Evidence map›Paper›PMID 40162583›Full record

Trial reportInternational journal of cosmetic science2025

Understanding the dandruff flare-up: A cascade of measurable and perceptible changes to scalp health.

Kathryn C S Locker, Robert A Bacon, Tamara L Caterino, Laurie Breyfogle, Derrick Johnston Alperet, Pradipta Sarkar, Melissa Piliang, Michael G Davis

Abstract readRandomized Controlled Trial
In one paragraph

Trial report in International journal of cosmetic science, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Trial
  2. Review
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Kathryn C S LockerThe Procter & Gamble Company, Mason, Ohio, USA.ORCID https://orcid.org/0000-0002-3669-3617
Robert A BaconThe Procter & Gamble Company, Mason, Ohio, USA.
Tamara L CaterinoThe Procter & Gamble Company, Mason, Ohio, USA.
Laurie BreyfogleThe Procter & Gamble Company, Mason, Ohio, USA.
Derrick Johnston AlperetThe Procter & Gamble Company, Singapore.
Pradipta SarkarThe Procter & Gamble Company, Singapore.
Melissa PiliangDepartment of Dermatology, Cleveland Clinic, Cleveland, Ohio, USA.
Michael G DavisThe Procter & Gamble Company, Mason, Ohio, USA.

Funding

The Procter & Gamble Company
6 · The paper itself

Abstract

objectiveClinical studies assessing the dandruff condition typically focus on the therapeutic resolution of the signs and symptoms of dandruff, starting with a symptomatic scalp as a baseline. The reverse, the progression of events leading to a scalp flare-up after stopping the use of an anti-dandruff (AD) shampoo, is poorly understood. This study explored onset time and progression of the signs and symptoms of dandruff in individuals who stop using an AD shampoo.

methodsThis randomized, double-blind, parallel design study recruited self-identified, scalp-concerned adults. After a 2-week run-in with an AD shampoo, participants were randomized into two groups: The first continued using the AD shampoo and the second switched to a cosmetic (non-AD) shampoo. At baseline and defined intervals over the 28-day study period, objective measures of scalp condition were investigated: expert-assessed flaking, scalp impedance, and biomarkers. These were combined with self-assessments of scalp condition. A Stochastic Mixed-Effect Random Forest (SMERF) machine-learning algorithm was explored to model time-varying technical measurements and daily self-assessment responses from participants.

resultsSwitching from an AD shampoo to a non-AD shampoo resulted in increased scalp Malassezia load, degree of flaking, barrier disruption, and inflammatory and oxidative stress biomarkers compared to those maintaining AD shampoo usage. Signs of declining scalp condition (histamine, complement component C3) were observed as early as 3 days after ceasing AD shampoo usage despite no statistical increase in flaking (ASFS) until around 3 weeks of using a non-AD shampoo. These changes were accompanied by self-perceived itching and flaking, reported to be significantly worse in those using the non-AD shampoo compared to the AD shampoo at the end of the study. No statistically significant increase from baseline was observed for any objective measure in the AD shampoo group. In the SMERF model, markers of inflammation, oxidative stress, and Malassezia load were predictive of self-perceived scalp attributes.

conclusionFor the first time, a comprehensive understanding of changes that occur as scalp condition goes from asymptomatic to dandruff-affected has been established. For scalp-concerned individuals, regular, sustained use of an AD treatment promotes optimal scalp health. When switching to a non-AD shampoo, scalp health deteriorates rapidly, even before visible flakes appear.

Indexed as

DandruffHair PreparationsScalpAdultDouble-Blind MethodFemaleHumansMaleMiddle AgedHair PreparationsdandruffinflammationMalasseziaoxidative stressscalp healthseborrheic dermatitis

Identifiers

PMID40162583
PMCPMC12319465

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.