Yeast and Zoryve: New findings provide better understanding of seborrheic dermatitis
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Key takeaways:
- Malassezia yeast may not be the root cause of seborrheic dermatitis.
- A new study showed that Zoryve was a cosmetically pleasing treatment option for seborrheic dermatitis in diverse hair types.
Dermatologist Raj Chovatiya, MD, PhD, MSCI, recently spoke to Healio about his new findings in seborrheic dermatitis and how to best treat diverse patient groups with this condition.
“For many years, people have thought that seborrheic dermatitis was largely driven by yeast, specifically of the Malassezia species,” Chovatiya, clinical associate professor at Chicago Medical School at Rosalind Franklin University and founder and director of the Center for Medical Dermatology and Immunology Research, told Healio. “However, there’s been emerging data that suggest that there may be more to this story than just the yeast itself.”
According to one of Chovatiya’s studies, published in Archives of Dermatological Research, dermatologists previously considered Malassezia yeast to be the primal cause of seborrheic dermatitis due both to its widespread proliferation on affected skin and the fact that patients would have clinically meaningful responses to antifungal therapy. However, analyses have shown that even healthy people can have traces of this yeast in many body areas, yet they do not have seborrheic dermatitis.
Further, studies about Malassezia yeast density in one area vs. another area on the skin are not consistent, suggesting additional factors to the development of seborrheic dermatitis. According to Chovatiya, the evidence shows that dysregulation of the skin barrier and immune system may be those factors.
“The immune system and the skin barrier are important parts of this disease,” Chovatiya said. “And the yeast probably does have a part to play too, but it may not necessarily be causative.”
According to Chovatiya, the same way staphylococcus bacteria is an important and influential aspect, but not the primary cause, of atopic dermatitis, a similar relationship between Malassezia yeast and seborrheic dermatitis may be at play here.
In addition to these recent findings about Malassezia yeast, researchers have further validated the utility of topical formulation for the treatment of seborrheic dermatitis, which commonly affects hair-bearing areas of the body including the scalp. In another recently published study in the Journal of Clinical and Aesthetic Dermatology, Chovatiya and colleagues found that Zoryve (roflumilast, Arcutis) topical foam 0.3%, a once-daily steroid-free foam FDA-approved in December 2023 for treatment of seborrheic dermatitis in individuals aged 9 years or older, is a cosmetically pleasing option for all hair types.
“Whether you’re somebody that washes your hair all the time, washes your hair infrequently, whether you have highly coiled and kinked hair or whether you have straight hair, Zoryve is formulated so that it consistently works across all hair and skin types,” Chovatiya said.
Seborrheic dermatitis is a chronic disease with a chronic burden. Patients often experience quality of life impairment, which necessitates a need for effective treatments.
“Seborrheic dermatitis has historically been somewhat of an afterthought because while it's something that we commonly see in clinic, we never had pathogenesis-driven drug development that could allow us to both treat with high efficacy and appeal to diverse patient preferences for long-term management,” he said. “The fact that we can now specifically target an element of the inflammatory cascade to create a high level of response in a foam vehicle that allows all types of patients to use it on all parts of the body is really a win-win for everyone.”
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