Introduction:

Seborrheic dermatitis of the scalp (SD) can cause physical discomfort and social embarrassment for those affected. Mild to moderate DS of the scalp can be managed using topical products with antifungal, anti-inflammatory and keratolytic properties.

Method:

A two-phase randomized controlled trial was conducted to evaluate the clinical efficacy of a newly formulated anti-DS shampoo containing two patented antifungal actives, and to examine associated changes in scalp microbiota. The intervention comprised a 2-week intensive phase for the 42 subjects included in the study, consisting of application of the anti-DS shampoo three times a week; a randomized [1:1], controlled, parallel-group 8-week maintenance phase, in which the test group applied the study shampoo once a week alternating with a neutral shampoo twice a week; and the control group applied the neutral shampoo alone three times a week.

Results:

After the intensive phase, scalp condition improved significantly, as evidenced by a significant decrease in the severity of dandruff, erythema and pruritus, coupled with an improvement in DS-related dysbiosis. These improvements were more durable in the test group than in the control group during the maintenance phase. Rediversification of the scalp microbiota involved a significant increase in fungal and bacterial richness, as well as a decrease in the level of Malassezia fungi and Staphylococcusbacteria predominant in DS, and an increase in the level of sparsely abundant fungal genera belonging to thePhylum Ascomycota.

Conclusion:

The synergistic effects of antimycotic and anti-inflammatory agents in the shampoo studied probably contributed to rebalancing the fungal and bacterial ecosystem, thus improving scalp symptoms.