Androgenetic alopecia (AGA) and seborrheic dermatitis (SD) are two common scalp disorders that frequently impair the quality of life and may coexist in a subset of patients across all genders. SD presents in 40%-50% of all patients diagnosed with AGA. Although these conditions are traditionally discussed separately, increasing evidence suggests that they may share overlapping pathogenic factors, including androgen-driven sebum hypersecretion, imbalance of the scalp microecology, barrier dysfunction, and inflammatory signaling. We propose an integrated framework for understanding SD-AGA coexistence, emphasizing the interplay among endocrine influences, sebum alterations, microbial imbalance, and inflammatory activation. Therefore, the management of patients with coexisting AGA and SD should move beyond single-target approaches and emphasize the restoration of scalp homeostasis, control of inflammatory cascades, and integration of antiandrogen therapy through comprehensive, individualized treatment strategies. This review may offer a new perspective for the combined management of these dual scalp disorders.

Indigenous communities in Canada experience higher prevalence and disease burden of atopic dermatitis (AD) alongside systemic barriers to dermatologic care. This scoping review synthesizes evidence on AD prevalence, assessment approaches, barriers to access, and intervention models for Indigenous populations, an area with a critical dearth of rigorous research. A PROSPERO-registered, PRISMA-compliant systematic search of 5 databases identified limited rigorous research: No randomized trials specific to AD management exist, and Indigenous participants remain underrepresented in clinical trials (0.91% vs population share). Barriers operate across 4 domains: systemic (historical and intergenerational trauma), geographic (distance from specialists, absent phototherapy), resource-related (unsafe water, mold exposure, medication costs), and cultural safety deficits. Together, these represent compounding barriers to dermatological care. Common dermatologic conditions including acne, psoriasis, seborrheic dermatitis, and eczema impose higher quality-of-life burden among Indigenous patients, yet receive less diagnostic inquiry and fewer follow-up recommendations than among non-Indigenous patients. Promising interventions include Indigenous Extension for Community Healthcare Outcomes telementoring, hybrid models combining community navigators with e-consult platforms, culturally grounded outreach rotations, and codesigned care pathways respecting traditional healing practices. Based on our synthesis of the included literature, we recommend that dermatologists, health system planners, and policymakers prioritize upstream determinants of health (housing, water quality), implement mandatory cultural safety training, establish documented Indigenous governance in program design, and adopt minimum viable evaluation metrics capturing wait times, disease control, and equity stratification. Dermatologists must advocate for clean water infrastructure, universal pharmacare, and mandatory cultural safety training, while adapting clinical protocols to patients facing housing instability, water insecurity, and geographic barriers that make standard AD recommendations unachievable.

Stress-induced sebaceous hyperactivity is a key driver of acne and seborrheic dermatitis; however, research investigating the pathway-specific mechanisms through which stress exerts its effects and the suppression of sebum production via targeting stress signaling remains relatively limited. In this study, we investigated whether Camellia nitidissima flower extract (CNF) could counteract stress-induced sebaceous dysfunction and its underlying mechanisms. Using a cortisone-stimulated SZ95 human sebocyte model, we evaluated lipid accumulation, cortisol production, signaling pathway activation, and apoptotic markers. CNF treatment dose-dependently suppressed cortisone-induced lipid production, reducing triglyceride, cholesterol, and free fatty acid levels by up to 35.44%, 38.02%, and 46.39%. Mechanistically, CNF inhibited 11β-HSD1 expression (17.17% reduction) and cortisol secretion (32.84% decrease), thereby blocking local cortisol reactivation. This upstream interception subsequently attenuated PI3K/Akt/mTOR hyperphosphorylation, downregulated lipogenic transcription factors (SREBP-1, PPARγ, LXRα, C/EBP-α) and their target enzymes (FAS, ACC, DGAT). Beyond lipid synthesis inhibition, CNF reversed cortisone-induced apoptosis resistance by reducing the Bcl-2/Bax ratio and suppressing PCNA-mediated hyperproliferation, thereby decreasing sebocyte number. These findings demonstrate that CNF exerts dual oil-control effects: reducing lipid production per cell and reducing lipid-producing cell abundance. Collectively, CNF represents a promising multi-target botanical agent for managing stress-related sebaceous disorders and cosmetic sebum regulation.

Introduction: Seborrheic dermatitis (SD) is a lipid-dependent inflammatory dermatosis in which sebaceous activity, Malassezia, barrier dysfunction and host inflammation interact. Whether scalp SD severity is associated with systemic lipid and liver-associated biochemical parameters remains unclear. Methods: In this exploratory cross-sectional observational study, we included 34 adults with clinically diagnosed scalp SD. Severity was assessed using a published 16-point scalp SD score and a study-specific 0-36 physician-assessed score. Fasting lipids, glucose, alanine aminotransferase (ALT), aspartate aminotransferase and gamma-glutamyl transferase (GGT) were recorded. The triglyceride/high-density lipoprotein cholesterol ratio and non-HDL cholesterol were calculated. Patients were stratified as having non-severe or severe disease according to the 16-point score. Results: Complete 16-point data were available in 33 patients: 15 with non-severe and 18 with severe scalp SD. Severe disease was associated with higher triglycerides (116.0 vs. 78.0 mg/dL; p = 0.004), triglyceride/high-density lipoprotein cholesterol ratio (2.57 vs. 1.23; p = 0.006), ALT (46.0 vs. 20.0 U/L; p = 0.028) and GGT (33.0 vs. 11.0 U/L; p = 0.003). The strongest correlations with the 16-point score were observed for GGT (rho = 0.745), triglycerides (rho = 0.634), ALT (rho = 0.572) and triglyceride/high-density lipoprotein cholesterol ratio (rho = 0.569; all p < 0.001). These prespecified associations remained significant after false-discovery-rate adjustment and after adjustment for age and BMI. The correlation pattern was strengthened using the 0-36 score and persisted after excluding one liver enzyme outlier. Conclusions: More severe scalp SD was associated with triglyceride-related lipid parameters and liver-associated enzymes, suggesting a broader lipid-liver metabolic phenotype. These findings require confirmation in larger controlled studies.

Kerion is an abscess caused by a fungal infection, commonly occurring on the scalp among children and rarely in adults. This report illustrates the case of a 12-year-old boy who presented with multiple plaques with crusty lesions on the scalp for 2 months, associated with purulent discharge and boggy swelling, initially misdiagnosed as seborrheic dermatitis. Following unsuccessful treatment, his condition was correctly diagnosed as kerion based on clinical appearance, history of contact with domestic animals and Wood's lamp examination findings. The diagnosis was delayed for 2 months, leading to a prolonged disease course. Complete resolution of symptoms and lesions was achieved with systemic antifungal treatment, although permanent scarring alopecia remained. The delay in diagnosis and treatment led to prolonged illness and alopecia.

Yeasts of the Malassezia genus are implicated in numerous skin conditions, including seborrheic dermatitis, pityriasis versicolor, and folliculitis. While ciclopirox olamine (CPO) and piroctone olamine (OCT) are effective anti-Malassezia agents, the activity of magnetized water against pathogenic yeasts remains unclear. The aim of this study was to examine the in vitro efficacy of magnetized saline water (MSW), alone or combined with CPO plus OCT, against three Malassezia species (M. furfur, M. globosa, and M. restricta) using broth microdilution to determine minimal inhibitory concentrations (MICs). A proof-of-concept study evaluating a shampoo containing MSW 30% + CPO 0.5% + OCT 1.0% in 20 patients with scalp seborrheic dermatitis (SSD) was subsequently conducted. Participants applied the shampoo four times per week for 12 weeks; efficacy was assessed by changes in a validated 16-point SSD severity score. The triple combination demonstrated additive-to-synergistic activity, with MIC values of 3.91 mg/L across all three species, representing a 2.0- to 4.0-fold MIC reduction compared to CPO + OCT alone, and synergy (FIC=0.31) for M. furfur. The total SSD score decreased by 33.9% after 12 weeks (p<0.001), with improvements in pruritus (49.0%), erythema (54.3%), and scaling (24.2%); all p values remained significant after Bonferroni correction (α=0.0125). These findings support MSW as a vehicle to potentiate the anti-yeast activity of CPO and OCT while reducing the chemical load, potentially offering a novel strategy for Malassezia-associated skin disorders. The open-label, single-arm design limits causal attribution, and larger controlled trials are needed.