Ketoconazole beyond antifungal activity: Bioinformatics-based hypothesis on lipid metabolism in dandruff and seborrheic dermatitis.

The role of Malassezia yeasts in dandruff and seborrheic dermatitis is unclear; however, antifungal therapy with ketoconazole is commonly used. We propose that ketoconazole shifts skin lipid profile, affects Malassezia lipid metabolism and favours biotin-producing bacteria. Biotin regulates inflammatory response and cell proliferation, contributing to symptom improvement.