TREATMENT OF DANDRUFF AND SEBORRHEIC ERUPTIONS 453 It has been shown that over feeding animals with fat and with carbo- hydrates results in an increased amount of sebum. This increase is greater after excess fat intake than with carbohydrates. This rationalizes cus- tomary restriction of fat and carbohydrates in treatment of seborrheic disorders, especially ache vulgaris. Influences of the aforementioned circumstances is well-shown in the report of Shelton (25). In the early period of captivity of prisoners of war in Singapore seborrheic dermatitis was common. After the first nine months it became practically nonexistent. The climate was hot and humid with excess sunshine. Most prisoners took shower baths at least twice daily. After the first two months, total fat intake was rationed and limited no butter was issued. Unfortunately, the effect on dandruff could not be evaluated since routine inspection of the scalp was not con- ducted. It is generally stated that dandruff and seborrheic dermatitis of the scalp are more frequent in those who wear hats or other hair covering almost constantly. I have observed its frequent occurrence in nuns. With few exceptions nuns have their hair cut close. I have observed disappearance or improvement of dandruff in the male and female following free exposure to the sun. I have no knowledge of the mechanism of this beneficial effect. V•TAM•S DErIcIE•c¾ This particularly concerns vitamin B complex. Brewer's yeast and liver extract have long bccn used in treatment of scborrhcic disorders. This may bc rationalized by several deficiency syndromes in animals from lack of vitamin B components. These syndromes arc characterized among other symptoms by a scaly dcrmatitis resembling scborrhcic dcrmatitis, dulling of the hair, and at times hair loss and microscopic evidence of effect on the sebaceous glands. This has been observed from diets deficient in ribofiavin (vitamin B2), pantothenic acid (a vitamin B factor), and from biotin (vitamin H). These syndromes notably described by Gyorgy, Sebrell and Butler, McCall, et al., and others need not be reviewed since a comprehensive discussion is afforded by Lorincz (26). It is to be recalled that Burr and Burr (27) described a syndrome with similar derreal symptoms in rats by excluding fat from the diet. Linoleic, linolenic and other fatty acids cured the symptoms. Such fatty acids were designated by some (although not too accurately) as vitamin F.* These experimental studies indicate a close relationship between fat *Some writers compared the scurfy rats in Burr and Burr's study to human dandruff also the lack of luster of the hair of the animals, their dry skin and their brittle nails to similar changes in human beings as an expression of vitamin F deficiency.

454 JOURNAL OF THE SOCIETY OF COSMETIC CHEMISTS metabolism, particularly unsaturated fatty acids and pyridoxine. Of the unsaturated fatty acids linoleic and arachidonic acids appear to be most intimately involved in this relationship. Whether this pertains to human seborrheic dermatitis is not clearly established. It is perhaps significant that fat metabolism long has been implicated in seborrheic eruptions and recent studies, notably those of Schreiner, eta/. (28), suggest that seborrheic dermatitis may represent a local metabolic defect in the skin involving pyridoxine. NEWER MEDIeAMENTS IN TRE^TMENT Many proprietary preparations for dandruff contain time-honored ingre- dients, such as, salicylic acid, sulfur, resorcinol, tar (Paragmatar, Diasporal Cream, Resorcitate Collo-Sul Cream, Supertah). Exceptions are prepara- tions conaprising (a) selenium sulfide (Selsun), (b) sulfonamide compound sodium sulfacetamide, (c) tellurium dioxide (Teles, 2.5 per cent sulfated tellurium dioxide). It is interesting to know how selenium and tellurium exert curative action. Their action is probably similar to that of sulfur, to which they are chemi- cally related. The action of sodium sulfacetamide is doubtless in conform- ity with many antidandruff agents that exert bactericidal action. Sulfur has long been used in treatment of dandruff and seborrheic dis- orders. Combes (29) attributes its favorable effect to its keratoplastic action, which refers to the aggregate of chemical processes involved in the normal formation of keratin, the principal ingredient of the stratum cor- neum. The basic changes are oxidative. Sulfur is essential for this proc- ess it is one of the most important elements in the skin. Sulfur is a facultative element resembling oxygen. Its action facilitates oxygenation, thus promoting more normal maturation of keratin and reducing para- keratosis. Through the years a number of new proprietary compounds have become available, the therapeutic action of which can be attributed to their sulfur content. One such recent compound is Dermasulf, a solution of complex polythionic acids of the general formula H2SxO6. The bulk of the sulfur is in the form of the tetrathionate or pantothionate. Finnerud and Riddell (30) report favorable results with Dermasulf in treatment of seborrhea of the scalp. According to these authors, poly- thionates afford better penetration of the skin by virtue of their water solubility. They regard this form of sulfur more effective than in the poly- sulfides, which are easily oxidized precipitating elemental sulfur. VITAMIN B IN THERAPY Schreiner, eta/. (28), employed an ointment of pyridoxine (10 nag. per gram) in treatment of seborrheic dermatitis of the sicca type (mild cry-