The efficacy of a topical application comprising Calendula officinalis Ø and Olea europaea in the management of seborrheic dermatitis of the scalp (dandruff)

Abstract

Background Seborrheic dermatitis (SD) also known as pityriasis capitis is a common skin condition that affects mainly the scalp, causing scaly patches, red skin and stubborn dandruff (Preedy 2012). It has been reported that dandruff occurs in at least 50% of the world’s adult population and approximately 15% to 20% of the world’s total population (Mia 2016). Recent studies suggest that a scalp specific yeast called Malasseiza globosa appears to be responsible for SD (Zhang, Ran, Xie and Zhang 2013). Seborrheic dermatitis does not affect overall health but it can be uncomfortable and may cause embarrassment and low self-esteem (Del Rosso 2011; Preedy 2012).

Anecdotal evidence at Ukuba Nesibindi Homoeopathic Community Clinic (UNHCC) indicated that patients with SD responded positively to Calendula officinalis Ø in combination with Olea europaea (olive oil). Notwithstanding this, there is a dearth of clinical data available to validate the aforesaid patient’s positive response. Hence this study aims to provide clinical evidence to prove or disprove patient’s response to Calendula officinalis Ø in combination with Olea europaea (olive oil).

Objective The aim of this double blind randomized controlled study was to determine the efficacy of a topical application comprising Calendula officinalis Ø with Olea europaea in the management of SD of the scalp (dandruff).

Material and methods The sample was selected by means of non-probability convenience sampling and consisted of 64 consenting participants between the ages of 18 to 50 years who had read the information letter and met the inclusion criteria. Participants were evenly distributed between the treatment and control groups according to the randomization list (32 participants in each group). The treatment group received Calendula officinalis Ø with Olea europaea and the control group received Olea europaea only. Three participants withdrew from the study resulting in only 61 completing the study, 30 from the control group and 31 from the treatment group. The study was conducted at the Durban University of Technology Homoeopathic Day Clinic (DUTHDC) under the supervision of a qualified and registered homoeopathic clinician.

The duration of the study was six weeks with three consultations in total. Consultations took place on day 1, day 22 and day 43. At each consultation the participants were assessed by three individuals – the participant themselves, the researcher, and an independent party (the homoeopathic clinician on duty that day). The assessment tools included the Visual Analogue Scale (VAS) for the researcher and clinician consisting of the following categories: irritation, flaking, greasiness, percentage of the scalp involved and overall impression; and the Patient Perception Questionnaire (PPQ) for the patient consisting of the following categories: irritation, flaking, greasiness, itching and overall impression. This was accompanied by a detailed case history and physical examination performed by the researcher.

Results Both the control and treatment groups displayed overall improvement in terms of Patient Perception Questionnaire and Visual Analogue Scale which means that a combination of Olea europeae with Calendula officinalis Ø (treatment group) and Olea europeae only (control group) were effective in the management of SD. There was no statistically significant difference between the effect of a combination of Olea europaea with Calendula officinalis Ø and Olea europaea only.

In terms of the VAS and PPQ categories, there was a statistical significance between the groups, with the exception of irritation. Significant differences found were as follows: Flaking (clinician and patient rated p = 0.019) on visit 3 for the control group. Greasiness (clinician and patient rated p = 0.027) on visit 3 for the control group. Greasiness (researcher and patient rated p = 0.012) on visit 2 for the treatment group. Percentage of the scalp involved (researcher and clinician rated p = 0.013) on visit 2 for the treatment group. Overall impression (researcher and patient rated p = 0.026) on visit 2 for the control group. Overall impression (researcher and clinician rated p = 0.026) on visit 3 for the treatment group.

Conclusion Both the combination of Olea europaea with Calendula officinalis Ø and Olea europaea only improve SD. Therefore, a topical application comprising Calendula officinalis Ø and Olea europaea is effective in the management of SD of the scalp (dandruff) and therefore permits further investigation.