Products for Itchy, Flaky or Bumpy Scalps

Updated: March 2023
Below is a list of medicated shampoos and conditioners for troubled scalps, sorted by product type and active ingredients. This blog is not intended as, nor replacement for medical advice. We're just sorting out products here. 
I may receive a small commission when you click some of the links on this page, at no cost to you.

Irritation warning: 

Many shampoos contain herbal ingredients which can either soothe, or irritate (or do absolutely nothing). Proteins may soothe a dry scalp, but can also be irritating for some people.
Essential oils like tea tree, rosemary, thyme, sage, peppermint (neem oil is going in small letters because it's so stinky) can be anti-fungal or anti-bacterial. But they can also cause sensitivity reactions or allergic reactions.

Sometimes detergents in dandruff shampoos can irritate already-irritated skin, however, there are some detergent-free options in this post and there are medicated conditioners at the bottom of the page for people whose skin or hair does not tolerate detergents. You can wash your hair and scalp with medicated conditioners.

Not everybody with itching will have flakes, not everybody with flakes will have itching. Some people get painful or itchy bumps instead - but the treatments are usually the same.

If you're not getting relief from over-the-counter treatments:

1) See a doctor or dermatologist to make sure you're treating the correct problem.
2) You may be reacting to an ingredient badly, or using a product that doesn't address the correct issue.
3) You may need to address the problem more systemically, by treating allergies if you have them, washing pillowcases regularly, avoiding hot water and vigorous scrubbing, keeping the sun off your scalp, protect your scalp from dry and cold or hot winds, etc.
4) If you've developed a skin issue at the same time as an illness, change in diet, change in medication, change in skin-care or hair-care products - see #1. Consult a doctor or dermatologist for their professional assistance.

Lets talk about rotating treatments! If you are a frequent customer in the itchy or flaky or bumpy, scaling, patchy scalp-product aisle, there is a good chance you need to have 2 or 3 different strategies  on standby. Why?

Conditions change, products change: A few things contribute to how a flare-up of Seborrheic dermatitis behaves - and responds. Those may influence which treatments work better.

  •  The yeast Malasezzia, which is normally on our scalps can 1) Be an allergen, or 2) Be an irritant. If, for some reason these yeasts increase in number, they can cause problems. Many of these active ingredients are anti-yeast.
  • Skin health and its ability to function as a barrier to the outside can vary. If you sweat a lot, if your scalp is wet a long time, if the seasons change abruptly, or you're out in the wind, you wear a hat you're not used to, a new product irritates your skin - all those things can weaken your skin barrier and cause some irritation and inflammation. Different active ingredients may work better under different conditions - and different product formulas may be more scalp-friendly under different circumstances.
  • Hormones (for men and women) affect skin inflammation and oil production. Oil production has an effect on scalp yeast growth (they "eat" oils). Hormones vary over time with age, pregnancy, stress.
  • Presence of flakes or scaling vs. absence. Being able to see flakes might make us reach for a Salicylic acid shampoo because that's such good exfoliant. Other topicals are mild exfoliants too (Zinc pyrithione, Selenium sulfide, Ketoconazole). Flakes can physically trap yeasts, bacteria and moisture in the top layer of our skin, which could worsen irritation and inflammation. One product may work better when you have flakes than others.
  • Amount of itch: Some products may work better for you for itch. Some may work better for flakes. Keep notes! Make informed choices based on your symptoms.
  • Season and weather: The products you use-and your scalp symptoms may change if you live someplace where there are dry and humid seasons. These environmental changes have big implications for skin health.
  • Product discontinuation. We've all been there, haven't we? We shed a tear for you, beloved discontinued products that kept our scalps happy. Seriously - if you alternate products, you have an automatic back-up plan. May it never happen to you. 

  • Choose based on your need, alternate products for multiple benefits, or look for products with more than one active ingredient - those multi-taskers have their own list at the bottom of the page!

The Active Ingredients: Look for the listed concentration when possible. It may not be listed.
  • Zinc pyrithione: Anti-yeast, reduces flaking, anti-inflammatory. Effective at 1%, or 0.1% to 0.25% for leave-on products.
  • Tar: Slows proliferation of skin cells. Skin cells may proliferate extra-fast with dandruff - so you end up with scaling and flaking. Effective as 0.5% active tar.
  • Salicylic acid: Exfoliating (remove scales and reduces flaking), can be anti-inflammatory. Effective at 1% to 1.5% and greater, sensitive skin may need 0.5% to avoid irritation. 
  • Selenium sulfide: Anti-yeast, reduces flaking, effective at 1%
  • Sulfur: Mild antifungal and antiseptic, anti-inflammatory, mild exfoliant. Effective at 2%
  • Ketoconazole: Anti-yeast. Effective at 1%, 2% is a prescription dose (non-prescription outside the USA). 
  • Tea tree oil: Anti-fungal, anti-septic.
  • Rosemary oil, thyme oil, cedar, peppermint oils: Anti-fungal, anti-septic, may promote healing.
  • Hydrocortisone and topical steroids: Reduces inflammation and relieves itching. Effective at 1%.
  • Piroctone Olamine: Anti-yeast, Effective at 1%, or possibly as low as 0.1% to 0.3%. 
  • Ciclopirox olamine: Anti-yeast.
  • Climbazole: Anti-yeast, 2% or lower in rinse-off products.
Note: This is organized by active ingredients. Also indicated are: Sulfate-freesilicones. Sulfates ("sulfate detergents," a class of anionic detergents) and silicone emollients/detanglers are not necessarily bad for itchy or scaly scalps, but some people avoid them so I'm just trying to help you narrow the field. "Sulfate-free" shampoos are not necessarily milder or non-drying. 

Medicated Shampoos

Tar

Tea Tree

Zinc Pyrithione

Salicylic acid


Sulfur

Ketoconazole

Selenium sulfide

Hydrocortisone

Piroctone Olamine

Ciclopirox olamine

Climbazole


Medicated Conditioners and Co-washes: Note, you can leave these on for 10-15 minutes before washing your hair (you might want to dampen it first), then cleanse with your usual cleanser.

Non-Shampoo (Leave-on) Products - good for between washes, protective styles, braids and locs:


    More than 1 active ingredient:

    19 comments:

    1. Hi Wendy, I'm hugely impressed by your blog.

      I'm a 25y male suffering mild MPB and seborrheic dermatitis. I have an incredibly inflamed & sore scalp continuously- I have used coal tar and other medicated shampoos. My question is do you consider urea shampoos and topicals an effective soothing treatment? For example 'Eucerin DermoCapillaire CALMING UREA SHAMPOO', and their 'Eucerin calming urea treatment' topical. Or perhaps I would be better going for 'Redken Scalp Relief Soothing Balance Shampoo'? What do you think about the ingredients of these?

      I have some further topical treatments you can add to your list, but will wait for you to respond before I post them all here. I have done some research into each and put together ingredient lists if you are interested.

      Thanks,
      Sam

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      1. Hello Sam,
        I have added urea (powder, cosmetic ingredient) at 5% to my own shampoo (mild detergent, fragrance-free) and my opinion is that it is soothing for a chronically itchy, inflamed scalp. You can hunt down some articles or abstracts on Pubmed. It is not easy to formulate with, but I'm not sure if that's the reason so few products use it. My concern with a product like Eucerin DermoCapillaire shampoo is that there is so much detergent, it could be causing more irritation - unless one has a very greasy scalp naturally and not caused by over-washing. I don't see a good ingredient list for the topical treatment.

        I actually find that niacinamide is more soothing and has the potential to reduce inflammation so skin can repair itself and I have been using that with satisfactory results. There is more research supporting niacinamide than urea. I believe there is an OGX shampoo with niacinamide.

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    2. Hi, Wendy! How are you?
      What is the adequate concentration of essential oils and how to use?
      Thanks!

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      1. Hello Dorothy,
        The concentration for tea tree oil is listed on this page, following some published studies. It's about mid-way down the page. http://science-yhairblog.blogspot.com/2011/12/itchy-scalp-some-easy-remedies.html
        You can add essential oils to a shampoo or to another oil, but it's best to patch-test first if you have sensitive skin.

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      2. Sorry. I saw the information after I have sent the message hahaha Thanks!

        Delete
    3. Hi WS,

      I have something I am super confused about. Maybe you can help or help me get to the bottom of it.

      I have been using shampoo with SLES since always, I think. But suddenly I got these dry scalp flakes. I was using a drugstore SLES shampoo with silicones at the time. So I switched to a SLES shampoo from Lush but without silicones. The problem persisted. Then I tried these Lush Fun bars on my hair for, well, fun. They all contain:

      Cornflour, Talc, Glycerine, Sodium Laureth Sulfate, and then just different essential oils, perfume and color – depending on which color you use.

      And what can I say, they've delivered some of the best result on my scalp and hair so far. OK, they're not so great on my bleached ends, but: no flaking! Regardless of which essential oils are in it besides.

      So what could it be? The cornflour and talc are clearly there just to achieve the Fun bars' form and peculiar texture. So the only things doing anything are the glycerin and SLES, no? I'm basically washing my hair and scalp purely with detergent, and not even a mild one at that!! So, why is it still so good for my scalp and hair? Doesn't that also mean that all that other stuff in shampoo is useless?!

      Thank you in advance for your help!

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      1. That's interesting. The Lush Fun bars will have quite a lot of cornstarch in them to get that texture. And then the amount of detergent is probably similar to some drugstore shampoos. However - the glycerine is a humectant and may reduce skin irritation from detergent. You're also diluting the product when you lather it up in your hands.

        Think about what is NOT in this product - the fragrances are essential oils, which are less irritating than synthetic fragrances for some people. The thickener is starch and talc, not a lot of irritation potential. No pearly-looking thickeners, no conditioning ingredients or herbal additives, they're not listing much in the way of preservatives and preservatives can cause irritation. Each additional ingredient in a shampoo comes with its own irritation potential. Thickeners aren't useless, (who likes runny shampoo?) and conditioners etc. are useful for some people's hair that tangles during washing. But a lot of ingredients are added to a product because they help sell the product. Maybe a customer is more likely to buy a product with conditioners and herbal extracts because that sounds like more value or a better product. Or maybe a customer will buy a shampoo that helps detangle their hair because that is an absolute necessity. Shampoo-makers cater to both. "Bare bones, nothing but detergent and glycerin" shampoo won't appeal to a large demographic. But those extra ingredients aren't all that necessary for YOU, and that's useful information for you to have.

        The problem your skin was having may have been a sensitivity reaction to an ingredient(s) in a shampoo you were using. And you may be using less detergent overall with the Lush product, depending on how much liquid shampoo you used.

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    4. Hi WS,

      I am trying to do the curly method which looks for "sulfate free" conditioners and I also have dandruff. With that said, can you point me in the right direction to a conditioner which satisfies both qualities (sulfate-free/helps w. dandruff). I understand that there are varieties of causes for dandruff and dry scalp, and am still hoping you may know something.

      Thank you for your time.

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      Replies
      1. I can point you to the list on this page above for medicated (dandruff-treating) conditioners and co-washes, especially if you want to conditioner-wash your hair. That is the second-to-last list. Look for the conditioners that are not marked "contains silicone" - which is in orange so it's easy to find.
        You do NOT need to worry about sulfates in conditioners. The Curly Girl book says not to use sulfates, but it means detergents like Sodium lauryl sulfate. Ingredients in conditioners like Behentrimonium methosulfate are not bubbly detergents and are very curl-friendly conditioning ingredients.

        You might also be able to use one of the non-shampoo, non-conditioner treatments which are the last list on this page. Good luck! W

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    5. Hi Wendy, thank you so much for this detailed list of shampoos, conditioners and soo much more. Speaking for all my Curly hair girls around the world, WE APPRECIATE IT THANK YOU. So I having a natural for about half a year now and have recently started developing dandruff in my scalp and my curls have totally dehydrated. I am low porosity and well I do not know what products are out there to apply before or after I wash my hair in order to hydrate my low porosity curls and prone to dandruff hair. I'M REALLY STRUGGLING, please if you have any products in mind, like deep conditioners or anything, it would be of great help.

      Thank You for this Blog it rocks

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      Replies
      1. Hello Steph,
        One thing about changing hair routines - sometimes it brings on an attack of dandruff because you're using new and different products and one or more of them might be irritating your scalp - and the solution is to find something that does not irritate your scalp or promote dandruff and stick with it.

        For low porosity hair, I'll direct you to the "Moisturizing Low Porosity Hair" post in the Popular Posts link on the right side of the page. For a deep conditioner (because I have an extremely picky scalp), I usually mix a little oil and a liquid protein additive or a little honey or aloe with my rinse-out conditioner and leave it on with some heat. Although I try to keep products like conditioner off my scalp because it tends to flare up the itching.
        With low porosity hair, humectants are extremely helpful, there should be some film-forming humectants like panthenol, aloe, flax, in your rinse-out conditioner and leave-on products to help with hydration - but without being oily or heavy.
        -If you're using products with protein every wash day - take a break from protein, you may need it less often. too mugh protein can dry hair out.
        -If you're using a lot of coconut oil - take a break from ALL products with coconut oil (including actual coconut oil) in case you're a person who can't use coconut oil and that's causing the dryness. Coconut oil can be a scalp irritant for some people - and a scalp healer for others. My skin hates it!
        -If none of those help, then a medicated scalp treatment may be a good idea. The non-shampoo treatments at the end of the list may be helpful. Like the Davine's Natural Tech Purifying Gel. It's a gel that goes on your scalp 10 or 15 minutes before washing your hair. It comes in a pretty large tube. Or either of the Scalpicin formulas, which can be applied at any time.
        -Get an inexpensive scalp brush to massage your scalp and loosen up the dead skin and use it regularly on your scalp - those can make a tremendous difference. Exfoliating helps the skin stay healthy.
        - If all else fails, see a dermatologist. Some people would do that first. They might have better insurance than I have. They can prescribe very effective treatments. Not all of which are shampoo. I'm not a huge fan of medicated shampoos, the detergents can dehydrate the skin and create irritation. If you are experiencing an ingredient sensitivity, a dermatologist can do a patch test so you'll know what ingredients to avoid, which could be a huge help. Good luck! I hope that helps. W

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    6. Hi Wendy,
      Would you recommend that these shampoos are diluted at use, or kept as they are to fulfill their concentration requirements? For instance, would Zinc pyrithione- containing products at a 1% concentration be diluted 1:1 with water so that they are at 0.5% concentration? Or is that not how it would work?

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      1. Hello Rain Storm,
        You can dilute a 1% Pyrithione Zinc shampoo 1:1 with water for 0.5%, but the response may be slower or the treatment may be less effective. 0.5% does work for some people.

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    7. Hi Wendy I've only just discovered this blog and I'm totally loving it! I've been through so many things with my hair over the years but finally completely natural after a lot of flip flopping with weaves and relaxers, I'm now only totally only rocking my natural which I'm really enjoying albeit the work involved.

      One of the first methods I experimented with was the water only washing method which tbh was totally working for me as my schedule at the time was pretty open so I had the time to follow all the steps everyday. I was also on a detox at the same time (lots of time on my hands) so I had the time to take care of my hair and I noticed a significant difference in my curl pattern. It became a lot looser allowing for greater pliability - I have 4C, low porosity, dense hair that hates coconut oil when not mixed with anything else...

      I noticed the difference in the texture after a few weeks and couldn't believe how fast my hair was growing so I continued using the method as the results were so great. It's an interesting one as I didn't feel my scalp was producing excessive amounts or any sebum for that matter which would really have contributed to the softer texture. I didn't understand it but continued... My schedule then changed and I could no longer continue with the method which was a shame as I was seeing fast and great results but it started becoming dry and brittle so I flung a weave in again as time wouldn't prevail and I had no real idea how to take care of my hair then. Fast forward a year or so - I got rid of the weave again and decided to have a crack at sorting out my hair care.

      I started out using the DIY's that I used during the WOW days including baking powder and ACV rinses (which I never used after the second time due to the excessive drying out of my strands) avocado, fenugreek and banana hair conditioner which my hair loves and I still use prob once a month, I detangled with okra juice once again my hair loves this stuff (every time Gumbo was on the menu, my hair got a treat) so most of the DIY's I used when I water only washing got injected into my hair regime along with my Shea butter mix consists of various other oils used as a sealant. Once again a schedule change meant I had no time to do DIY's anymore so I started looking into products that could help me get the same effect as the DIY's or better...

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    8. In the first few months I got heat happy using temporary keratin treatments - Lord help me! Eventually, one day as I started using my flat iron, my ends became stiff and looked fried! From that day I haven't used heat on my hair again. I cut my hair prob 5 inches off and stopped using the keratin treatments instead started using Shea moisture products following the LCO method. They are ok but they don't have the slip I really liked with my DIY's and some of the keratin treatments I had used as they had more slip. I'm currently also experimenting with Bekurla products and some Ayurvedic powders such as amla and henna which I feel I will use more of... I feel like this has become an almighty ramble but the reason I'm here is because I teach hot yoga (schedule changes) and my scalp itches quite a bit. I feel its due to the fact that my scalp is mostly wet which when I wore weaves was great as I feel my hair grew faster then. Now, my roots become tight so I stretch them to prevent the breakage with a Green Beauty product that restores the natural PH of the hair every night but then maybe the next morning I will teach a hot class again so am wondering if you recommend I use a conditioner maybe with added tea tree oil each time i teach a class? I also have an issue with shedding even though I've cut off a fair amount of hair whenever I pull the ends some hair must come out I should say here that my hair has always shed quite a bit I'm not sure if this is normal but its always been like that so i never worried about it but surely it should stop if I've cut off the dead ends? my final question is that my curl pattern when wet is becoming more and more elongated which is strange, I'm still experiencing the trials a 4C hair type experiences; knots, tangles (although not as much) and I noticed that some hairs I put in water the other day didn't just float on top anymore (I've been low porosity for as long as I can remember) a little ball sank to the bottom some didn't but do you think the porosity of my hair is changing and if so can this explain the continuous shedding or would that be down to the itch scalp?

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      Replies
      1. Hello Mary,
        That's a lot of information! Itchy scalp due to staying damp often could well be a yeast or bacteria overgrowth, they love moist, warm conditions. Also - your scalp might be reacting to a product you are using. Losing hair daily is normal. Losing hair when you pull on it can sometimes be a sign that your scalp is not entirely happy - there may be some irritation or inflammation.

        A leave-on medicated treatment is probably best for that to discourage itchy microorganisms. There are some prescription medications (lotions, gels) if it gets very troublesome and over-the-counter treatments don't work well enough.
        Tea tree oil conditioners may not contain enough tea tree oil to really work (it smells strongly like turpentine), but you might add a drop of tea tree oil to your conditioner when you use it. Rosemary essential oil can also be helpful.

        I have not personally tried the "Save Your Do" hair wrap, but it is supposed to be sweat-wicking and if it's truly effective, it might help pull some moisture from your scalp. That's what "workout wear" fabrics like that do - they have little channels that pull moisture from one side, through the fabric and to the other side where it evaporates. At least between hot yoga classes. You might read some reviews, see what people say about it. I do like the sweat-wicking band I have in one of my sun hats much better than the non-wicking ones.

        Using a hair dryer on the cool setting to get your scalp dry more quickly can go a long way towards keeping the scalp healthy too. I'd be reluctant to set it on "warm" because that might create more irritation.

        With the change in your hair's curl pattern and float-ability recently, I suspect there are a number of things going on. The keratin treatments may have caused some damage, as well as heat-styling. If the product you are using that restores pH contains vinegar, citric acid, or a lot of aloe, the pH might be too low (acidic) and causing some accumulated damage to your hair. Which seems all the more likely when you mention that vinegar rinses did not agree with your hair.

        Sometimes hair and curl will change when the scalp is irritated because the texture and composition of the sebum changes - sometimes it becomes more waxy and less fluid. But there may be more going on than just that.

        If your hair and scalp was very happy with your DIY products and water-washing, do you think you might be able to brain-storm up an abbreviated, streamlined version that would fit your schedule, no matter how it changes?

        It sounds like your hair might benefit from some oil pre-wash treatments. The amount of oil you use should be completely "wear-able" - just enough to make hair feel more easy to detangle and flexible, but not greasy. Leave it on for a few hours before washing. That can help when hair has become more porous.
        Best wishes - W

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    9. I just got the email for this page! I hadn't seen this one! I have the oily, waxy film but suuuuuper dry hair (4a). I've figured out some of the great advice on this blog through trial and error. I use and love the Body Shop Ginger scalp shampoo! I do add essential oils to it also. I stopped using pyrithione zinc shampoos because I read studies about it causing hair loss/thinning over time whereas piroctone olamine actually can encourage thicker hair growth. Co washing is fine ONLY if done between my weekly wash with shampoo, otherwise the itchy, waxy film comes right back. Before I wet my hair, I apply and massage the shampoo directly on my scalp and let it sit for 30 min with conditioner on my length/ends. Then, I rinse it all out and proceed with detangling and DC. Oh and the ONLY oil I can use on my scalp is castor oil. Anything else just feeds the yeast. I would love to know if there are any other oils out there like castor oil. Thanks so much for your research and for sharing what you find!

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      1. Hi Rad4Chica, I have used The Body Shop Ginger shampoo. It has to be the nicest-feeling, nicest-smelling itchy scalp shampoo ever! My stupid scalp hated it (and my husband's too), but they really nailed the fresh ginger scent. I've seen some studies of Pyrithione zinc helping with thinning hair somewhat - but I haven't seen anything about promoting hair thinning. Yet. Anything is possible with cranky scalps, in my (biased) opinion, though. That is very interesting about castor oil. I have read some studies that indicate it has anti-inflamamtory and anti-microbial effects. Coconut oil has some anti-microbial effects, but it doesn't get along well with everybody's scalp. Thanks for sharing your shampoo routine. Best wishes - W

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    10. I'm having trouble finding a good color-safe shampoo with an anti-fungal active. Is there anything else I should look for color-safe besides sulfate-free?

      Nizoral is listed to be sulfate-free, but I see SLS in the ingredients list.

      ReplyDelete