Characterization of the major bacterial–fungal populations colonizing dandruff scalps in Shanghai, China, shows microbial disequilibrium

<jats:title>Abstract</jats:title><jats:p>Dandruff is a scalp disorder characterized by the formation of flaky white‐yellowish scales due to an altered proliferation and differentiation status; a disrupted barrier function; a decrease in the level of hydration and of natural moisturizing factors (<jats:styled-content style="fixed-case">NMF</jats:styled-content>) in the scalp, with a persistent and relapsing inflammatory condition. It was recently reported that an imbalance between bacterial and fungal species colonizing the scalp of French volunteers was associated with dandruff condition. The purpose of the present study was to analyze the major bacterial and fungal species present on the scalp surface of Chinese volunteers and to investigate possible region‐related variation in the microbiota linked to dandruff condition. The data obtained from the Chinese populations were highly similar to those obtained in France, confirming that dandruff scalps are associated with a higher incidence of <jats:italic>Malassezia restricta</jats:italic> and <jats:italic>Staphylococcal</jats:italic> sp. The ratios of <jats:italic>Malassezia</jats:italic> to <jats:italic>Propionibacterium</jats:italic> and <jats:italic>Propionibacterium</jats:italic> to <jats:italic>Staphylococcus</jats:italic> were also significantly higher in the dandruff volunteers as compared to normal volunteers, suggesting that equilibrium between the major bacterial and fungal taxa found on the normal scalps is perturbed in the dandruff scalps. The main difference between the French and Shanghai subjects was in their <jats:italic>Staphylococcal biota</jats:italic>. The results obtained in China and in France suggest that targeting one particular <jats:italic>Malassezia</jats:italic> sp. by antifungals instead of using large spectrum antifungals and rebalancing the dandruff scalp microbiota could be common approach to improve dandruff condition in the two countries.</jats:p>