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Does tachyphylaxis occur in long-term management of scalp seborrheic dermatitis with pyrithione zinc-based treatments?
Int J Dermatol. 2009 Jan; 48(1):79-85.IJ

Abstract

BACKGROUND

Scalp seborrheic dermatitis and dandruff (SD/D) are chronic conditions requiring long-term treatment. There is a common belief that patients frequently experience decreasing benefits over time when using a single product. This physiologic accommodation is termed tachyphylaxis.

AIM

To systematically investigate the anecdotal belief that tachyphylaxis occurs in long-term treatment of SD/D using quantitative clinical assessments.

METHODS

An international questionnaire completed by 722 dermatologists assessed the belief of tachyphylaxis incidence with pyrithione zinc (PTZ)-based shampoos, time course, occurrence relative to active ingredients, and effect of switching products. Two double-blind, randomized, clinical evaluations were conducted, 24- and 48-week studies, whereby a 1% PTZ shampoo, a 2% PTZ shampoo, or a matched placebo control shampoo was used by each subject for the duration of the study. Dermatologists assessed the adherent scalp flaking (scale of 0-10) at baseline and at specified intervals.

RESULTS

Sixty-four per cent of responding dermatologists believed tachyphylaxis occurred with PTZ products, and most felt that tachyphylaxis occurred within 3 months of use. Evaluation of mean treatment responses vs. placebo and individual responses as a function of study duration showed a consistent benefit for all products at all time points; therefore, no evidence for tachyphylaxis was found (within 48 weeks of treatment).

CONCLUSION

No evidence for tachyphylaxis in SD/D treatment by PTZ-based shampoos was found. Compliance could explain the decreasing response rate seen over time; the solution is to choose an affordable therapeutic product that is effective long term without cosmetic trade-offs.

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Authors+Show Affiliations

Schwartz JR
Beauty Care Product Development, The Procter & Gamble Company, Cincinnati, Ohio 45241, USA. Schwartz.jr.2@pg.com
Rocchetta H
No affiliation info available
Asawanonda P
No affiliation info available
Luo F
No affiliation info available
Thomas JH
No affiliation info available

MeSH

Administration, TopicalDermatitis, SeborrheicDermatologyFemaleHair PreparationsHumansIncidenceLong-Term CareMaleMulticenter Studies as TopicOrganometallic CompoundsPyridinesRisk AssessmentScalp DermatosesSensitivity and SpecificitySurveys and QuestionnairesTachyphylaxisTime Factors

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19126058

Citation

Schwartz, James R., et al. "Does Tachyphylaxis Occur in Long-term Management of Scalp Seborrheic Dermatitis With Pyrithione Zinc-based Treatments?" International Journal of Dermatology, vol. 48, no. 1, 2009, pp. 79-85.
Schwartz JR, Rocchetta H, Asawanonda P, et al. Does tachyphylaxis occur in long-term management of scalp seborrheic dermatitis with pyrithione zinc-based treatments? Int J Dermatol. 2009;48(1):79-85.
Schwartz, J. R., Rocchetta, H., Asawanonda, P., Luo, F., & Thomas, J. H. (2009). Does tachyphylaxis occur in long-term management of scalp seborrheic dermatitis with pyrithione zinc-based treatments? International Journal of Dermatology, 48(1), 79-85. https://doi.org/10.1111/j.1365-4632.2009.03794.x
Schwartz JR, et al. Does Tachyphylaxis Occur in Long-term Management of Scalp Seborrheic Dermatitis With Pyrithione Zinc-based Treatments. Int J Dermatol. 2009;48(1):79-85. PubMed PMID: 19126058.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Does tachyphylaxis occur in long-term management of scalp seborrheic dermatitis with pyrithione zinc-based treatments? AU - Schwartz,James R, AU - Rocchetta,Heather, AU - Asawanonda,Pravit, AU - Luo,Fangyi, AU - Thomas,Jennifer H, PY - 2009/1/8/entrez PY - 2009/1/8/pubmed PY - 2009/5/6/medline SP - 79 EP - 85 JF - International journal of dermatology JO - Int J Dermatol VL - 48 IS - 1 N2 - BACKGROUND: Scalp seborrheic dermatitis and dandruff (SD/D) are chronic conditions requiring long-term treatment. There is a common belief that patients frequently experience decreasing benefits over time when using a single product. This physiologic accommodation is termed tachyphylaxis. AIM: To systematically investigate the anecdotal belief that tachyphylaxis occurs in long-term treatment of SD/D using quantitative clinical assessments. METHODS: An international questionnaire completed by 722 dermatologists assessed the belief of tachyphylaxis incidence with pyrithione zinc (PTZ)-based shampoos, time course, occurrence relative to active ingredients, and effect of switching products. Two double-blind, randomized, clinical evaluations were conducted, 24- and 48-week studies, whereby a 1% PTZ shampoo, a 2% PTZ shampoo, or a matched placebo control shampoo was used by each subject for the duration of the study. Dermatologists assessed the adherent scalp flaking (scale of 0-10) at baseline and at specified intervals. RESULTS: Sixty-four per cent of responding dermatologists believed tachyphylaxis occurred with PTZ products, and most felt that tachyphylaxis occurred within 3 months of use. Evaluation of mean treatment responses vs. placebo and individual responses as a function of study duration showed a consistent benefit for all products at all time points; therefore, no evidence for tachyphylaxis was found (within 48 weeks of treatment). CONCLUSION: No evidence for tachyphylaxis in SD/D treatment by PTZ-based shampoos was found. Compliance could explain the decreasing response rate seen over time; the solution is to choose an affordable therapeutic product that is effective long term without cosmetic trade-offs. SN - 1365-4632 UR - https://www.unboundmedicine.com/medline/citation/19126058/Does_tachyphylaxis_occur_in_long_term_management_of_scalp_seborrheic_dermatitis_with_pyrithione_zinc_based_treatments L2 - https://doi.org/10.1111/j.1365-4632.2009.03794.x DB - PRIME DP - Unbound Medicine ER -