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Date Published: 02/22/2017

The Ultimate Shampoo Guide for Scalp Psoriasis

Finding the right shampoo can alleviate those more intense symptoms and make it easier to enjoy the day or sleep.

In this guide, we look at the best psoriasis shampoos and their key attributes. Hopefully after reading this, you’ll know exactly what type of shampoo will work best for your scalp psoriasis.

Tar-Based Shampoos
Coal tar is one of the oldest and most commonly used treatments for psoriasis. Tar works by:

  • Slowing the growth of skin cells, preventing some of the excess buildup
  • Killing off the bacteria that causes scalp psoriasis
  • Soothing irritation
  • Softening scales and crusting
  • Helping restore your skin’s health

Coal tar shampoos vary in concentration and (as one would expect) a higher concentration means stronger effects. The FDA only allows up to 5% tar to be sold over the counter, since extremely high concentrations may be carcinogenic. Don’t worry, levels of tar that may cause cancer are the types to be found in industrial paving! You won’t be at risk from a shampoo. Nevertheless, the link warrants certain restrictions on what you can get without a prescription.

Speaking of risks, there are a couple things you should know about coal tar shampoo:

  • It may be smelly and cause irritation rather than helping. Like most topical medications, you should test it on a small patch of skin before using it.
  • It makes you sensitive to the sun for at least 24 hours after use, sometimes longer. Plan accordingly and pay special attention to sun exposure. On the day following a hair wash, hats and sunscreen are an even better idea than usual!

If you get coal tar shampoo in your eyes, rinse them with water for at least five minutes. If you swallow any, contact a poison control center immediately.

Talk to your doctor before trying coal tar shampoo if you are:

  • Pregnant, nursing, or may become pregnant
  • You are already taking other psoriasis medications (including over-the-counter treatments!)
  • You have sores or cuts on your scalp

Now that we’ve gotten all of the warnings out of the way, let’s get to the tips! If you and your doctor think coal tar shampoo is a good choice for you, here are some things to keep in mind:

  • Coal tar shampoo works best if you leave it in for a full ten minutes after lathering. You can even rinse and repeat if necessary.
  • Don’t use conditioner afterwards. If your hair is prone to dryness, try to find a coal tar shampoo with added coconut oil or other oils.
  • Read the instructions on the bottle regarding how often to use the coal tar shampoo. You can use normal shampoo on off days if you like.
  • If your doctor says it’s right for you, you can use a moderate-strength topical steroid solution overnight after using your coal tar shampoo. This is often an effective combination.

Some common examples of coal tar shampoo include:

  • Pentrax
  • Sebutone
  • T-Gel
  • Zetar
  • Salicylic Acid Shampoos

Does salicylic acid already sound familiar to you? If so, there’s a good chance you or one of your loved ones struggles with acne.

Patient with scalp psoriasis uses salicylic acid shampoo
Salicylic acid is actually used to treat a variety of skin conditions, including several types of psoriasis! The acid causes the skin to shed its cells, which may cause extra flaking in the short term. However, a salicylic acid shampoo can have excellent long-term effects on your scalp psoriasis symptoms.

As with tar-based shampoos, there are a couple situations in which you should avoid using salicylic acid. In fact, some of them are the exact same. Talk to your doctor if any of the following apply to you:

  • Currently pregnant, nursing, or may become pregnant
  • Taking any other medications for your psoriasis (including over-the-counter treatments!)
  • Have a cut or open sore on your scalp

You have any of the following issues:

  • Kidney or liver problems
  • Diabetes
  • Skin irritation or infection
  • Poor circulation
  • A history of Reye syndrome
  • You are under 18

If you are on:

  • Ammonium sulfate
  • Heparin/warfarin
  • Steroids
  • Methotrexate
  • Aspirin
  • Sulfonylureas

Salicylic acid shampoo also comes in both prescription and nonprescription varieties. If you and your doctor think an over-the-counter salicylic acid shampoo is right for you, here are some instructions:

  • Apply shampoo to a DRY scalp
  • Let it sit for 5 minutes (you can gradually increase this time if needed)
  • Rise your hair thoroughly
  • Wash your hair as usual, with a normal shampoo and conditioner

How often you use the medicated shampoo will depend on the concentration of the salicylic acid. Remember to read the instructions carefully and consult with your doctor if needed.

If you only have mild psoriasis and salicylic acid shampoo is too harsh, you can either find a brand with a lower concentration or try a shampoo with:

  • Lactic acid
  • Phenol
  • Urea

If your nonprescription option seems like it’s not making enough of a difference, you may want to ask your doctor or healthcare provider if a prescription option is better for you. There are a few differences when it comes to prescription salicylic acid shampoos:

  • Apply to a WET scalp with the provided applicator
  • Massage in and rinse thoroughly, without waiting 5 minutes
  • Repeat daily unless instructed otherwise
  • Don’t use a traditional shampoo and conditioner afterward
  • Keratolytic Shampoos

Keratolytic shampoos are somewhat like salicylic acid shampoos, since they also work by forcing the excess cells to shed. However, keratolytic shampoos are a more intense treatment option and typically only used for severe cases of psoriasis. Keratolytics are typically only used on the scalp, since it’s one of the thickest layers of skin on the body and sometimes requires extra heavy lifting. Ask your doctor or healthcare provider if a keratolytic shampoo could be right for you.

Alternative Treatments
There are a variety of other ways to alleviate psoriasis symptoms. Though there is no link between non medicated shampoos and a cure for psoriasis, certain alternative options may help remove scales and moisturize the skin. These include:

  • Aloe vera
  • Capsaicin
  • Coconut oil
  • Tea tree oil
  • Zinc pyrithione

Some psoriasis patients use phototherapy, a light therapy that exposes them to controlled amounts of UV light. Others make sure that whatever treatment shampoo they use contains eggs, which have over 70 naturally-occurring vitamins, minerals, and proteins. Orally taking fish oil has also been known to help.

Just because something is “natural” doesn’t mean it’s risk-free. Please be sure to run any changes or treatment ideas by your dermatologist or other health care provider before trying them.

Of course, a healthy lifestyle is something that will help with any medical condition, including psoriasis. Eating right, exercising, getting enough sleep, and managing stress are always good ideas.

Psoriasis can be both physically and emotionally painful, but finding the right shampoo can work wonders for your scalp. From coal tar shampoo to salicylic acid shampoo to even the strongest keratolytic shampoo, you can find the right shampoo for your scalp psoriasis. Just don’t forget to let your doctor know about any changes you make!

We’d also like you to know that if you live in Central Florida, you may qualify for a psoriasis clinical trial at our clinic in DeLand. If you’d like to learn more Sign up on the form on our website.


Ready to be part of healthcare history? Find the right clinical trial for you.

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