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Three Etiologic Facets of Dandruff and Seborrheic Dermatitis: Malassezia Fungi, Sebaceous Lipids, and Individual Sensitivity
Open accessAbstract
Application of new molecular and biochemical tools has greatly increased our understanding of the organisms, mechanisms, and treatments of dandruff and seborrheic dermatitis. Dandruff results from at least three etiologic factors: Malassezia fungi, sebaceous secretions, and individual sensitivity. While Malassezia (formerly P. ovale) has long been a suspected cause, implicated by its presence on skin and lipophylic nature, lack of correlation between Malassezia number and the presence and severity of dandruff has remained perplexing. We have previously identified the Malassezia species correlating to dandruff and seborrheic dermatitis. In this report, we show that dandruff is mediated by Malassezia metabolites, specifically irritating free fatty acids released from sebaceous triglycerides. Investigation of the toxic Malassezia free fatty acid metabolites (represented by oleic acid) reveals the component of individual susceptibility. Malassezia metabolism results in increased levels of scalp free fatty acids. Of the three etiologic factors implicated in dandruff, Malassezia, sebaceous triglycerides, and individual susceptibility, Malassezia are the easiest to control. Pyrithione zinc kills Malassezia and all other fungi, and is highly effective against the Malassezia species actually found on scalp. Reduction in fungi reduces free fatty acids, thereby reducing scalp flaking and itch.
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Individual predispositions and host interactions with Malassezia, rather than the mere presence of Malassezia, contribute to SD and dandruff pathogenesis.
“While these observations support a pathogenic role for Malassezia in SD and dandruff, there is also strong evidence suggesting that individual predispositions and host interactions with Malassezia, rather than the mere presence of Malassezia, contribute to SD and dandruff pathogenesis.”
From Seborrheic Dermatitis and Dandruff: A Comprehensive Review (2015) · cites this paper as [48]
Dandruff patients are more reactive (higher itch perception or flaking) than controls to topical applications of histamine or oleic acid to the scalp.
“Consistent with the structural findings, dandruff patients have been found to be more reactive (higher itch perception or flaking) than controls to topical applications of histamine or oleic acid to the scalp [48,69,70].”
From Seborrheic Dermatitis and Dandruff: A Comprehensive Review (2015) · cites this paper as [48]
Topical application of oleic acid did not induce visible changes in non-dandruff subjects, but caused skin flaking on the non-lesional scalp of dandruff patients.
“Moreover, while topical application of oleic acid did not induce visible changes in non-dandruff subjects, it caused skin flaking on the non-lesional scalp of dandruff patients [48].”
From Seborrheic Dermatitis and Dandruff: A Comprehensive Review (2015) · cites this paper as [48]
These observations suggest intrinsic epidermal barrier defects in the pathogenesis of SD and dandruff.
“These observations are suggestive of intrinsic epidermal barrier defects in the pathogenesis of SD and dandruff [48].”
From Seborrheic Dermatitis and Dandruff: A Comprehensive Review (2015) · cites this paper as [48]
Among the multiple chemical entities effective in treating SD and dandruff, the sole common mechanism of action is antifungal activity.
“Additionally, among the multiple chemical entities that are effective in treating SD and dandruff, such as azoles, hydroxypyridones, allylamines, selenium and zinc, the sole common mechanism of action is antifungal activity [47–49].”
From Seborrheic Dermatitis and Dandruff: A Comprehensive Review (2015) · cites this paper as [48]
Citations
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Sorted by citations
Seborrheic Dermatitis and Dandruff: A Comprehensive Review
(2015) · Journal of Clinical and Investigative Dermatology · doi:10.13188/2373-1044.1000019 · Cited by 398
Naldi, L., & Rebora, A. (2009) · New England Journal of Medicine · doi:10.1056/nejmcp0806464 · Cited by 188
Isolation and Expression of a Malassezia globosa Lipase Gene, LIP1
DeAngelis, Y. M., Saunders, C. W., Johnstone, K. R., Reeder, N. L., Coleman, C. G., Kaczvinsky, J. R., Gale, C., Walter, R., Mekel, M., Lacey, M. P., et al. (2007) · Journal of Investigative Dermatology · doi:10.1038/sj.jid.5700844 · Cited by 164
Self-citationTurner, G. A., Matheson, J. R., Li, G. ‐., Fei, X. ‐., Zhu, D., & Baines, F. L. (2013) · International Journal of Cosmetic Science · doi:10.1111/ics.12007 · Cited by 43
Essential Oils as Potential Source of Anti‐Dandruff Agents: A Review
Arora, P., Nainwal, L. M., & Jain, S. (2022) · Combinatorial Chemistry & High Throughput Screening · doi:10.2174/1386207324666210712094148 · Cited by 23
Metadata
- Authors
- DeAngelis, Y. M., Gemmer, C. M., Kaczvinsky, J. R., Kenneally, D. C., Schwartz, J. R., & Dawson, T. L.
- Affiliations
- Procter & Gamble (United States) (US)
- Corresponding author
- Dawson, Thomas L.
- Venue
- Journal of Investigative Dermatology Symposium Proceedings
- Publisher
- Elsevier BV
- Published
- 2005-12
- Volume
- 10
- Issue
- 3
- Pages
- 295-297
- ISSN
- 1087-0024 (ISSN-L)
- OpenAlex
- W2077400262
- Cited by
- 289
- References
- 1
- Citations by year
- 2026: 12 · 2025: 21 · 2024: 17 · 2023: 17 · 2022: 26 · 2021: 15 · 2020: 27 · 2019: 23 · 2018: 8 · 2017: 19 · 2016: 17 · 2015: 9 · 2014: 11 · 2013: 15 · 2012: 12
- FWCI
- 95.65
- Type
- conference paper
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of Investigative Dermatology Symposium Proceedings (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Dermatology › Nail Diseases and Treatments
- Health Sciences › Medicine › Dermatology › Dermatology and Skin Diseases
- Health Sciences › Medicine › Dermatology › Hair Growth and Disorders
- Keywords
- dandruff, seborrheic dermatitis, Malassezia, sebaceous lipids, free fatty acids, oleic acid, individual sensitivity, pruritus
- MeSH terms
- Disease Susceptibility, Humans, Keratolytic Agents, Malassezia, Models, Biological, Scalp, Sebaceous Glands, Dermatitis, Seborrheic, Sebum, Case-Control Studies, Oleic Acid
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