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Thread: Seb Derm, etc resouces

  1. #21
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    Hi sejon, can you get a copy of the Lopez-Padilla (1996) article? The full article isn't anywhere on the web, and the print-version probably can be found only in a medical library in Mexico or Central America because the article is in Spanish. The results are not typical of any other study concerning climbazole and malassezia, so it would be interesting to read the full article.
    Hi Tom, I'm in Belize at the moment, though I doubt that I could find it here since our library service is shamefully almost non-existent. If I hop over to any city in Mexico within the next few months I might try to find it.

    A recent Meta Analysis of decades of research into SD treatments has been published on PubMed. Climbazole is not even mentioned in it.
    To be fair, I believe climbazole doesn't get as much research attention simply because it was never approved by the FDA in the US. Considering the US is the world's largest and potentially most lucrative market for pharmaceutical companies, if a particular ingredient isn't approved for use there the ingredient might be sidelined by a lot of researchers, especially as in many cases such research is funded by these companies.

    Also, according to in vitro tests against M. furfur, climbazole has indeed been shown to be as effective as ketoconazole, such as in this study.

    However, I think it's important to consider that other Malassezia strains, such as M. restricta and M. globosa, might be more susceptible to other anti-fungals than climbazole. This paper tests climbazole, ketoconazole, zinc pyrithione, and zinc vitanol against M. globosa and finds ketoconzole to be the most effective, but climbazole to be the least effective. Yet, bizarrely, this paper (on page 3) concludes that climbazole is more effective against M. globosa than M. furfur and M. restricta. So the studies can be rather confusing.

    To reiterate, I believe the takeaway from this is that with anti-fungal treatment, either combination therapy of more than one anti-fungal, or cycling through several to find the most effective, is a wiser approach than putting all our stock in a single ingredient and hoping for the best.

    Also, the vehicle by which an anti-fungal is delivered to the skin is as important as the anti-fungal itself. Zinc pyrithione, the most common commercially available anti-fungal, doesn't get much love on this forum due to its history of simply not being all that effective in anti-dandruff shampoos like Head & Shoulders, yet it shows a very high bioactivity against Malassezia in vitro. The fact that it doesn't work all that well in many anti-dandruff shampoos speaks more of the poor quality of the shampoo formulations than of zinc pyrithione's inherent fungicidal properties. This study shows that a "potentiated" zinc pyrithione shampoo (where the bioavailability of zinc pyrithione is maximised) shows better results than a shampoo containing a combination of climbazole and standard zinc pyrithione.

    Regarding ciclopirox olamine, I believe it should be mentioned more often on this forum for a few reasons. Firstly, ciclopirox olamine cream is cheap and available OTC in many parts of the world (and as prescription in the US). Secondly, studies suggest that its antimicrobial properties are quite broad, having range of bioactivity against fungal and bacterial strains (as suggested here, for example) -- it even shows activity against the bacteria p.acnes which is implicated in acne (source). Many dermatitic conditions may have a fungal and bacterial component, so its broadness could prove useful. Thirdly, it is anti-inflammatory, more so than hydrocortisone and the imidazole anti-fungals (as suggested here. And fourthly (although this is just from a personal perspective) the ciclopirox olamine creams are the lightest and least comedogenic anti-fungal creams I've found, whereas the use of other anti-fungal creams clogged my acne-prone skin within days, probably because the ciclopirox olamine creams lack the highly comedogenic emollient ingredient isopropyl myristate.

    It's my opinion that the versatility of ciclopirox olamine would make it a highly useful adjunct therapy combined with another anti-fungal, particularly an imidazole. So far, the only studies I've found of being used in combination are with zinc pyrithione and with salicylic acid, both of which were tested against and proven to be superior to ketoconazole alone.
    Last edited by sejon; 22nd January 2017 at 05:43 PM.

  2. #22
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    Quote Originally Posted by Tom Busby View Post
    Hi sejon, can you get a copy of the Lopez-Padilla (1996) article? The full article isn't anywhere on the web, and the print-version probably can be found only in a medical library in Mexico or Central America because the article is in Spanish. The results are not typical of any other study concerning climbazole and malassezia, so it would be interesting to read the full article.

    Hi benjamin, trichosporons are fungi, but most do not respond to any of the -azole drugs. See Chapter 10, below, for more information and photos that may be useful to you.
    http://www.drmhijazy.com/english/ebook.htm Principles of Pediatric Dermatology
    http://www.drmhijazy.com/english/chapters/chapter10.htm Chapter 10, Fungal Skin Infections

    Thanks, tom but i don't think that what i have .

    While cimbazone isn't giving me any results, something that does is ciclopirox olamine which people are talking about. Works within one day but in about two weeks it stops working. The brand i used is oilatum shampoo for anyone interested.

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