Abstract
Background/Aim: Dandruff is a common scalp problem associated with flaky and inflamed skin. In this study, we investigated the efficacy of a shampoo containing piroctone olamine and climbazole and the combination of this shampoo with a scalp tonic containing piroctone olamine and licochalcone A, derived from Glycyrrhiza inflata root extract, to reduce dandruff. Study Design/Methods: After conditioning, 102 subjects (♂ 56 and 46 ♀) with moderate to very strong dandruff affection underwent a randomized half head study for 4 weeks. The volunteers’ heads were washed regularly either with a placebo or the anti-dandruff shampoo, followed by the anti-dandruff tonic application or no treatment. In a 2-week post-treatment phase, subjects only applied placebo shampoo. Every two weeks, trained experts assessed dandruff affection based on a scale of 1 to 6. At study start and after every 2 weeks, cytokine concentrations and anti-fungal activity of test products were determined in scalp wash-ups by enzyme-linked immunosorbant assays or a Malassezia colony-forming assay, respectively. Results: Results of expert grading and anti-fungal activity revealed a significant reduction in dandruff affection and Malassezia colony-forming units after treatment with the anti-dandruff shampoo or its combination with the tonic. Dandruff affection even remained reduced in the post-treatment phase when levels of Malassezia colony-forming units had returned to baseline. Cytokine analyses proved a significant decrease in pro-inflammatory dandruff markers after treatment with both anti-dandruff products. For the shampoo/tonic combination, a superior reduction of one scalp inflammatory marker was determined even after the post-treatment phase. Conclusion: Both the rinse-off shampoo as well as its combination with the leave-on tonic excellently alleviated dandruff and its associated micro-inflammation. Both treatments showed anti-fungal activity. The superior benefit, exerted by the combination, is primarily based on the known anti-inflammatory effect of licochalcone A and the improved scalp substantivity of the leave-on application.
Highlights
Dandruff represents a common scalp disorder affecting half of the world’s population regardless of gender or ethnicity [1]
The etiology of dandruff is dependent on the following factors: sebum secreted by sebaceous glands, metabolization of sebum by Malassezia species leading to the production of irritating unsaturated free fatty acids, and the individual susceptibility to these free fatty acids and subsequent inflammation [5]
Volunteers showing moderate to very strong dandruff affection participated in this in vivo study, which was performed to determine the efficacy of placebo shampoo, verum shampoo alone or verum shampoo in combination with tonic treatment to treat dandruff
Summary
Dandruff represents a common scalp disorder affecting half of the world’s population regardless of gender or ethnicity [1]. Since dandruff is a chronic relapsing condition, this disorder has a considerable impact on individual quality of life [4]. The etiology of dandruff is dependent on the following factors: sebum secreted by sebaceous glands, metabolization of sebum by Malassezia species leading to the production of irritating unsaturated free fatty acids, and the individual susceptibility to these free fatty acids and subsequent inflammation [5]. Dandruff symptoms are believed to be the result of a disturbed barrier function, which leads to (micro)-inflammation, and interferes with normal cell proliferation and differentiation [6]
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