<p>Comparison of efficacy and safety of atorvastatin 5% lotion and betamethasone 0.1% lotion in the treatment of scalp seborrheic dermatitis</p>

Abstract

Purpose: Seborrheic dermatitis (SD) is a chronic inflammatory skin disorder that mainly affects areas rich in sebaceous glands, such as the scalp. Although the exact cause of SD is not clearly understood, it seems that skin colonization with Malassezia fungus and the inflammatory responses of the immune system to this fungus play an important role in the pathology of SD. Recently a growing body of evidence has shown anti-inflammatory and anti-fungal effects of statins. Thus, this study aimed to evaluate the efficacy of topical atorvastatin in the treatment of scalp SD. Patients and methods: In this double-blind, clinical trial, 86 patients with mild-to-moderate scalp SD were divided into either atorvastatin (n=45) or betamethasone groups (n=41) by block randomization method. In addition to the ketoconazole 2% shampoo (3 times per week), the atorvastatin group received atorvastatin 5% lotion and the betamethasone group received betamethasone 0.1% lotion daily for 4 weeks. The SD severity of each patient was determined by Symptom Scale of Seborrheic Dermatitis (SSSD) at baseline and 4 weeks after treatment. Also, the patient’s satisfaction of the treatment and adverse effects were investigated through individual reporting. Results: After 4 weeks of treatment, the score of SD severity decreased significantly in both groups, while changes of SSSD score from baseline to the fourth week of treatment were comparable in the two groups ( P -value=0.476). Regarding patient’s satisfaction of the treatment, results demonstrated the non-inferiority of atorvastatin as compared to betamethasone. Topical atorvastatin was also well-tolerated in almost all patients. Conclusion: Although preliminary, the results of the present study showed that topical atorvastatin has a comparable effect to topical betamethasone and can be considered as an alternative therapeutic modality in the treatment of scalp SD. However, these results need to be confirmed in future studies while taking into consideration the improvement of topical statin formulations.

Atorvastatin Solid Lipid Nanoparticles as a Promising Approach for Dermal Delivery and an Anti-inflammatory Agent

“…Atorvastatin is an anti-hyperlipidemic drug which shows a poor oral bioavailability around 12% due to first-pass metabolism (9). Atorvastatin is a highly lipophilic drug in nature (10) and its anti-inflammatory effect on topical administration is comparable with the topical formulation of betamethasone which could be an alternative drug in the treatment of scalp seborrheic dermatitis (11). Many researchers have tried to apply atorvastatin for transdermal administration (12,13) and they have used lipid nanoparticles for avoiding the first-pass metabolism of atorvastatin (9).…”

Scalp Seborrheic Dermatitis: What We Know So Far

“…There is an increase in NK1+, CD16+ cells and interleukins – IL-1α, IL-1β, IL-2, IL-4, IL-6, IL-8, IL-10, IL-12, TNF-α, beta-defensins, IFN-γ, nitric oxide, and histamine. Also, the complement is activated [2–4, 7, 9, 14]. A significant increase in the ratio of IL-1RA: IL-1a and IL8 and overproduction of histamine were detected in SSD [2].…”

Recombinant human thymosin beta‐4 (rhTβ4) improved scalp condition and microbiome homeostasis in seborrheic dermatitis

“…At present, topical corticosteroids and antifungal agents are widely used for the treatment of SD, but with severe adverse effects such as skin atrophy and telangiectasia with long‐term use of topical corticosteroids and the ineffectiveness of antifungal drugs in some cases (Sobhan et al ., 2019). In this context, we found that rhTβ4 treatment was more effective than ketoconazole – the first‐line treatment for seborrheic dermatitis of the scalp – in improving symptoms and severity, ameliorating physiological conditions, and restoring microbiome homeostasis for a longer duration.…”