Follicles, Fungi, And Scalp Conditions

September 2011 in “ British Journal of Dermatology ”

Andrew G. Messenger

seborrhoeic dermatitis dandruff Malassezia azole antifungal treatments hair follicle infundibulum zinc pyrithione SD antifungal treatments

TLDR Malassezia yeast plays a key role in dandruff and seborrhoeic dermatitis.

Towards the end of the 19th century, seborrhoeic dermatitis and dandruff (SD/D) were attributed to a small micro-organism, likely a lipophilic yeast of the genus Malassezia. This idea was later replaced by the concept of SD/D as a hyperproliferative disorder with secondary microbial colonization. However, the effectiveness of azole antifungal treatments in the late 1970s and early 1980s revived interest in Malassezia's role in SD/D. Despite its commensal status, evidence strongly supported Malassezia's key role in SD/D pathogenesis. Advances in Malassezia biology, including subspecies identification and genome sequencing, have enhanced understanding of SD/D pathogenesis and treatment. Recent studies highlighted the hair follicle infundibulum's role in SD/D and as a drug delivery target, along with new insights into zinc pyrithione's mechanism and delivery.

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