A Folliculocentric Perspective of Dandruff Pathogenesis: Could a Troublesome Condition Be Caused by Changes to a Natural Secretory Mechanism?

The document investigates dandruff pathogenesis from a folliculocentric perspective, emphasizing the role of hair follicles (HFs) and their unique immune microenvironment. It identifies key factors such as microbial dysbiosis involving Malassezia spp. and other bacteria, weakened epidermal barrier, increased inflammation, and abnormal keratinocyte differentiation. The study suggests that changes in HF function, including insufficient immunoinhibitory signaling, contribute to dandruff. The authors propose that targeting HF microbiota, immune responses, and barrier function could lead to more effective long-term treatments than current anti-dandruff shampoos.