From the Guidelines
For dry and itchy hair, I recommend using a medicated shampoo containing ketoconazole 2%, as it has shown efficacy in reducing transmission of spores and alleviating symptoms 1. When selecting a medicated shampoo, consider the following key ingredients:
- Ketoconazole 2%
- Selenium sulfide 1% These ingredients have been found to be effective in reducing itching and inflammation associated with dry and itchy hair, particularly in the context of fungal infections such as tinea capitis 1. To use the medicated shampoo effectively:
- Apply to wet hair
- Massage into the scalp
- Leave on for 3-5 minutes before rinsing thoroughly
- Use 2-3 times weekly until symptoms improve, then reduce to once weekly for maintenance It is also essential to note that topical therapy alone may not be sufficient for the management of underlying conditions, and consultation with a dermatologist may be necessary for comprehensive treatment 1. Additionally, to maintain moisture and reduce dryness, consider alternating with a moisturizing shampoo containing ingredients like aloe vera, coconut oil, or shea butter, and avoid hot water when washing your hair, reduce heat styling, and consider using a leave-in conditioner to maintain moisture.
From the FDA Drug Label
PRINCIPAL DISPLAY PANEL - 251 mL Bottle Label NDC 76162-190-01 TopCare® beauty THERAPEUTICANTI-DANDRUFFSHAMPOO with 2.5% Coal TarTopical Solution(0.5% Coal Tar) ORIGINAL STRENGTH Fights itching & flaking Controls the symptoms of dandruff, psoriasis &seborrheic dermatitis The coal tar shampoo can be used for dry and itching hair, as it fights itching and flaking and controls the symptoms of dandruff, psoriasis, and seborrheic dermatitis 2.
- Key benefits:
- Fights itching and flaking
- Controls symptoms of dandruff, psoriasis, and seborrheic dermatitis The ketoconazole cream is not a shampoo and its use for dry and itching hair is not directly mentioned in the label 3.
From the Research
Medicated Shampoos for Dry and Itching Hair
- Medicated shampoos containing ketoconazole and zinc pyrithione have been shown to be effective in treating dry and itching hair associated with dandruff and seborrheic dermatitis 4, 5, 6, 7.
- Ketoconazole 2% shampoo has been found to be significantly superior to zinc pyrithione 1% shampoo in treating severe dandruff and seborrheic dermatitis, with a 73% improvement in total dandruff severity score compared to 67% for zinc pyrithione 1% 4.
- A study comparing the therapeutic efficacy of potentiated zinc pyrithione and zinc pyrithione/climbazole shampoos found that the potentiated zinc pyrithione formula exhibited greater anti-fungal potency and delivered more zinc pyrithione to the lower infundibulum, resulting in superior clinical efficacy 5.
- However, zinc pyrithione has also been reported to cause allergic contact dermatitis and exacerbate psoriasis in some cases 8.
- The combination of ketoconazole 2% and zinc pyrithione 1% shampoo has been shown to be safe and effective in treating moderate to severe dandruff, with a reduction of > 90% in dandruff scores and significant improvement in other signs and symptoms such as erythema and itching 7.
Active Ingredients
- Ketoconazole is a compound active against the Malassezia spp. yeasts, which are believed to play a major role in dandruff and seborrheic dermatitis 4, 6.
- Zinc pyrithione is also active against the Malassezia spp. yeasts and has fungistatic and antimicrobial activity, although its exact mode of action is unknown 4, 5, 8, 6.
- Selenium sulfide is another ingredient that has been shown to have antifungal activity against Pityrosporum, a yeast thought to play a pathogenic role in seborrheic dermatitis and dandruff 6.
Treatment Efficacy
- Medicated shampoos containing ketoconazole and zinc pyrithione have been shown to be effective in treating dandruff and seborrheic dermatitis, with significant improvements in dandruff scores and other signs and symptoms such as erythema and itching 4, 5, 6, 7.
- The efficacy of these shampoos can be attributed to their ability to deliver the active ingredients to the scalp and reduce the growth of Malassezia spp. yeasts 4, 5, 6.