Evaluation of Scalp Hydration and pH Values in Hijab-Wearing and Non-Hijab-Wearing Women

Risa Miliawati Nurul Hidayah, Muhamad Radyn Haryadi Widjaya, Hendra Gunawan, Endang Sutedja, Reiva Farah Dwiyana, Eva Krishna Sutedja Department of Dermatology and Venereology, Faculty of Medicine, Universitas Padjadjaran - Dr. Hasan Sadikin Hospital, Bandung, IndonesiaCorrespondence: Risa Miliawati Nurul Hidayah, Department of Dermatology and Venereology, Faculty of Medicine, Universitas Padjadjaran - Dr. Hasan Sadikin Hospital, Jl. Pasteur 38, Bandung, West Java, 40161, Indonesia, Tel +62 8122324231, Email [email protected]: Indonesia is the most populous Muslim-majority country, where some women wear hijab covering their scalp and neck. Some hijab-wearing women complain of scalp problems eg, itch, dandruff, and hair loss, which might be related to severe and chronic skin barrier impairment due to occlusion. Excessive water accumulation in the occluded stratum corneum might result in increased permeability, followed by increased skin pH values. This study aimed to evaluate scalp hydration and pH values in hijab-wearing and non-hijab-wearing women.Material and Methods: This was a cross-sectional comparative analytical study using stratified random sampling methods conducted on 63 subjects, who were divided into two groups, consisting of 33 hijab-wearing and 30 non-hijab-wearing women. Both groups underwent physical examination and their medical history recorded. Scalp hydration was measured using a Corneometer (Courage + Khazaka, Koln, Germany), and scalp pH value was measured using a Skin & Scalp pH Tester (Hanna Instruments® HI981037, Rumania). This study was conducted at the Dermatology and Venereology Clinic of Hasan Sadikin General Hospital Bandung.Results: The mean scalp hydration and pH values were 18.34 ± 2.91 AU and 4.93 ± 0.17, respectively, in hijab-wearing women. Meanwhile, the mean scalp hydration and pH values were 17.71 ± 3.35 AU and 4.91 ± 0.16, respectively, in non-hijab-wearing women. The difference of scalp hydration and pH values between the groups was not statistically significant based on the independent t-test, with p-values of 0.430 and 0.597, respectively.Conclusion: Scalp hydration and pH values in hijab-wearing and non-hijab-wearing women did not differ significantly. Hijab-wearing women should not worry about scalp barrier impairment as long as they do not have any history of underlying scalp and skin disorders, and do not wear hijab in wet condition.Keywords: hijab, hydration, pH, scalp, wome

Characteristics of Biofilm-Forming Ability and Antibiotic Resistance of Cutibacterium acnes and Staphylococcus epidermidis from Acne Vulgaris Patients

Kartika Ruchiatan,1,2 Trustia Rizqandaru,1 Panji Respati Satjamanggala,1 Nisrina Tache,1 Adi Imam Cahyadi,3 Andri Rezano,4,5 Hendra Gunawan,1 Eva Krishna Sutedja,1 Reiva Farah Dwiyana,1 Risa Miliawati Nurul Hidayah,1 Pati Aji Achdiat,1 Endang Sutedja,1 Oki Suwarsa,1 Reti Hindritiani1 1Department of Dermatology and Venereology, Faculty of Medicine, Universitas Padjadjaran-Dr. Hasan Sadikin Hospital, Bandung, West Java, Indonesia; 2Doctorate Program, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia; 3Division of Microbiology, Department of Biomedical Sciences, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia; 4Division of Cell Biology, Department of Biomedical Sciences, Faculty of Medicine, Universitas Padjadjaran, Sumedang, Indonesia; 5Graduate School of Biomedical Sciences Master Program, Faculty of Medicine, Universitas Padjadjaran, Bandung, IndonesiaCorrespondence: Kartika Ruchiatan, Department of Dermatology and Venereology, Faculty of Medicine, Universitas Padjadjaran - Dr. Hasan Sadikin Hospital, Jl. Pasteur 38, Bandung, West Java, 40161, Indonesia, Tel +62811247932, Email [email protected]: Acne vulgaris (AV) is a common and chronic disorder of the pilosebaceous unit and has a multifactorial pathology, including activities of Cutibacterium acnes (C. acnes) and Staphylococcus epidermidis (S. epidermidis). Antibiotic resistance has become a major concern in dermatology daily practice, and the ability of biofilm formation by both bacteria is suggested to increase antibiotic resistance in acne.Purpose: Our aim was to analyze the comparison of antibiotic resistance between biofilm-forming (BF) and non-biofilm-forming (NBF) strains of C. acnes and S. epidermidis towards seven antibiotics commonly used for acne.Methods: This is a cross-sectional analytical study involving 60 patients with AV. Samples were obtained from closed comedones on the forehead using the standardized skin surface biopsy (SSSB) method at the Cosmetic Dermatology Clinic Dr. Hasan Sadikin in Bandung, Indonesia. Isolates were cultured and identified before undergoing the biofilm-forming test using the tissue culture plate method. Antibiotic susceptibility testing for each antibiotic was then performed using the disc diffusion method.Results: The incidence of antibiotic resistance to clindamycin in BF and NBF C. acnes isolates was 54.5% (p=1.00), while in BF and NBF S. epidermidis isolates, it was 54.5% and 45.5% respectively (p=0.67). The incidence of antibiotic resistance to erythromycin and azithromycin in BF and NBF C. acnes isolates was 54.5% and 63.6% respectively (p=1.00), whereas for S. epidermidis BF and NBF isolates, it was 54.5% (p=1.00). There was no resistance observed to tetracycline, doxycycline, levofloxacin, and cotrimoxazole in all groups.Conclusion: There were no significant differences in resistance against seven antibiotics between the C. acnes and S. epidermidis in BF and NBF groups. Furthermore, although statistically not significant, some resistances were observed against clindamycin, erythromycin, and azithromycin. Consequently, the use of these three antibiotics should be judiciously regulated.Keywords: acne vulgaris, antibiotic resistance, biofilm, Cutibacterium acnes, Staphylococcus epidermidi