Finding a good soap or shampoo when you have psoriasis can be hard. Any product you choose needs to manage the flaking and other issues that come with scalp psoriasis. Many shampoos on the market have ingredients that make psoriasis symptoms worse. No one wants their already itchy, painful scalp to have an allergic reaction to something that’s supposed to help the skin.
One MyPsoriasisTeam member aptly described the struggle. “I find it more important to watch what shampoos, laundry soap, and lotions have direct contact with the skin — even the materials they’re made from.”
The scalp is one of the most common areas of affected skin for people with psoriasis. One study estimated that 80 percent of people with psoriasis have had it on the scalp. Shampoo and conditioner are both simple treatments for scalp psoriasis. They’re easily applied as part of your daily routine, and they can be discontinued quickly if they cause an adverse reaction.
There are several shampoos and treatments available over the counter that can soften psoriasis scales and heal sensitive skin on your scalp. Many can be ordered online or purchased at your local drugstore. It is best to choose two or three of these shampoos and rotate their use, so the scalp does not get used to only one shampoo.
Coal tar doesn’t seem like the sort of thing you would want on your scalp, but in fact, coal tar shampoo is one of two over-the-counter treatments the U.S. Food and Drug Administration (FDA) has approved to fight psoriasis. (It can also be used as a dandruff shampoo.) Unlike several other psoriasis treatments for the scalp, coal tar can be used on a long-term basis.
Coal tar can treat itching and plaque psoriasis. One member warned that, while coal tar worked, the smell was unappealing. “I currently use coal tar shampoo, but it has a very strong odor.” You can use a regular shampoo after using coal tar to leave your hair feeling and smelling the way you like it.
Coal tar can also irritate the skin and cause a rash, so any use should be carefully monitored. Warnings about coal tar causing cancer apply to highly concentrated industrial uses, such as paving. However, it can’t hurt to get screened for skin cancer periodically if you’re using such a product.
If scalp psoriasis is particularly thick, it might not be possible to use medicated shampoos at first. Salicylic acid can soften it. While it’s mostly known as an acne medication, salicylic acid is a keratolytic — an agent that helps the outermost layer of the skin to shed. It can help soften scales on the scalp and make them more able to absorb medication.
However, salicylic acid can also cause irritation if left on the skin for too long, and it can weaken hair follicles. Since hair loss is also a symptom of scalp psoriasis, some people may not consider that a fair trade. One MyPsoriasisTeam member said, “Washed hair with salicylic acid shampoo. Was OK for a while, then it kicks up again!” Another member swore by it: “I found this line of shampoos and conditioners a few months back on my search for scalp relief. … It says it's ‘anti-dandruff’, but the main ingredient is salicylic acid, which is made for our condition.”
One member found that a product combinating coal tar and salicylic acid helped the most: “It's called MG217. There are two shampoos — one’s a salicylic acid to use first, then you switch to the coal tar shampoo after the peeling and flaking stops.”
While it’s not a psoriasis treatment, zinc pyrithione shampoos can also be helpful. They’re usually recommended to treat severe dandruff, but they can reduce the itching and skin flaking that is a part of psoriasis. “I find that a shampoo with at least 1 percent zinc pyrithione seems to keep my scalp issues at bay,” a MyPsoriasisTeam member said.
Ketoconazole shampoo is available over the counter (1 percent) and by prescription (2 percent). While ketoconazole is antifungal, it is used to treat scalp psoriasis and dandruff.
Selenium sulfide is another ingredient commonly found in over-the-counter shampoos for scalp psoriasis.
Coconut oil isn’t a shampoo, but you may see it mentioned as a potential scalp treatment. It doesn’t treat the underlying psoriasis, but it works to keep skin moisturized. Properly moisturized skin itches less than dry skin. Coconut oil isn’t the only way to do this — many creams, ointments, and any cooking oil or even shortening will moisturize. They should not be used daily; only apply them on an occasional basis. One member said, “I was warned not to wash my hair every day, as this adds to drying out of your scalp and potentially washing out any good creams, lotions, and natural oils.” Not all members reported positive results with coconut oil. “My scalp is so weak that coconut oil makes my hair fall out badly,” one member said.
The true “big gun” in the fight against scalp psoriasis is Clobetasol topical. It’s a topical steroid available in some prescription shampoos, lotions, and solutions. Unlike other shampoos, Clobetasol shampoos are specifically designed for psoriasis. Since it’s only available by prescription, a dermatologist will need to give it to you. Clobetasol shampoos can be used every day for up to four weeks, or once or twice a week on a long-term basis. This shampoo is usually left on the scalp for about 15 minutes before washing out. Studies have shown that treatment with Clobetasol is highly effective at managing psoriasis build-up on the scalp.
The National Psoriasis Foundation has a Seal of Recognition attached to certain products. When it’s attached to personal care products like shampoo, it means the product is formulated not to irritate the skin. The Seal of Recognition Product Directory is available online. Just because a product is designed not to irritate doesn’t mean that it won’t irritate your skin specifically. Be sure to test any new product on a small area of your skin first, and watch for any side effects.
MyPsoriasisTeam members have reported a variety of shampoos that help their scalp psoriasis symptoms:
Do you have scalp psoriasis? Are you looking for a shampoo? Found a brand that works for you? Comment below or start a new conversation on MyPsoriasisTeam.