Should we be targeting the root cause?
Intro
I feel like too much emphasis is placed on managing the condition rather than finding a fully effective solution that can be used long term. Typical treatments such as antifungals target the yeast, but the yeast is a normal occurance on everyone's scalp, so that must not be the root cause (apart from cases where there really is a significant overgrowth of malassezia, but this is not true for all cases especially after antifungal treatment). I believe the immune response is the real issue that should be targeted.
Easier said than done, some strong medicine can provide changes to it but side effects and a lack of evidence complicate things.
Immune-system manipulation
Some meds suppress the immune system (rarely but can be used for seb derm). The issue with this is you obviously do need your immune system.
Immunoregulators have a similar goal of suppressing immune pathways, but more targeted, retaining alternative immune pathway functionality.
An example of this is zoryve, inhibits PDE4 -> increases cAMP -> "freezes" overactive immune cells only. This leaves the rest of the immune system functioning as intended.
In seborrheic dermatitis this cleared 50% of patients in some trials. This is pretty much on par with topical steroids (which is an immunomodulator, so it cant be used long term), but can actually be used long term.
Anti-inflammatory
Simple supplements like omega-3s and specific lifestyle factors will target this.
More complicated version with much less evidence and more just going off on a whim, but I would like to know your opinions on KLOW peptide blend, specifically KPV because of its multi-factoral (theoretical) benefits:
- Antimicrobial properties
- Anti-inflammatory
- Barrier restoration
and with the rest of the KLOW blend extra anti inflammatory and skin benefits may be seen.
Conclusion
In my experience I never benefited much from antifungal shampoos, and could never find a long term solution I was never really happy with because every treatment plan I tried out was just making it livable, not a state I wanted to sustain.
I think there could be a real solution within immunology, development in this area is slow as expected due to the high side effect risk and complicated mechanisms to actually be able to target the immune system, but I want to know your thoughts on if this is as important as I think it is, and if there is any feasible ways to tackle this.