Decoding scalp health and microbiome dysbiosis in dandruff

Abstract A balanced scalp microbiome is crucial for scalp health, yet the mechanisms governing this balance and the etiology of dysbiosis in scalp disorders remain elusive. We conducted a detailed investigation of the scalp and hair follicles, in healthy individuals and those with dandruff/seborrheic dermatitis (D/SD). It was demonstrated that the microbiome inhabiting hair follicles serves as a reservoir for the scalp microbiome, thereby integrating the scalp, follicle, and the hair into one functional unit. Using in vitro models, we further elucidated mechanisms governing the assembly and interactions of the follicular microbiome under healthy and D/SD conditions. We show that propionic acid, produced by C. acnes , plays a pivotal role in maintaining microbiome balance, with implications for scalp health, which was validated through a clinical study.