In daily life, problems such as dandruff, itching, oily hair, and hair loss often plague us, and as one of the ten standards for healthy people issued by the World Health Organization, scalp health is the real "top priority".
Many scalp health problems are related to Malassezia, Malassezia is a conditionally pathogenic bacteria that resides on the surface of human beings, when the body's immunity is low or there are triggers, Malassezia can multiply and cause a variety of diseases, such as pityriasis versicolor, Malassezia folliculitis, seborrheic dermatitis and atopic dermatitis. Seborrheic dermatitis usually presents with an oily scalp with erythema, papules, scales, and itching. In addition to seborrheic dermatitis, androgenetic alopecia and other problems are also the most common hair loss diseases, the largest number of patients, androgenetic alopecia in recent years is very young trend, and patients are often accompanied by seborrheic dermatitis, recently, by the Chinese Association of Integrative Medicine ** STD Professional Committee Trichoriology Group four experts jointly prepared the "Ketoconazole Lotion Expert Consensus" (hereinafter referred to as the "consensus") published in the ** Chinese core journal "Clinical ** Journal". This is the first expert consensus on ketoconazole lotion in China, which is an in-depth elaboration of the mechanism of action, clinical application, efficacy and safety research progress of ketoconazole lotion in different diseases, and the use of ketoconazole lotion is proposed based on the evidence of existing clinical trials and clinical application, aiming to provide a scientific reference for common scalp health problems such as seborrheic dermatitis.
What scalp health problems require medication?Recently, I interviewed Professor Yang Qinping, the author and corresponding author of the "Expert Consensus on Ketoconazole Lotion", Professor Yang Qinping, Chief Physician of the Department of Huashan Hospital Affiliated to Fudan University. Yang Qinping said that if there is persistent or frequent dandruff, oily hair, scalp itching, hair loss or scalp thinning, and receding hairline, this problem continues to be unimproved or very frequent, it is necessary to pay attention to examination, clear diagnosis, and effective **.
Malassezia multiplies can lead to a variety of scalp health problems.
In modern society, hair and scalp problems are getting more and more attention. Scalp and hair problems plague many people, more than 50% of the world's people can't avoid dandruff health problems, and there are 200 million dandruff patients in China. These scalp health problems are all linked to Malassezia.
Malassezia spp. are conditionally pathogenic bacteria that reside on the surface of humans. When the body's immunity is low or there are triggers, Malassezia can multiply in large numbers and cause a variety of diseases, such as pityriasis versicolor, Malassezia folliculitis, seborrheic dermatitis and atopic dermatitis. Seborrheic dermatitis usually presents with an oily scalp with erythema, papules, scales, and itching. Patients with moderate to severe seborrheic dermatitis may have a greasy smell and thick scabs on the scalp, and hair loss, and the excess sebum secreted by the scalp tissue will provide nutrients to Malassezia, which will affect the growth and development of hair follicles, and then make it difficult for hair to grow. These two often go hand in hand, which greatly affects the image and temperament.
Yang Qinping said that scalp health is the foundation of hair health, and only with a good scalp can there be good hair. Nowadays, many people are overstressed, stay up too late, and have poor eating habits, which leads to excessive production of scalp oil, which exacerbates the growth of Malassezia. "Malassezia metabolites and sweat stimulation can easily cause inflammation such as seborrheic dermatitis, which can then damage the scalp environment, resulting in dandruff, itching, and even hair loss, such as androgenetic alopecia, which is often accompanied by seborrheic dermatitis. If the scalp is itchy for a long time, there is a lot of dandruff, or the hair is very oily, it may be a sign of seborrheic dermatitis and needs to be taken seriously. ”
The consensus pointed out that ketoconazole lotion has antibacterial and anti-inflammatory effects, can kill and inhibit the growth of Malassezia from the source, is the gold standard for seborrheic dermatitis, and has been recommended as a first-line drug for pityriasis (dandruff), seborrheic dermatitis and pityriasis versicolor. The efficacy and safety of 1%-2% ketoconazole lotion topical**Seborrheic dermatitis Pityriasis (dandruff) of the scalp has been demonstrated in 20 randomized controlled studies and is the most well-documented drug available, significantly improving dandruff, pruritus, and erythema.
Standardize the use of drugs to achieve "chronic disease" long-term care.
For the problem of hormones that many people are worried about, Professor Yang said that do not "talk about hormones and discoloration", hormones are very important drugs for diseases, and they have a strong and rapid anti-inflammatory and anti-allergic effect. Moreover, hormones only stay on the scalp for a short time, and the absorption of the scalp and the human body is very low. The specific use of ketoconazole lotion or compound ketoconazole lotion should be decided according to the symptoms of the scalp, if there is obvious scalp itching, you can choose compound ketoconazole lotion to quickly relieve itching, and then use ketoconazole lotion to maintain **, which can have a good effect.
In terms of standardized medication, Yang Qinping emphasized that if it is simple seborrheic dermatitis, the lotion needs to be twice a week, and the drug cannot be stopped immediately after the symptoms improve, but should be gradually reduced to once a week, and it needs to be maintained for a long time. Ketoconazole lotion is the gold standard for seborrheic dermatitis, after 2 times a week, it can effectively improve symptoms such as dandruff, itching, erythema, etc., and the rate of ketoconazole lotion is higher, according to relevant data, the rate of use for 4 weeks can reach 88%, and the follow-up can consolidate the effect once a week and prevent it.
Consensus recommends that patients with mild seborrheic dermatitis can be treated with ketoconazole lotion**, which is recommended to be used twice a week for a total of 4 weeks. After the effect, use it once a week for 2-3 months**, which can be effectively prevented**. For patients with moderate to severe seborrheic dermatitis, topical corticosteroids or combined ketoconazole hair lotion can be used as a single agent.
In addition to seborrheic dermatitis, hair loss problems such as androgenetic alopecia have also become people's "top priority". As the most common and most common type of hair loss disease, androgenetic alopecia (referred to as androgenetic alopecia) has become very young in recent years. Androgenetic alopecia, formerly known as seborrheic alopecia, is characterized by thinning, softening, and gradual loss of hair on the top of the head and hairline. And it is often accompanied by seborrheic dermatitis, on the one hand, severe seborrheic dermatitis can lead to hair loss, on the other hand, seborrheic dermatitis can promote the development of androgenetic alopecia.
In this regard, Yang Qinping reminded that hair loss has a certain similarity with some chronic diseases such as diabetes and hypertension, which require long-term management, long-term **, and androgenetic alopecia is often irreversible. In clinical practice, scalp seborrheic dermatitis is usually used to improve the scalp microenvironment, which further plays the role of androgenetic alopecia. Therefore, hair growth drugs such as finasteride and minoxidil combined with ketoconazole lotion are common recommended regimens.