A Comprehensive Pathophysiology of Dandruff and Seborrheic Dermatitis – Towards a More Precise Definition of Scalp Health

    January 2013 in “Acta dermato-venereologica”
    James R. Schwartz, A.G. Messenger, Antonella Tosti, Gail Todd, Maria Hordinsky, Roderick J. Hay, Xuemin Wang, Claus Zachariae, Kathy Kerr, James P. Henry, R.C. Rust, Michael K. Robinson
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    TLDR The document concludes that dandruff and seborrheic dermatitis are linked to inflammation and skin changes, and treating them with specific shampoos can reduce these issues.
    The 2013 document reviews the pathophysiology of dandruff and seborrheic dermatitis (D/SD), emphasizing the role of Malassezia yeasts in triggering inflammatory and hyper-proliferative responses in the skin. It suggests using new biomolecular markers to improve understanding and treatment assessment of D/SD. The pathophysiological changes are categorized into four phases, and the review underlines the need for treatments to normalize skin structure and function. Additionally, a study within the document used non-invasive sampling and ELISA quantification to analyze inflammatory and structural biomarkers in large clinical sample sizes. It found significant differences in biomarker levels between D/SD and normal populations, indicating issues with differentiation and barrier integrity. Treatment with a 1% potentiated ZPT shampoo reduced these biomarkers and correlated with flake reduction, supporting the classification of D/SD as an inflammatory dermatosis and the use of biomarkers in treatment assessment. The document does not provide the number of participants, so the strength of the study cannot be determined.
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