Quick Take
A social media post claims that using an anti-dandruff shampoo helps get rid of comedonal acne. We analysed the assertion and determined it is false.
The Claim
Drpriyacare’s Instagram reel promotes a DIY solution for comedonal acne. The post with the description, “Your anti-dandruff shampoo has a secret superpower!” asserts that the key antifungal and antibacterial ingredient in anti-dandruff shampoos such as Head & Shoulders, zinc pyrithione (ZPT), facilitates the fight against Malassezia, responsible for fungal acne.
Fact Check
What is meant by “comedonal acne”?
Comedonal acne, which usually manifests as whiteheads or blackheads, gets its name from the word “comedo,” which means “plug of keratin.” Classically, comedones have been linked to acne and acne-related issues. Nonetheless, they may co-exist with dermatological illnesses other than acne. The non-inflammatory form of acne develops when hair follicles get clogged with excess sebum, dead skin cells, or external environmental contaminants. The comedonal bumps usually appear on the forehead, chin, nose, chest area, and upper back. Compared to pustular or cystic acne, comedonal acne usually involves less redness and irritation.
The condition is primarily triggered by hormonal abnormalities, particularly those brought on by androgens, as well as the use of certain cosmetic skin care products, genetic predispositions, stress, humidity, pollutants, and unhealthy eating patterns. Adolescents are particularly at a higher risk, along with adults those who have oily skin or a family history of acne. Learning the specific nature of the condition helps in early intervention and appropriate skin care.
Is comedonal acne the same as fungal acne?
While both can manifest as little bumps on the skin, it is critical to acknowledge that the two are distinct forms of acne.
When we asked Dr. Gurman Singh Bhasin, Director & Chief Dermatologist, Skinclarity Clinic, Nagpur, he explained that comedonal acne is caused by clogged pores, either open or closed comedones, caused by excess sebum, dead skin, and keratin—not fungus. In contrast, fungal acne (Malassezia folliculitis) is actually a yeast infection of hair follicles and presents as itchy, monomorphic papules or pustules rather than comedones. Owing to the differences in their development, both the forms necessitate their respective treatment modalities.
What are the basic ingredients found in antidandruff shampoos?
Anti-dandruff shampoos are specific formulations designed to address the root causes of dandruff. These mainly include excessive oil production, fungal overgrowth, and even scalp inflammation. Thus, the active ingredients in shampoo aid in reducing itching, flaking, and irritation of the scalp. Zinc pyrithione (ZPT) is one of the most frequently employed antifungal and antibacterial components in anti-dandruff shampoos. It’s considered to be effective against the yeast species Malassezia, which is associated with the pathophysiology of dandruff. Another crucial antifungal ingredient used in more potent formulations is ketoconazole. It helps to cure moderate or resistant cases by reducing the fungal load and scalp inflammation.
Next is salicylic acid, a keratolytic agent. It prevents the buildup of scales on the scalp by exfoliating dead skin cells. Another crucial element that has antifungal properties and reduces scalp cell turnover is selenium sulphide. It is usually administered for managing dandruff and seborrhoeic dermatitis. In addition to this, some preparations might include essential oils, such as tea tree oil, because of their antibacterial properties.
Dr. Sachin Gupta, a consultant dermatologist at Amrita Hospital in Faridabad, has verified these ingredients. He suggests that potent compounds such as zinc pyrithione, selenium sulphide, or ketoconazole may successfully address the persistent condition of dandruff. For best effects, Dr. Gupta stresses the need for a meticulously monitored regimen of the medicated preparation.
It is critical to understand that these ingredients, which provide a targeted therapeutic approach to scalp care and symptomatic relief, are usually selected based on the severity and underlying cause of dandruff.
Should anti-dandruff shampoos be considered for addressing comedonal acne?
No. While the notion of using anti-dandruff shampoo for comedonal acne is gaining popularity on social media, the scientific evidence supporting the practice remains limited.
Zinc pyrithione (ZPT) in anti-dandruff shampoos primarily regulates keratinisation. The active ingredient helps heal the scalp by restoring normal sebum production, epithelium keratinisation, or both. Certain studies have shown that ZPT can dramatically lower the quantity of yeasts and structural irregularities found in dandruff.
ZPT has shown promise in addressing Malassezia-related disorders such as dandruff and seborrheic dermatitis, but its effectiveness in managing nonfungal comedonal acne is yet unclear. This is because comedonal and fungal acne have distinct pathophysiologies, making antifungal agents less relevant in such cases.
Dr. Gurman Singh Bhasin also supports this by stating that anti-dandruff shampoos may help reduce spillover and prevent worsening of acne around the forehead and temples. However, comedonal acne is better managed with keratolytics like salicylic acid or retinoids like adapalene and not antifungals.
There may also be misunderstandings regarding the potential benefits of topically applying certain zinc-based compounds to acne-prone skin due to their anti-inflammatory and sebum-regulating qualities. Zinc products, however, might not be able to treat all forms of acne. Therefore, further research must be conducted to completely investigate zinc’s potential for lowering inflammation and regulating sebum production, two important aspects of acne development.
ZPT antidandruff shampoos may have nonspecific benefits, but they cannot substitute for the evidence-based treatments for acne. Reliance on such uncertain remedies may do more damage than good by delaying the essential therapy.
How does a dermatologist handle comedonal acne?
Dermatologists usually approach the skin condition of comedonal acne with a primary objective of:
- Normalising skin cell turnover
- Regulating the excessive oil production
- Prevention of pore blockage
The management of comedonal acne is usually a combination of personal hygiene and prescribed medications. After medically supervised gentle scrubbing, doctors usually prescribe topical retinoids. These are vitamin A derivatives that unclog pores and prevent the formation of new comedones. In case they are ineffective, salicylic acid, benzoyl peroxide, glycollic acid, or other AHAs may be prescribed.
According to Dr. K Kranthi Varma, Consultant Dermatologist at Renova Hospitals in Sanath Nagar, Hyderabad, there are numerous approaches used to address comedonal acne. These include both prescribed medications and lifestyle changes. Moderate cases usually necessitate topical therapies. Oral medications such as low-dose isotretinoin may be prescribed in cases that are resistant or chronic. The three primary in-office procedures—chemical peels, comedone extraction, and microdermabrasion—are usually employed for resistant cases. Above all, pharmaceutical intervention should always be coupled with a well-nourished diet, stress management, optimal sun protection, and gentle cleansing.
Furthermore, the ones diagnosed with comedonal acne should wear minimum make-up, wash their hair frequently, keep hair products away from their face, and have a well-nourished diet.
Conclusion
Doctors strongly caution against attempting do-it-yourself hacks in the age of social media influencers because they might cause complications and delay necessary treatment. To promptly identify the true ailment and develop a customised treatment plan. Hence, it is always advisable to have oneself clinically evaluated.
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