13.9 Shampoos and other preparations for scalp and hair conditions

Dandruff is considered a mild form of seborrhoeic dermatitis. Patients should be encouraged to manage dandruff with long term over the counter treatments.
Ketoconazole should be considered for more persistent or severe dandruff or for seborrhoeic dermatitis of the scalp
Corticosteroid gels and lotions can also be used
Shampoos containing coal tar and salicylic acid may also be useful
Patients who do not respond to these treatments may need to be referred to exclude the possibility of other skin conditions


Choice	Drug
1st choice	Capasal® shampoo 250mls (coal tar 1%, coconut oil 1%, salicylic acid 0.5%)
		or
		Polytar Scalp shampoo 150mls
		or
		T/gel® shampoo 125mls/250mls (coal tar extract 2%)


Choice	Drug
1st choice	Nizoral® 2% Shampoo (ketoconazole 2%) 120mls


Choice	Drug
1st choice	Cocois® ointment: (coal tar solution 12%, salicylic acid 2%, precipitated sulphur 4% in coconut oil emulsion basis)

Treatment depends on the severity of the condition. Shampoo formulations are preferred for moderate scaly scalp conditions, whereas more severe conditions may require an ointment
Ketoconazole shampoo is often helpful for seborrhoeic dermatitis of the scalp