Expert opinion on management of Pityriasis capitis (dandruff) and related scalp conditions in clinical practice

Dandruff and related scalp conditions, including seborrhoeic dermatitis (SD), scalp psoriasis, folliculitis, pityriasis versicolor (PV) and acne vulgaris (AV), are common globally. Dandruff, caused by Malassezia fungi, leads to excessive scalp skin shedding, whereas SD can vary in severity. Scalp psoriasis presents with chronic inflammation and scaly plaques. PV is a benign fungal infection that affects the trunk and neck, whereas AV primarily impacts the face and can also appear on the body. Both acne and dandruff are associated with imbalances in the skin and gut microbiome and altered immune responses. Treatments range from topical antifungals and anti-inflammatories to systemic therapies. The key active ingredients such as Selenium sulphide (SS), Zinc pyrithione (ZPT), Coal tar, Salicylic acid, Ketoconazole, Ciclopirox and Clobetasol are commonly employed in antidandruff formulations. Comparative studies suggest SS has a superior anti-dandruff effect compared with ZPT and coal tar. SS is effective against fungal infections, cost-efficient and has minimal side effects. In chronic and recurrent conditions, the use of SS in maintenance therapy can significantly lower treatment costs. This makes it a practical choice for long-term management. The current study presents the consensus statements derived from focused group discussions held across various regions of India between March and September 2023 concerning clinical strategies for the management of dandruff and related dermatological conditions.