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Narshana and Ravikumar, IJPSR, 2018; Vol. 9(2): 417- 431. E-ISSN: 0975-8232; P-ISSN: 2320-5148 Narshana and Ravikumar, IJPSR, 2018; Vol. 9(2): 417- 431. E-ISSN: 0975-8232; P-ISSN: 2320-5148 IJPSR (2018), Volume 9, Issue 2 (Review Article) Received on 14 May, 2017; received in revised form, 22 July, 2017; accepted, 25 July, 2017; published 01 February, 2018 AN OVERVIEW OF DANDRUFF AND NOVEL FORMULATIONS AS A TREATMENT STRATEGY M. Narshana*and P. Ravikumar Dr. Bhanuben Nanavati College of Pharmacy, Vile Parle (West), Mumbai - 400058, Maharashtra, India. Keywords: ABSTRACT: This review gives an insight of the scalp condition- Liposomes, Solid lipid dandruff which affects more than 50% of the human population. nanoparticles, Malassezia, Malassezia furfur is reported as the main cause of dandruff. This article Anti- dandruff agents, Novel aims at investigating other causes of dandruff which include microbial formulations, Silver nanoparticles and non - microbial factors. These factors have been explained in this Correspondence to Author: article. It also highlights the various treatment options and newer Ms. M. Narshana formulations. Various active agents like anti- fungal agents, keratolytic M. Pharm, agents and anti - proliferative agents that are used against dandruff, along Dr. Bhanuben Nanavati College with their mechanisms of action are covered in this article. Conventional of Pharmacy, Gate No.1, Mithibai formulations like Shampoos, creams and lotions have their own set of College Campus, Vaikunthlal Mehta advantages and limitations. To overcome the disadvantages and prolong Road, Vile Parle (West), Mumbai - 400056, Maharashtra, India. the release of actives, novel formulations like Liposomes, Niosomes, Solid lipid nanoparticles, Nanolipid carriers and Silver nanoparticles are E-mail: [email protected] being developed. Novel delivery systems have been successfully used for pharmaceutical formulations and they can prove to be a promising delivery system for scalp treatment too. INTRODUCTION: Scalp is unique among skin Even minor changes in hair like greying of hair, areas in human. It is characterized by thick skin affects the self-confidence and self- esteem of an layer with high follicular density and abundant individual. Scalp disorders include fungal and sebaceous glands. The pH of scalp is 5.5 and that of bacterial infestations that cause problems like Tinea a hair shaft is 3.67 1. The presence of these glands capitis or Pediculosis capitis. There are various along with the dark and warm environment of the types of Scalp disorders 2 some common and some scalp makes it more prone to mycotic infections uncommon. These include- (Ref Fig. 1). like dandruff, seborrhoeic dermatitis and even parasitic infections like Pediculosis capitis. 1. Alopecia- Hair loss. Although scalp disorders are not among those that 2. Seborrheic Dermatitis- inflammation of cause severe physical illness or morbidity, yet are scalp skin characterized by scaly, itchy, of great social concern. Scalp and hair conditions flaky skin. have more of psychological impact in human 3. Ring Worm-also known as Tinea capitis is a societies. cutaneous fungal infection of scalp, the causative fungi is Trichophytum rubrum. QUICK RESPONSE CODE DOI: 4. Scalp psoriasis- It’s a common scalp skin 10.13040/IJPSR.0975-8232.9(2).417-31 disorder characterized by raised reddish patches that may spread beyond the scalp to Article can be accessed online on: forehead or back of the neck or ears. www.ijpsr.com 5. Scalp folliculitis- Inflammation of hair DOI link: http://dx.doi.org/10.13040/IJPSR.0975-8232.9(2).417-31 follicle. International Journal of Pharmaceutical Sciences and Research 417 Narshana and Ravikumar, IJPSR, 2018; Vol. 9(2): 417- 431. E-ISSN: 0975-8232; P-ISSN: 2320-5148 6. Head Lice- scientifically termed as Causes: The cause of dandruff varies among Pediculosis capitis, is a contagious infection individuals, depending on their susceptibility. caused by an obligate parasite, called Causes can be classified into- a) Microbial and b) Pediculus humanus capitis, resides on Non-microbial. human scalp and feeds on human blood. 7. Dandruff- It is the shedding of the dead skin Microbial Factors: cells. 1. Fungal: Malassezia furfur is considered as the leading cause of dandruff. The fungi - Malassezia can lead to dandruff by either or both of the following mechanisms- Malassezia stimulates the enzyme called Lipase on the scalp. The enzyme causes oxidation of triglycerides of sebum to produce unsaturated and saturated fatty acids. Saturated fatty acids are consumed by the fungi for self-proliferation and growth. Unsaturated fatty acids include oleic acid and arachidonic acid. Oleic acid is an irritant for human skin while arachidonic acid is involved in potentiating the inflammatory responses. Hence the result of the degradation FIG. 1: DEPICTS THE CLASSIFICATION OF SCALP of the fatty acids is scalp skin irritation, DISORDERS inflammation and fungal growth. These further Some disorders have a definite cause while some cause dry flakes called dandruff. Fig. 2 may be idiopathic. Treatment of these disorders is represents this mechanism. important for personal hygiene. The other mechanism by which this fungi Dandruff: causes dandruff is altering the normal shedding Definition: Dandruff is a common scalp disorder, of dead skin cells. Few enzymes on scalp eat up characterized by presence of corneocytes that form connections between dead skin cells to slough clusters due to their high cohesive power, in the them individually. Malassezia modifies this form of flaky white to yellowish scales, function of enzymes and inhibits cutting of the 3 accompanied by itching . It has been observed that connections. This leads to aggregation of dandruff occurs mainly between puberty to middle- corneocytes that shed off in clusters, leading to age, the phase when sebaceous glands are most visible white flakes. This mechanism has been active. explained in the Fig. 3. FIG. 2: REPRESENTS THE MECHANISM BY WHICH MALASSEZIA FURFUR CAUSES DANDRUFF International Journal of Pharmaceutical Sciences and Research 418 Narshana and Ravikumar, IJPSR, 2018; Vol. 9(2): 417- 431. E-ISSN: 0975-8232; P-ISSN: 2320-5148 4. Oily or irritated skin. 5. Dirt accumulation due to less frequent shampooing. 6. Sensitivity to hair cosmetics. 7. Other scalp conditions like psoriasis, eczema, etc. Treatment: Treatment of dandruff can be done by 7 FIG. 3: EXPLAINS ANOTHER MECHANISM BY adopting any or all of the following strategies: WHICH DANDRUFF IS CAUSED Treatment strategies include: (Refer Fig. 4) 2. Bacterial: Disequilibrium in the proportion of 1. Treatment of the Cause: This primarily the two main bacterial populations found on scalp includes use of anti-fungal agents like Zinc Propionibacterium acnes and Staphylococcus Pyrithione, Selenium sulphide, Ketoconazole, epidermidis may also be a cause of dandruff 4, 5. Climbazole, etc. b) Non-microbial Factors: 2. Treatment of the Symptoms: This comprises of employing anti- proliferative like coal tar 6 1. Damage to the scalp Stratum corneum . and keratolytic agents like Salicylic acid. 2. Individual susceptibility to Oleic acid. 3. Dry scalp. FIG. 4: CLASSIFIES TREATMENT STRATEGIES FOR DANDRUFF 1. Zinc Pyrithione: Most common anti-fungal Normally 0.5-2% concentration of ZPT is used drug used for dandruff treatment in various in shampoos for Anti-fungal activity. formulations. Side Effects: No common side effects. But may be harmful on ingestion. Rare but severe allergic reactions include rash, hives, difficulty in breathing, tightness in the chest, swelling of the mouth, face, lips, or tongue, skin irritation, etc. and these need immediate attention. Mechanism of Action: (Refer Fig 5a and Fig. 5b) 9. Zinc Pyrithione increases the intracellular Copper reserves in the fungal cells, which leads to formation of endogeneous CuPT. International Journal of Pharmaceutical Sciences and Research 419 Narshana and Ravikumar, IJPSR, 2018; Vol. 9(2): 417- 431. E-ISSN: 0975-8232; P-ISSN: 2320-5148 This then leads to loss of iron-sulphur protein This will deactivate the enzyme Aconitase loading activity. which further leads to cellular toxicity. FIG. 5A: MECHANISM OF ACTION OF ZINC PYRITHIONE FIG. 5B: CELLULAR MECHANISM OF ZINC PYRITHIONE 2. Ketoconazole: Another commonly used anti- Consult Doctor in case of effects like severe fungal drug. itching, burning, or irritation where the medicine is applied; oily or dry scalp, mild hair loss; redness, pain, or oozing of treated skin areas; or eye redness, swelling, or irritation. Mechanism of Action: (Refer Fig. 6). Ketoconazole acts by intervening Ergosterol biosynthesis. Normally 0.25-2% concentration of Ketoconazole It inhibits the Cyp-450 enzyme 11 responsible is used in shampoos for Anti-fungal activity. for conversion of Lanosterol to Ergosterol. Side Effects: Less serious side effects include: Inhibition of Ergosterol synthesis disrupts the membrane function and increases the mild skin itching or irritation; dry skin; or 12 headache. permeability . FIG. 6: MECHANISM OF ACTION OF KETOCONAZOLE International Journal of Pharmaceutical Sciences and Research 420 Narshana and Ravikumar, IJPSR, 2018; Vol. 9(2): 417- 431. E-ISSN: 0975-8232; P-ISSN: 2320-5148 3. Climbazole: It is one of the newer anti-fungal reduces cellular adhesion in the Stratum drugs used usually in combination or as a corneum. monotherapy 13. It also has local irritant, antibacterial, and mild antifungal activity, which may contribute to its effectiveness. Its anti-mitotic mechanism of action involves decrease in the rate of incorporation of thymidine
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