What type of shampoo is indicated for eczema?

Shampoo Recommendations for Eczema

For patients with eczema, mild pH-neutral shampoos are recommended to avoid exacerbating skin irritation, with specific products containing ingredients like ichthammol or coal tar being particularly beneficial. 1

General Principles for Selecting Shampoos

• Avoid regular soaps and detergents as they remove natural lipids from the skin surface, which is particularly problematic for eczema patients who already have dry skin 1
• Use very mild shampoos with pH-neutral formulations and tepid water to minimize skin irritation 1
• Shampoos containing known contact allergens should be avoided, as these can trigger or worsen eczema symptoms 2

Recommended Shampoo Types

• Medicated options:

  • Ichthammol-containing shampoos (less irritating than coal tar) are beneficial for scalp eczema 1
  • Coal tar solution shampoos can be effective but may be more irritating than ichthammol 1
  • Ketoconazole, betadine, and ceanel shampoos can reduce the risk of scalp folliculitis in eczema patients 1

• Non-medicated options:

  • pH5 neutral bath and shower formulations are recommended for daily use 1
  • Dispersible cream-based shampoos can be used as soap substitutes 1
  • Emollient-based shampoos help maintain skin hydration 1, 3

Bathing and Washing Recommendations

• Bathing is beneficial for both cleansing and hydrating the skin in eczema patients 1
• Patients should be allowed to determine their most suitable bathing regimen 1
• After washing hair, pat dry gently rather than rubbing to avoid irritation 1
• Apply emollients after bathing to provide a surface lipid film that prevents water loss 1, 4

Ingredients to Avoid

• Common allergens found in shampoos that may worsen eczema include:
  • Fragrances (most common allergen in shampoos) 2
  • Cocamidopropyl betaine 2
  • Methylchloroisothiazolinone/methylisothiazolinone 2
  • Formaldehyde releasers 2
  • Greasy formulations that might facilitate folliculitis 1

Additional Considerations

• Shampoo use should be part of a comprehensive eczema management approach that includes appropriate emollients and topical treatments 5, 3
• For severe scalp eczema, topical corticosteroids may be needed alongside appropriate shampoos 5
• Keeping nails short is recommended to prevent damage from scratching during washing 1
• Parents of children with eczema typically prefer non-fragrant, non-herbal products 6

Common Pitfalls

• Using regular soaps and detergents can worsen eczema by removing natural skin lipids 1
• Hot water can exacerbate eczema symptoms; tepid water is recommended 1
• Bath additives have not shown significant clinical benefit in childhood eczema management according to recent research 7
• Overuse of medicated shampoos (particularly those containing coal tar) can lead to systemic side effects 1