title: Physiological and microbiological verification of the benefit of hair washing in patients with skin conditions of the scalp.
abstract: BACKGROUND
  It is unclear whether hair washing is effective against scalp eruption and pruritus caused by seborrheic dermatitis or psoriasis vulgaris.
  
  
  OBJECTIVE
  To assess whether a proper hair-washing regimen, including the use of antibacterial shampoo, can ameliorate scalp eruption symptoms and alter the composition of the scalp microflora.
  
  
  METHODS
  Eighteen patients with seborrheic dermatitis or psoriasis vulgaris scalp eruptions were instructed in proper techniques of daily hair washing, rinsing, and shampooing, which they underwent for 12 weeks. They used control shampoo in weeks 1-4 and 9-12, and an antibacterial shampoo during weeks 5-8. At the start of the test period and at weeks 4, 8, and 12, we assessed scalp symptoms (erythema, scaling/desquamation, dryness, itchiness, and scratching scars); microbial DNA levels from lesion and nonlesion areas; and levels of interleukin (IL)-1α, IL-1ra, and total protein in the scalp's horny layer.
  
  
  RESULTS
  Compared to baseline values, scaling/desquamation and itchiness improved significantly at weeks 8 and 12. Other observed skin symptoms also improved over time. Malassezia colonization levels in lesion and nonlesion areas decreased gradually; the decrease was significant at week 8 in lesion areas and at weeks 4 and 8 in nonlesion areas. Bacterial colonization levels also decreased gradually, achieving significance in lesion areas at week 4. Gradual decreases in IL-1ra/IL-1α level showed statistical significance at weeks 4 and 12, while the protein quantity significantly decreased at week 12.
  
  
  CONCLUSIONS
  Proper hair washing improved scalp condition symptoms, and possibly the underlying etiology.
authors.affiliation: Department of Dermatology, University of Occupational and Environmental Health, Kitakyushu, Japan.
authors.forename: Miwa
authors.initials: M
authors.lastname: Kobayashi
authors.affiliation: Department of Dermatology, JR Sapporo Hospital, Sapporo, Japan.
authors.forename: Kei
authors.initials: K
authors.lastname: Ito
authors.affiliation: Department of Microbiology, Meiji Pharmaceutical University, Kiyose, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Sugita
authors.affiliation: Tokiwa Pharmaceutical Co., Ltd., Tokyo, Japan.
authors.forename: Yumi
authors.initials: Y
authors.lastname: Murakami
authors.affiliation: Tokiwa Pharmaceutical Co., Ltd., Tokyo, Japan.
authors.forename: Ryoko
authors.initials: R
authors.lastname: Yamashita
authors.affiliation: Tokiwa Pharmaceutical Co., Ltd., Tokyo, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Matsunaka
authors.affiliation: Department of Dermatology, University of Occupational and Environmental Health, Kitakyushu, Japan.
authors.forename: Motonobu
authors.initials: M
authors.lastname: Nakamura
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001419:Bacteria / Q000302:isolation & purification; D004269:DNA, Bacterial / Q000032:analysis; D004271:DNA, Fungal / Q000032:analysis; D012628:Dermatitis, Seborrheic / Q000378:metabolism / Q000382:microbiology* / Q000628:therapy; D004890:Erythema / Q000628:therapy; D005260:Female; D006197:Hair; D006203:Hair Preparations / Q000627:therapeutic use*; D006801:Humans; D006920:Hygiene; D053590:Interleukin 1 Receptor Antagonist Protein / Q000378:metabolism; D053582:Interleukin-1alpha / Q000378:metabolism; D008290:Malassezia / Q000302:isolation & purification; D008297:Male; D008875:Middle Aged; D011537:Pruritus / Q000628:therapy; D011565:Psoriasis / Q000378:metabolism / Q000382:microbiology* / Q000628:therapy; D012535:Scalp / Q000378:metabolism / Q000382:microbiology; D012536:Scalp Dermatoses / Q000378:metabolism / Q000382:microbiology* / Q000628:therapy; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D004269:DNA, Bacterial; D004271:DNA, Fungal; D006203:Hair Preparations; C507763:IL1RN protein, human; D053590:Interleukin 1 Receptor Antagonist Protein; D053582:Interleukin-1alpha
keywords: Malassezia spp.; bacteria; proper hair washing; psoriasis vulgaris; seborrheic dermatitis; shampoo