Seborrheic dermatitis and dandruff: An overview of pathogenesis, role of Malassezia spp., and natural treatment approaches

Abstract

Seborrheic Dermatitis (SD) and dandruff are prevalent dermatological disorders that primarily affect the sebaceous glands and have significant implications for adults and children. While chronic skin lesions characterise SD, dandruff is characterised by excessive scalp flaking, pruritus, and erythema. Despite their overlapping clinical manifestations, these conditions differ in their underlying pathophysiology, with overgrowth of Malassezia species (spp.) emerging as a central pathogenic factor in both. Malassezia, a commensal yeast naturally residing on the skin, has been implicated in exacerbating inflammation and triggering immune responses, thereby contributing to the initiation and progression of SD and dandruff. In this comprehensive review, we systematically evaluated the role of natural and plant-derived ingredients in managing SD and dandruff, with a particular focus on their effects on Malassezia spp. The literature search was conducted using Google Scholar, Google Patents, PubMed, and SciFinder until December 2025. The extracted data were qualitatively synthesised to identify key findings and highlight existing research gaps. The results indicate that Malassezia spp., particularly Malassezia furfur, play a pivotal role in SD and dandruff by overgrowing, leading to excessive sebum production, yeast colonisation, and subsequent inflammation. M. furfur has been shown to stimulate the release of proinflammatory cytokines and activate the NLRP3 inflammasome, further promoting the inflammatory cascade associated with these conditions. Plant-derived ingredients, such as antimicrobial and anti-fungal compounds, have garnered attention for their potential therapeutic effects. Several studies suggest that substances like tea tree oil, aloe vera and various herbal extracts may reduce Malassezia load and mitigate the inflammation associated with these disorders. However, there remains a lack of clarity regarding the precise mechanisms by which these natural agents influence the skin's microbiome and immune system. Further clinical investigations are essential to assess the efficacy, safety, and optimal formulations of these plant-based treatments. Despite promising evidence supporting their use, additional well-designed studies are needed to clarify their roles and to establish standardised treatment protocols for SD and dandruff management.

Keywords: Anti-fungal; Dandruff; Inflammation; Malassezia furfur; Natural products.