Abstract
BACKGROUND: Scalp seborrheic dermatitis (SD) is a chronic, recurrent inflammatory skin condition associated with scalp sebum secretion and dysbiosis. AIMS: The aim of this study is to evaluate the efficacy and safety of a topical salicylic acid/piroctone olamine/zinc salt of L-pyrrolidone carboxylate (Zinc PCA) scalp pre-application gel in combination with a salicylic acid/piroctone olamine/antimicrobial peptide cleansing lotion for the treatment of moderate to severe scalp SD. PATIENTS/METHODS: In this prospective cohort study, 20 patients with moderate to severe scalp SD were treated with a combination of the scalp pre-application gel and cleansing lotion for 4 weeks (one tube of the pre-application gel per week and the cleansing lotion used every 1-3 days depending on the frequency of hair washing). This was followed by maintenance treatment with the cleansing lotion for 12 weeks. Efficacy was assessed through clinical and trichoscopic examinations, measuring the severity of dandruff, itching, erythema, and greasiness using a 4-point scale. RESULTS: This cohort study included a total of 20 patients with moderate to severe scalp SD. By the 4th week, the average dandruff score had significantly decreased from a baseline of 2.45 to 1.10 (p < 0.01). The average itchiness score reduced from 2.35 to 1.10 (p < 0.01), the erythema score dropped from 1.55 to 1.10 (p < 0.05), and the greasiness score decreased from 2.60 to 1.40 (p < 0.01). After 16 weeks, 12 patients with severe SD improved to mild SD, and six patients with moderate SD also improved to mild. During the treatment, two patients experienced a recurrence of dandruff, which subsequently resolved. The overall clinical improvement was 80%. CONCLUSIONS: Our study results indicate that the combination treatment of the scalp pre-application gel and cleansing lotion is highly effective and safe for treating SD. The subsequent use of the cleansing lotion effectively maintains the benefits of the combined treatment. Trichoscopic examination provides accurate and reliable quantifiable data, aiding in the monitoring of treatment progress.