The lipophilic yeast Malassezia spp. normally inhabits the scalp, making up about 45% of its resident microflora. In patients with dandruff, it is the predominant yeast type with about 75%. Modern classification and nomenclature of Malassezia spp. are based on DNA typing. The most common types found on the scalp are M. restricta and M. globosa, the latter of which in particular has a major role in the development of dandruff given its high level of lipase activity resulting in breakdown of sebum to free fatty acids that auto-oxidize to skin-irritating lipoperoxides.
Therefore, the mainstay for treatment of dandruff and preserving a healthy scalp is the use of anti-microbial shampoos that are effective in inhibiting Malassezia yeasts. Appropriate shampoo formulation allowing efficacy with short contact time.
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