<b>COMPARATIVE ANALYSIS OF HERBAL AND SYNTHETIC SHAMPOOS FOR MALASSEZIA FURFUR-INDUCED DANDRUFF: A CROSS-SECTIONAL STUDY IN LAHORE, PAKISTAN</b>

The most widespread cause of dandruff (pityriasis capitis) is Malassezia furfur, which has a prevalence rate of about 50 percent of the global population. Synthetic antifungal shampoos are the most commonly used agent, although there is an increasing interest in natural products by consumers, which has led to a higher demand of herbal alternatives, although little comparative data exist (Mesfin et al., 2024). This study was aimed at comparing user experiences and perceived efficacy, side effects and preferences of herbal versus synthetic anti-dandruff shampoos with Malassezia furfur-induced dandruff in adults in Lahore, Pakistan. At CMH and Sir Ganga Ram Hospital, Lahore, a cross-sectional survey was done on 179 participants aged between 18 and 50 years of age with self-reported or clinically diagnosed dandruff. Data collection was conducted through structured face-to-face questionnaires which were analysed with IBM SPSS 25 with descriptive statistics, chi-square tests and independent t-tests. Of the 179 respondents, 85.5% had dandruff, with most of the patients having mild (39.7) or moderate (45.3) cases. Synthetic/chemical shampoos were found to be most used (43.6%), then herbal (31.8%), then medicated (24.6%). The statistical analysis demonstrated no significant difference between the types of the shampoo in terms of perceived efficacy (p=0.349), time to improvement (p=0.851), and the side-effect profile (p=0.630). About 77-78 percent of users of all types rated their shampoo as effective or highly effective. Nevertheless, 58.7 percent of the respondents believed that herbal shampoos were safer and 68.2% of them said that they were ready to change to a tested herbal product. At the price and efficacy parity, 41.3% of people liked the herbal choices. Herbal and synthetic anti-dandruff shampoos showed the same real-life performance and time to effect, so the traditional assumption that herbal products are not effective should not be accepted. It is suggested that future randomized controlled studies based on objective clinical endpoints should be conducted.