Seborrheic dermatitis: topical therapeutics and formulation design.

Sean E Mangion, Lorraine Mackenzie, Michael S Roberts, Amy M Holmes

Journal: European journal of pharmaceutics and biopharmaceutics : official journal of Arbeitsgemeinschaft fur Pharmazeutische Verfahrenstechnik e.V 2023;185():148-164

PMID: 36842718

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Abstract

Seborrheic dermatitis (SD) is a common dermatological disorder with symptoms that include skin flaking, erythema and pruritus. This review discusses the topical products available for treating SD, which target several aspects of disease pathobiology, including cutaneous microbial dysbiosis (driven by Malassezia yeast), inflammation, sebum production and skin barrier disruption. Among the various treatments available, zinc pyrithione (ZnPT) based products that exhibit anti-fungal action are the market leaders. A skin compartment approach is presented here for combining ZnPT exposure information with threshold levels for anti-fungal efficacy and toxicity, overall providing a comprehensive picture of ZnPT therapeutics and safety. While Malassezia yeast on the surface are effectively targeted, yeast residing beyond the superficial follicle may not receive adequate ZnPT for anti-fungal effect forming the basis for skin re-colonisation. Levels entering systemic circulation from topical delivery are well below toxic thresholds, however the elevated zinc levels within the viable epidermis warrants further investigation. Strategies to improve formulation design can be broadly classified as influencing 1) topical delivery, 2) therapeutic bioactivity, 3) skin mildness, and 4) sensory attributes. Successful SD treatment ultimately requires formulations that can balance efficacy, safety, and consumer appeal.

Address: UniSA: Clinical and Health Sciences, University of South Australia, Adelaide 5000, South Australia, Australia; Therapeutics Research Centre, Basil Hetzel Institute for Translational Health Research, The Queen Elizabeth Hospital, Woodville South 5011, South Australia, Australia; Sydney Medical School, University of Sydney, Camperdown 2050, New South Wales, Australia.; UniSA: Clinical and Health Sciences, University of South Australia, Adelaide 5000, South Australia, Australia; Therapeutics Research Centre, Basil Hetzel Institute for Translational Health Research, The Queen Elizabeth Hospital, Woodville South 5011, South Australia, Australia.; UniSA: Clinical and Health Sciences, University of South Australia, Adelaide 5000, South Australia, Australia; Therapeutics Research Centre, Basil Hetzel Institute for Translational Health Research, The Queen Elizabeth Hospital, Woodville South 5011, South Australia, Australia; Therapeutics Research Centre, Frazer Institute, University of Queensland, Woolloongabba 4102, Queensland, Australia.; UniSA: Clinical and Health Sciences, University of South Australia, Adelaide 5000, South Australia, Australia; Therapeutics Research Centre, Basil Hetzel Institute for Translational Health Research, The Queen Elizabeth Hospital, Woodville South 5011, South Australia, Australia. Electronic address: [email protected].

DOI: 10.1016/j.ejpb.2023.01.023

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MeSH Terms: Humans, Dermatitis, Seborrheic, Saccharomyces cerevisiae, Skin, Epidermis, Sebum, Malassezia