The Gut-Scalp Axis: A Systematic Review of Dietary Interventions on Microbiome Dysbiosis in Scalp Disorders | [Journal of Pioneering Medical Sciences • 2025]

Author(s):

1. Hind B. Alshalhoob: College of Medicine, Majmaah University, Al Majmaah, Riyadh Region, Saudi Arabia

2. Ghaida A. Almarshoud: College of Medicine, King Saud University, Riyadh, Saudi Arabia

3. Elaf A. Alamari: College of Medicine, Ibn Sina National College, Jeddah, Saudi Arabia

4. Abdulaziz A. Alomari: College of Medicine, Almaarefa University, Riyadh, Saudi Arabia

5. Lama M. Albelowi: College of Medicine, Taibah University, Al Madinah Al Munawwarah, Saudi Arabia

6. Hisham S. AlQifari: College of Medicine, King Saud University, Riyadh, Saudi Arabia

7. Waleed Khalid Z. Alghuyaythat: Department of Dermatology, Security Forces Hospital, Ministry of Interior, Riyadh, Saudi Arabia

8. Wesam S. Alharbi: College of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia

9. Abdulmajeed Alajlan: Dermatology Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia

Abstract:

The goal of this systematic review was to measure the existing evidence for the efficacy of probiotics, prebiotics, synbiotics, postbiotics and dietary supplements in modifying gut and/or scalp microbiota in individuals with scalp disorders such as alopecia areata, androgenic alopecia and dandruff. Systematic searching across six databases- PubMed, Embase, Scopus, Web of Science, Cochrane CENTRAL and ClinicalTrials.gov was conducted to find human studies comparing interventions on the microbiome in clinically diagnosed scalp disorder patients. Randomized controlled trials, nonrandomized interventional designs and cross-sectional observational studies were deemed to be eligible study designs. Throughout the 14 studies, signals converged on a 4-24-week treatment window wherein clinically apparent improvements also accrued on hair and scalp endpoints. The trials also measured change and established statistically significant advantages-higher hair counts/density or lower dandruff severity-with p-values ranging <0.05-<0.0001, usually assessed by standardized trichoscopy/phototrichogram scoring and validated dandruff indices. Biomarker readouts also correlative with these clinical effects: multiple studies reported decreases in inflammatory mediators (e.g., IL-6, IL-31, TGF-ß1, hsCRP) and shifts of antioxidant defenses upwards (e.g., SOD, with concurrent immunomodulatory effects such as increased IFN-?), consistent with reduction of scalp inflammation and oxidative stress. Microbiome profiling (qPCR/16S/ITS) also repeatedly indicated increased Lactobacillus spp., decreased Cutibacterium acnes and/or Malassezia and normalization of community balance, with one Mendelian-randomization analysis providing evidence of causality: Corynebacterium appeared protective (OR = 0.82) but Betaproteobacteria and Burkholderiales paralleled higher disease risk (ORs = 1.21 and 1.20). The findings suggest that nutritional and topical interventions that influence the microbiome may be associated with beneficial changes in scalp symptoms, microbiota and inflammatory features in scalp disorder patients. While the general safety profile was acceptable, heterogeneity of study design, outcome measures and microbial analysis diminished the strength of conclusions reached.

Page(s): 9-21

DOI: 10.47310/jpms2025141002

Published: Journal: Journal of Pioneering Medical Sciences, Volume: 14, Issue: 10, Year: 2025

Keywords:

Probiotics , alopecia , Probiotics , Scalp Microbiome , GutScalp Axis , Microbiota Modulation

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