13.9 Shampoos and other preparations for scalp and hair conditions

General Notes

  • Dandruff is considered a mild form of seborrhoeic dermatitis.
  • Shampoos containing antimicrobial agents such as pyrithione zinc and selenium sulfide (which are widely available) may have beneficial effects.
  • 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.

Shampoos

ChoiceDrugDosage
1st choiceCapasal® shampoo 250mls (coal tar 1%, coconut oil 1%, salicylic acid 0.5%)

Dose:
Apply daily as necessary

or
Polytar Scalp shampoo 150mlsDose:
Apply 1-2 times weekly as directed
or
T/gel® shampoo 125mls/250mls
(coal tar extract 2%)
Dose:
Apply 2-3 times per week

Shampoos with antifungal

ChoiceDrugDosage
1st choice Ketoconazole 2% shampoo 120mls

Dose:
Apply twice weekly for 2-4 weeks (prophylaxis apply once every 1-2 weeks)

Scalp Treatments

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

Dose:
Apply to scalp as necessary; shampoo off after 1 hour

Prescribing Notes

  • 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.
  • Shampoo should be left on the scalp for 20-30 minutes before washing off.
  • Ketoconazole shampoo is often helpful for seborrhoeic dermatitis of the scalp.
  • Eucerin® shampoo (which contains urea 5%) can be particularly useful for elderly patients with very dry scalp.

Caution

Sebco® and Capasal® contain coconut oil; caution should be used if nut allergy is a co-morbidity.

Hirsuitism-see chapter 7 for further information.