Effects of a cream containing 5% hyaluronic acid mixed with a bacterial-wall-derived glycoprotein, glycyrretinic acid, piroctone olamine and climbazole on signs, symptoms and skin bacterial microbiota in subjects with seborrheic dermatitis of the face

Mario Puviani,1 Elena Campione,2 Anna Maria Offidani,3 Roberta De Grandi,4 Luca Bianchi,2 Ivan Bobyr,3 Melania Giannoni,3 Anna Campanati,3 Marta Bottagisio,4 Alessandro Bidossi,4 Elena De Vecchi,4 Klaus Eisendle,5 Massimo Milani5,61Medica Plus Dermatology Outpatients Clinic, Modena, Italy; 2Dermatology Clinic, Tor Vergata University, Rome, Italy; 3Dermatology Clinic, Ospedali Riuniti Ancona University, Ancona, Italy; 4Laboratory of Clinical Chemistry and Microbiology, IRCCS Orthopedic Institute Galeazzi, Milan, Italy; 5Dermatology Clinic, Ospedale Centrale di Bolzano (BZ), Bolzano, BZ, Italy; 6Medical Department Cantabria Labs, Difa Cooper, Caronno Pertusella, VA, ItalyObjective: A new cream formulation containing hyaluronic acid 5%, complexed with a mix of a bacterial-wall-derived glycoprotein and peptide glycan complex (EDS), has been recently developed. We evaluated in a prospective, assessor-blinded, 6-week study the efficacy and tolerability of EDS in the treatment of facial seborrheic dermatitis (SD) and the effects on skin microbiota.Subjects and methods: Seventy-five subjects (mean age 46; 60 men) with moderate-severe SD of the face were enrolled. EDS cream was applied twice daily. The primary outcome was the evolution of the Investigator Global Assessment (IGA) score, evaluating erythema, scale/flaking, grade of seborrhea and itch. Superficial skin bacterial microbiome at baseline and after treatment was assessed, using the 16S rRNA gene methodology, in affected and non-affected face areas. Local tolerability was evaluated checking self-reported side effects at each visit.Results: Baseline IGA scores (mean±SD) was 10±3. The use of EDS reduced IGA score significantly by 70% at week 3 and by 88% at week 6. An increase in the abundance of Cutibacterium acnes genera associated with a significant drop of Staphylococcus genera presence was detected in affected areas. The ratio of relative abundance of genera Cutibacterium/Staphylococcus incr