If you have seborrheic dermatitis, you may experience skin flaking and itchiness, which can often show up as dandruff. Many people with this skin condition find they can better manage their symptoms by switching from a regular shampoo to a medicated one.

If you’re looking for an effective shampoo, it can be helpful to seek out active ingredients in over-the-counter (OTC) products that treat flaky skin, itchiness, or rashes. The following ingredients found in medicated shampoos might help control your seborrheic dermatitis.

1. Zinc Pyrithione

Zinc pyrithione, an active ingredient in many dandruff shampoos, is modeled after a naturally occurring antifungal agent called antimicrobial aspergillic acid. Therefore, it has several antifungal properties.

Although scientists aren’t sure why it’s effective, it may be that zinc pyrithione helps control the population levels of bacteria and a fungus called Malassezia on the scalp, reducing dandruff.

Zinc pyrithione is also believed to work well when combined with other ingredients, such as ketoconazole or ciclopirox.

2. Salicylic Acid

Using salicylic acid as a keratolytic (a substance that breaks down the skin’s outer layer) provides a method of exfoliating your skin. It peels away the scaly layer associated with seborrheic dermatitis seborrheic dermatitis symptoms and can also be used to treat psoriasis, eczema, and contact dermatitis.

You’ll find salicylic acid listed on the ingredients labels of shampoo brands such as Neutrogena T/Sal, Selsun Blue, Ionil T, and Salex. Make sure to check with a doctor before using a product containing salicylic acid, particularly if you have kidney or liver disease.

3. Selenium Sulfide

Selenium sulfide shampoos are often used to treat fungal infections on the scalp, in addition to dandruff or dermatitis. Shampooing with a product containing selenium sulfide has been shown to treat seborrheic dermatitis effectively.

Shampoo brands such as Selsun Blue and Dandrex have selenium sulfide as an active ingredient.

4. Ketoconazole

Antifungal agents like ketoconazole are typically regarded as effective treatments for seborrheic dermatitis. Azoles, which also include itraconazole and bifonazole, work by inhibiting the growth of fungus on the affected areas. Many of these agents may also have anti-inflammatory properties.

Shampoos containing ketoconazole are available over the counter (1 percent strength) — such as Nizoral — and by prescription (2 percent strength). Ketoconazole may also be prescribed in combination with other active ingredients, such as zinc and selenium.

5. Coal Tar

Coal tar shampoo can be found on the shelf under brand names such as Neutrogena T/Gel, Pentrax, and Theraplex. Studies have shown that shampoo with coal tar — particularly when combined with other ingredients — can help reduce seborrheic dermatitis on the scalp.

Be aware that coal tar products may stain your hair, skin, or clothing.

Tips for Using a Medicated Shampoo

A medicated shampoo can be used two or three times weekly or even once daily, depending on your shampooing routine and symptoms. You can follow this regimen for several weeks, then cut back to just once a week or every other week. To maximize effectiveness:

• Rotate shampoos, using a different one each time you wash your hair. This may help prevent your scalp from becoming tolerant to a particular ingredient.
• Carefully follow directions, which usually call for lathering the shampoo into your scalp, letting it sit for several minutes, rinsing, and repeating.

If your shampoo seems to be losing effectiveness, make sure you’re leaving it on your scalp long enough before rinsing. If you’re confident that you’re using the shampoo correctly, you might need to combine it with products that have other active ingredients so that you continue seeing results.

General Hair Care Tips for Seborrheic Dermatitis

Each person’s treatment plan for seborrheic dermatitis is unique — what works for some people may not be effective for others. However, following a few rules of thumb can help keep your symptoms at bay.

• Wash your scalp regularly. Use warm water rather than hot, which could aggravate your skin.
• Avoid styling products such as hair sprays and gels that might make your skin more itchy or inflamed, such as those that contain alcohol.
• Consider using natural remedies such as tea tree oil or aloe, which might benefit you.

Check With Your Health Care Provider

If OTC treatments or home remedies aren’t working for you or you feel your symptoms are getting worse, check with your health care team. Prescription topical steroids may be helpful for treating seborrheic dermatitis. Talk to a dermatologist familiar with your symptoms to get personalized advice and ensure you don’t use shampoos that cause further irritation or side effects.

Talk to Others Who Understand

MySebDermTeam is the social network for people with seborrheic dermatitis and their loved ones. On MySebDermTeam, members come together to ask questions, give advice, and share their stories with others who understand life with seborrheic dermatitis.

Have you tried medicated shampoos for treatment of seborrheic dermatitis? Post your comments and questions on your Activities page and get insights from MySebDermTeam members regarding shampoos and other treatment options.