How to Pick a Dandruff Shampoo

Trying to pick a dandruff shampoo leaving you scratching your head? Here’s an article for you!

First, a little review of ZO Skin Health.  We have been offering products from Dr. Obagi since we first opened our practice in 2005.  Originally, he offered products under the name OBAGI and transitioned his company to ZO Skin Health in 2007.  They continue to offer some of the most innovative, effective, and trusted skin care products in the world.  

Generally, there are two main problems in seborrheic dermatitis. Number one, there is an overgrowth of yeast on the skin. Number two, the skin is inflamed. Shampoos and other medications to treat seborrheic dermatitis need to treat both of these problems to be most effective.

Before we get to what to look for and specific brands, we also need to discuss how often and how to use a dandruff shampoo.

First, how often. If you are having trouble with extreme dandruff, Dr Rosenberger recommends you wash your hair every day. Many patients are worried they are drying their scalp out too much, but in general that is incorrect. Washing removes oil that the yeast feeds on and helps to loosen and remove the scale that is attached to the scalp. You may only need to use a medicated shampoo a few times a week, but continue washing every day if you have scaling.

Next, how to wash.  Dr Rosenberger recommends lathering up the scalp, leaving the shampoo in for a few minutes, then giving a gentle scrub with your fingertips.  Think of it more like a scalp treatment than washing your strands of hair.  After the scalp treatment portion you can use the same shampoo OR a different shampoo and conditioner to wash the strands of hair.

Many people have trouble choosing a dandruff shampoo because there are SO MANY choices. 

Ways we choose:

Scent – Let’s not kid ourselves.  This is the primary way most people choose a shampoo.

Ease of Use – Many men especially choose a 2 in 1 formula.

Hair Coloring – This one often requires input from the hair dresser who applies your color as to which types of shampoos might alter hair color.  As a simple rule, I do not recommend Selsun Blue or TGel shampoo for those with lightly colored hair.  Both of these can stain or yellow hair.

Active Ingredients – Unfortunately this is usually the last on the list because it is the most confusing.  Let’s review scientifically tested OTC active ingredients and when you might choose one over the other.  Please note I am not including tea tree oil and other ingredients that have very little scientific evidence. I am not including prescription strength ingredients as well since this is a consumer guide to shopping.

Salicylic acid –  This acid helps break down and dissolve the dead skin.  Most commonly found in Neutrogena TSal Shampoo.

Tar –  Tar works as an anti-inflammatory agent.  However, it usually does not kill yeast and has the negative of discoloration and poor smell.  Most commonly found in Neutrogena TGel Shampoo and overall more effective for those with psoriasis than seborrheic dermatitis. 

Ketoconazole – Works to kill the yeast involved in seborrheic dermatitis.  Most commonly found in Nizoral shampoo.  This can also be used to wash ears and hair bearing areas of the face where dandruff is found.

Selenium Sulfide– Works to kill yeast and as an anti-inflammatory however, it has that dreaded smell that really sticks with you.  Also not recommended for lightly colored hair.  It is most commonly found in Selsun Blue Shampoo.

Zinc Pyrithione – Most commonly found in Head and Shoulders.  This is often the most user friendly of the ingredients.  It works to kill yeast and fungus on the scalp.  

So, what do I usually recommend to my patients?  Head and Shoulders is generally the most user friendly.  Generally, Head and Shoulders is Pantene with medicine in it.  So, it comes in a lot of different varieties and leaves the hair feeling nice.  The 2 in 1 “clean” variety is often a patient preferred one.  In general, it checks all the boxes of scent, ease of use, efficacy and not bothering hair color.  

Hope this helps!  And share this with a friend or family member.

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