g of Triphala (standardized as 91.82 ± 0.5 mg gallic acid) or placebo (wheat flour) were administered BID. Scalp sebum levels were detected objectively using Sebumeter® sm 815, and treatment satisfaction was measured using a score between 0 and 100. [Registration no. IRCT2014070218332N1]. RESULTS: Eighty patients completed the study (40 in Triphala group and 40 in placebo group). Participants in the Triphala group experienced 25.34 scores (95% CI, 0.39-50.29: p = .047) more improvement in scalp sebum levels compared with the placebo group. The mean percentage of patients' satisfaction was 37.91 (24.88) in the Triphala group and 17.89 (25.80) in the placebo group (p = .001). CONCLUSION: Herbal prebiotic Triphala significantly reduced scalp sebum scores compared to placebo.

Ketoconazole beyond antifungal activity: Bioinformatics-based hypothesis on lipid metabolism in dandruff and seborrheic dermatitis.

The role of Malassezia yeasts in dandruff and seborrheic dermatitis is unclear; however, antifungal therapy with ketoconazole is commonly used. We propose that ketoconazole shifts skin lipid profile, affects Malassezia lipid metabolism and favours biotin-producing bacteria. Biotin regulates inflammatory response and cell proliferation, contributing to symptom improvement.

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

BACKGROUND: Scalp seborrheic dermatitis (SD) is a chronic inflammatory dermatosis associated with sebum imbalance and proliferation of Malassezia species. Various antifungal shampoos are commonly used for scalp SD. AIMS: Glycyrrhetinic acid is known to have antioxidative, anti-inflammatory, and anti-allergic effects. This study was designed to evaluate the effectiveness of a new-formula shampoo that contains glycyrrhetinic acid for the treatment of scalp SD. PATIENTS/METHODS: Thirty-four patients were enrolled and treated with the 6% glycyrrhetinic acid complex shampoo. Efficacy was assessed clinically with Dermatology Life Quality Index (DLQI) and Adherent Scalp Flaking Score (ASFS) by the same dermatologist at baseline, week 2, and week 5. Among the 24 subjects with the most significant clinical improvement, four common microorganisms from scalp samples were analyzed by quantitative polymerase chain reaction (qPCR) at baseline, and week 5. RESULTS: The DLQI and ASFS at week 2 and week 5 improved significantly relative to baseline. The bacteria profiles showed a significant increase of Cutibacterium acnes and a decrease of Staphylococcus epidermidis at week 5. The fungi profiles showed significant decreases of both Malassezia restricta and Malassezia globosa. The ratio of C. acne to S. epidermidis increased significantly from 0.93 at baseline to 1.55 at week 5. The ratio of M. restricta to M. globosa decreased from 5.02 at baseline to 1.00 at week 5. CONCLUSIONS: The effectiveness of this new regimen was objectively demonstrated at the clinical and microbiological levels. This new formula may alleviate the bacterial and fungal dysbiosis in scalp SD.

Continuous clinical improvement of mild-to-moderate seborrheic dermatitis and rebalancing of the scalp microbiome using a selenium disulfide-based shampoo after an initial treatment with ketoconazole.

OBJECTIVE: Scalp seborrheic dermatitis (SD) is a chronic, relapsing, and inflammatory scalp disease. Studies indicate a global bacterial and fungal microbiota shift of scalp SD, as compared to healthy scalp. Ketoconazole and selenium disulfide (SeS2 ) improve clinical signs and symptoms in both scalp dandruff and SD. AIM: The main objective of this study was to investigate the changes in the scalp microbiota diversity and counts in subjects with scalp SD during a two-phase treatment period. MATERIAL AND METHODS: The scalp microbiota and clinical efficacy were investigated in 68 subjects with mild-to-moderate scalp SD after an initial one-month treatment with 2% ketoconazole, and after a 2-month maintenance phase, either with a 1% SeS2 -based shampoo or its vehicle. RESULTS: Thirty one subjects in the active and 37 subjects in the vehicle group participated. Ketoconazole provided an improvement of clinical symptoms (adherent (-1.75 p < 0.05), non-adherent (-1.5, p < 0.05)) flakes and erythema (scores 1.67-0.93, p < 0.001), in an increased fungal diversity and in a significant (p < 0.005) decrease of Malassezia spp. SeS2 provided an additional clinical improvement (-0.8; p = 0.0002 and -0.7; p = 0.0081 for adherent and non-adherent flakes, respectively, at Day 84) compared to the vehicle associated with a low Malassezia spp. count and an additional significant (p < 0.001) decrease of the Staphylococcus spp. level. CONCLUSION: Selenium disulfide provides an additional benefit on the scalp microbiota and in clinical symptoms of SD and dandruff after treatment with ketoconazole. The results confirm the role of Staphylococcus spp. in scalp SD and open possible perspectives for preventing relapses.

[Malassezia spp.: interactions with topically applied lipids-a review : Malassezia and topically applied lipids]. / Malassezia spp.: Wechselwirkungen mit Lipidbestandteilen von Topika ­ eine Übersicht : Malassezia und Topika.

Lipophilic Malassezia yeasts are an important part of the human resident skin flora, especially in seborrheic areas. Besides mutualistic interactions with the host they are also linked to diseases although the specific causes are not yet comprehensively understood. The amount of available lipids on the skin correlates with the Malassezia density and also with the occurrence of certain diseases like tinea versicolor. Here, the naturally produced lipids of the sebaceous glands play a role. Hardly studied thus far is the impact of topically applied lipids. Here, growth promotion as well as inhibition of Malassezia cells as well as the production of new metabolites through ester cleavage are possible. One example is the release of antimicrobial fatty acids from hydroxypropyl caprylate through the action of Malassezia lipases. This "self-kill" principle results in the reduction of the amount of Malassezia cells and can be applied as new therapy option for dandruff treatment. A better understanding of the interaction between topica and Malassezia would increase their skin tolerance and open new therapy options.

Comparison of whole-head and split-head design for the clinical evaluation of anti-dandruff shampoo efficacy.

OBJECTIVE: Dandruff is a common scalp condition that can be improved by regular use of shampoos containing anti-fungal actives. The efficacy of anti-dandruff shampoos can be assessed by measuring scalp flaking, one of the important dandruff symptoms. A randomized, double-blind trial is often used with one of two clinical designs: whole-head parallel design and split-head paired design. We aimed to explore the difference in product differentiation between these two designs using the same two test shampoos and the same scalp flaking assessment method (Total Weighted Head Score Adhered Flakes-TWHS AF). METHODS: A clinical study was conducted with a 2- to 3-week wash-out phase and a 4-week test phase, consisting of 2 cells: 120 subjects with whole-head parallel design, divided into 2 subgroups (1:1) using on-site controlled washing method (either wash their own hair at a study site, under the instruction of a study supervisor or wash their own hair at home, as per instructions, but without supervision) and 35 subjects with split-head paired design using salon-staff washing method. Both cells employed hair washing at frequency of three times a week and TWHS AF measurement once a week from the baseline assessment. RESULTS: Both designs gave similar differences in TWHS AF between products: 5.6 units (95% CI: 4.1-7.0 units) in whole-head design and 5.9 units (95% CI: 4.9-6.9 units) in split-head design. CONCLUSION: Split-head paired design shows a similar ability of detecting product difference as whole-head parallel design, whereas it is a choice of more efficient and more cost-effective, as only a quarter of the subjects are required to demonstrate the efficacy between anti-dandruff shampoos.

OBJECTIF: Les pellicules sont une affection courante du cuir chevelu qui peut être améliorée par l'utilisation régulière de shampooings contenant des principes actifs antifongiques. L'efficacité des shampooings antipelliculaires peut être évaluée en mesurant la desquamation du cuir chevelu, l'un des symptômes importants associés aux pellicules. Il est souvent fait recours à une étude randomisée et en double aveugle reposant sur l'une des deux conceptions cliniques suivantes: une conception parallèle portant sur la tête entière et une conception appariée par séparation de la surface de la tête. Nous avons cherché à étudier en quoi des produits se différenciaient entre ces deux conceptions, en utilisant les deux mêmes shampooings d'examen et la même méthode d'évaluation de la desquamation du cuir chevelu (score total pondéré des pellicules collées sur la tête [Total Weighted Head Score Adhered Flakes, TWHS AF]). MÉTHODES: Une étude clinique a été menée avec une fenêtre thérapeutique de deux à trois semaines et une phase d'examen de quatre semaines, composée de deux cellules: 120 sujets recrutés selon une conception parallèle portant sur la tête entière, répartis en deux sous-groupes (1:1), avec un lavage réalisé au centre d'après une méthode contrôlée (lavage par le sujet dans l'un des centres de l'étude, réalisé sous les instructions d'un superviseur de l'étude, ou lavage par le sujet à son domicile, en suivant les instructions, mais sans surveillance) et 35 sujets recrutés selon une conception appariée par séparation de la surface de la tête, avec un lavage réalisé selon la méthode employée par le personnel des salons de coiffure. Pour les deux cellules, le lavage des cheveux avait lieu à une fréquence de trois fois par semaine et le score TWHS AF était mesuré une fois par semaine à partir de l'évaluation de référence. RÉSULTATS: Les deux conceptions ont permis d'observer des différences similaires des scores TWHS AF entre les produits: 5,6 unités (IC à 95%: 4,1 à 7,0 unités) avec la conception portant sur la tête entière et 5,9 unités (IC à 95%: 4,9 à 6,9 unités) avec la conception par séparation de la surface de la tête. CONCLUSION: Par comparaison avec la conception parallèle portant sur la tête entière, la conception appariée par séparation de la surface de la tête montre une capacité de détection similaire de la différence entre les produits, mais constitue un choix plus efficace et plus rentable, car elle n'exige de démontrer l'efficacité entre les shampooings antipelliculaires que chez un quart des sujets.

Longitudinal study of the scalp microbiome suggests coconut oil to enrich healthy scalp commensals.

Dandruff is a recurrent chronic scalp disorder, affecting majority of the population worldwide. Recently a metagenomic study of the Indian scalp microbiome described an imperative role of bacterial commensals in providing essential vitamins and amino acids to the scalp. Coconut oil and its formulations are commonly applied on the scalp in several parts of the world to maintain scalp health. Thus, in this study we examined the effect of topical application of coconut oil on the scalp microbiome (bacterial and fungal) at the taxonomic and functional levels and their correlation with scalp physiological parameters. A 16-weeks-long time-course study was performed including 12-weeks of treatment and 4-weeks of relapse phase on a cohort of 140 (70 healthy and 70 dandruff) Indian women, resulting in ~ 900 metagenomic samples. After the treatment phase, an increase in the abundance of Cutibacterium acnes and Malassezia globosa in dandruff scalp was observed, which were negatively correlated to dandruff parameters. At the functional level, an enrichment of healthy scalp-related bacterial pathways, such as biotin metabolism and decrease in the fungal pathogenesis pathways was observed. The study provides novel insights on the effect of coconut oil in maintaining a healthy scalp and in modulating the scalp microbiome.