Understanding the dandruff flare-up: A cascade of measurable and perceptible changes to scalp health

IF 2.5 4区 医学 Q2 DERMATOLOGY
Kathryn C. S. Locker, Robert A. Bacon, Tamara L. Caterino, Laurie Breyfogle, Derrick Johnston Alperet, Pradipta Sarkar, Melissa Piliang, Michael G. Davis
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引用次数: 0

Abstract

Objective

Clinical studies assessing the dandruff condition typically focus on the therapeutic resolution of the signs and symptoms of dandruff, starting with a symptomatic scalp as a baseline. The reverse, the progression of events leading to a scalp flare-up after stopping the use of an anti-dandruff (AD) shampoo, is poorly understood. This study explored onset time and progression of the signs and symptoms of dandruff in individuals who stop using an AD shampoo.

Methods

This randomized, double-blind, parallel design study recruited self-identified, scalp-concerned adults. After a 2-week run-in with an AD shampoo, participants were randomized into two groups: The first continued using the AD shampoo and the second switched to a cosmetic (non-AD) shampoo. At baseline and defined intervals over the 28-day study period, objective measures of scalp condition were investigated: expert-assessed flaking, scalp impedance, and biomarkers. These were combined with self-assessments of scalp condition. A Stochastic Mixed-Effect Random Forest (SMERF) machine-learning algorithm was explored to model time-varying technical measurements and daily self-assessment responses from participants.

Results

Switching from an AD shampoo to a non-AD shampoo resulted in increased scalp Malassezia load, degree of flaking, barrier disruption, and inflammatory and oxidative stress biomarkers compared to those maintaining AD shampoo usage. Signs of declining scalp condition (histamine, complement component C3) were observed as early as 3 days after ceasing AD shampoo usage despite no statistical increase in flaking (ASFS) until around 3 weeks of using a non-AD shampoo. These changes were accompanied by self-perceived itching and flaking, reported to be significantly worse in those using the non-AD shampoo compared to the AD shampoo at the end of the study. No statistically significant increase from baseline was observed for any objective measure in the AD shampoo group. In the SMERF model, markers of inflammation, oxidative stress, and Malassezia load were predictive of self-perceived scalp attributes.

Conclusion

For the first time, a comprehensive understanding of changes that occur as scalp condition goes from asymptomatic to dandruff-affected has been established. For scalp-concerned individuals, regular, sustained use of an AD treatment promotes optimal scalp health. When switching to a non-AD shampoo, scalp health deteriorates rapidly, even before visible flakes appear.

Abstract Image

了解头皮屑的爆发:一系列可测量和可察觉的头皮健康变化。
目的:评估头皮屑状况的临床研究通常侧重于头皮屑体征和症状的治疗解决,从有症状的头皮开始作为基线。相反,在停止使用去头屑洗发水后,导致头皮发炎的事件的进展却知之甚少。本研究探讨了停止使用AD洗发水的个体头皮屑的发病时间和体征和症状的进展。方法:这项随机、双盲、平行设计的研究招募了自我认定的、关注头皮的成年人。在使用阿尔茨海默病洗发水两周后,参与者被随机分为两组:第一组继续使用阿尔茨海默病洗发水,第二组切换到化妆品(非阿尔茨海默病)洗发水。在28天的研究期间,在基线和确定的间隔,研究了头皮状况的客观测量:专家评估的剥落,头皮阻抗和生物标志物。这些与头皮状况的自我评估相结合。研究了一种随机混合效应随机森林(SMERF)机器学习算法,以模拟参与者的时变技术测量和日常自我评估反应。结果:与维持AD洗发水使用的人相比,从AD洗发水切换到非AD洗发水导致头皮马拉色菌负荷增加,脱落程度增加,屏障破坏增加,炎症和氧化应激生物标志物增加。早在停止使用AD洗发水3天后就观察到头皮状况下降的迹象(组胺,补体成分C3),尽管直到使用非AD洗发水3周左右,剥落(ASFS)没有统计学上的增加。这些变化伴随着自我感觉的瘙痒和剥落,据报道,在研究结束时,与使用AD洗发水的人相比,使用非AD洗发水的人的情况明显更糟。在AD洗发水组中,任何客观指标均未观察到与基线相比有统计学意义的显著增加。在SMERF模型中,炎症、氧化应激和马拉色菌负荷标记物可预测自我感知的头皮属性。结论:首次全面了解了头皮状况从无症状到头皮屑影响所发生的变化。对于关注头皮的个体,定期持续使用AD治疗可促进最佳的头皮健康。当换用非ad洗发水时,头皮健康状况会迅速恶化,甚至在可见的头皮脱落之前就会出现。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
4.60
自引率
4.30%
发文量
73
期刊介绍: The Journal publishes original refereed papers, review papers and correspondence in the fields of cosmetic research. It is read by practising cosmetic scientists and dermatologists, as well as specialists in more diverse disciplines that are developing new products which contact the skin, hair, nails or mucous membranes. The aim of the Journal is to present current scientific research, both pure and applied, in: cosmetics, toiletries, perfumery and allied fields. Areas that are of particular interest include: studies in skin physiology and interactions with cosmetic ingredients, innovation in claim substantiation methods (in silico, in vitro, ex vivo, in vivo), human and in vitro safety testing of cosmetic ingredients and products, physical chemistry and technology of emulsion and dispersed systems, theory and application of surfactants, new developments in olfactive research, aerosol technology and selected aspects of analytical chemistry.
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