Seborrheic Dermatitis – OTC Shampoos

Over the counter (OTC) anti-seborrhea shampoos have a role in most seborrhea treatment regimens, which I include in many of the individualized treatment regimens for my patients at both my Conroe dermatology and Woodlands dermatology offices.  I usually have my patients buy 3 different anti-seborrhea shampoos and rotate them on a nightly basis.  The shampoo should be lathered into the scalp and allowed to sit for 5-10 minutes prior to washing it out.  After using a particular shampoo, it should be placed in a single file line behind the other shampoos so it is easy to remember which to use the next night.  Rotating the shampoos works very well by having the seborrhea exposed to a different active ingredient each night and preventing tachyphylaxis, in which the skin becomes immune to a particular medicine.  T-sal from Neutrogena is an excellent treatment for the white scaliness that causes dandruff.  It essentially dissolves the scale as its active ingredient is salicylic acid.  T-gel from Neutrogena is a shampoo containing coal tar which suppresses the inflammation of seborrhea.  Zinc pyrithionate is the active ingredient in Head and Shoulders and works similarly to coal tar.  Selsun Blue contains selenium sulfide and Nizoral 1% contains ketoconazole which both work to reduce the yeast colonies on the scalp.  After a patient uses the medicated shampoo it is fine to use a nice smelling shampoo with fragrance as the anti seborrhea shampoos may not have the most pleasing odors.  They can also be used as a wash for facial seborrhea.