Eczema Shampoo Guide: How to Choose a Shampoo for Scalp Eczema

When we started Eczema Honey in our own kitchen for our kids' eczema-prone skin, we learned fast that the scalp is its own puzzle. It is covered in hair, it gets oily, it gets washed with products that sit right on the skin, and the shampoo aisle is full of labels that all sound the same. This guide is the one we wish we'd had: what scalp eczema actually is, which kind of shampoo fits which situation, how to read a label, and when it is time to call a doctor.

What is scalp eczema?

The National Eczema Association (NEA) describes scalp eczema as an inflammatory condition with a few possible causes. The three main types are seborrheic dermatitis, atopic dermatitis and contact dermatitis, and each one calls for a slightly different approach.

• Seborrheic dermatitis is the most common form of scalp eczema. It shows up where the skin makes the most oil and causes greasy, yellowish flakes and redness. The NEA estimates it affects about 3 to 10 of every 100 people and links it in part to an inflammatory reaction to Malassezia, a yeast that lives on everyone's skin. Ordinary dandruff is a mild form of it. In babies it is called cradle cap.
• Atopic dermatitis is the most common type of eczema overall. It weakens the skin barrier and leaves skin dry, itchy and prone to rashes, and the scalp can be part of it.
• Contact dermatitis happens when something touching the skin irritates it (harsh detergents, dyes, bleach) or triggers an allergy (hair dye, preservatives, fragrance).

Symptoms overlap: flaking, itching or burning, rash that can look red or pink on lighter skin and brown or purple on darker skin, and sometimes crusting. Psoriasis and fungal infections can look similar, and the American Academy of Dermatology (AAD) notes that some people have both seborrheic dermatitis and psoriasis at once. That is why a diagnosis from a dermatologist is worth getting before you spend a lot on shampoos.

Step 1: Match the shampoo to the kind of scalp eczema

What you notice	Likely type	Where dermatologists usually start
Greasy, yellow or white flakes; redness along the hairline, eyebrows or sides of the nose	Seborrheic dermatitis / dandruff	A medicated dandruff shampoo, used as directed (see the ingredient table below)
Dry, tight, itchy scalp; eczema on other parts of the body too	Atopic dermatitis	A gentle, fragrance-free, non-soap shampoo, plus moisturizing dry patches between washes
Itch or rash in a "rinse-off" pattern: hairline, behind the ears, back of the neck, often after a new product or hair dye	Contact dermatitis	Stop the suspect product; ask about patch testing to find the trigger
Thick, yellowish, greasy scales on a baby's scalp	Cradle cap	Baby shampoo and gently loosening scales; it usually clears on its own

Sources: NEA, AAD, DermNet. This table is a starting point for a conversation with your doctor, not a diagnosis.

Step 2: Know the medicated shampoo ingredients

The NEA lists five active ingredients that are common in over-the-counter medicated shampoos for people whose eczema overlaps with seborrheic dermatitis, and it advises using them under the guidance of a healthcare provider. Here is what each one does, according to dermatology sources:

Active ingredient	What it does	Good to know
Ketoconazole (1% or 2%)	Antifungal; targets the yeast linked to dandruff and seborrheic dermatitis	The NEA lists 1% and 2% strengths; ask your doctor which one fits you
Zinc pyrithione (pyrithione zinc)	A common dandruff shampoo active	The NEA names it as an option for seborrheic dermatitis
Selenium sulfide	Antifungal	Can discolor hair and scalp, per an NHS dermatology leaflet
Salicylic acid	Helps lift and reduce scale	Ask your doctor how often to use it
Coal tar	Sheds dead cells from the top layer of skin and slows skin cell growth	Can discolor light-colored hair and make the scalp more sensitive to sunlight

Sources: NEA: Over-the-Counter Shampoos; Gloucestershire Hospitals NHS: Hair care for eczema of the scalp; AAD.

If an over-the-counter option isn't enough, the AAD notes a dermatologist may prescribe stronger options, such as ciclopirox shampoo, ketoconazole foam or gel, a short course of a topical corticosteroid, or roflumilast foam, which is approved for seborrheic dermatitis in people 9 and older. A 2015 Cochrane review of 51 studies found that ketoconazole and ciclopirox, the two most studied antifungals, worked better than placebo for seborrheic dermatitis, with ketoconazole giving results similar to steroids but with fewer side effects. Most of those trials lasted only about four weeks.

How to use a medicated shampoo so it actually works

• Give it time. The NEA suggests leaving medicated shampoo on the scalp for 5 to 10 minutes before rinsing. The AAD says to follow the time your dermatologist recommends so the medication can work.
• Match frequency to your hair. According to the AAD, people with straight or wavy hair may use dandruff shampoo 2 to 3 times a week, while people with curly or tightly coiled hair may be told to use it once a week.
• Rotate if it stops working. The AAD and NEA both mention that rotating between dandruff shampoos with different actives can help if one seems to lose its punch.
• Keep going once things calm down. The AAD notes many people keep using a dandruff shampoo about once a week to keep seborrheic dermatitis under control.
• Use a gentle shampoo on the other days, if your dermatologist agrees. That is where a mild, fragrance-free formula (see Step 3) fits in.

Step 3: How to pick a gentle everyday shampoo

For a dry, sensitive or atopic scalp, the goal is to clean without stripping. Here is a label checklist pulled from the NEA, an NHS dermatology department and DermNet:

• "Fragrance-free," not "unscented." The NEA explains that unscented products can still contain masking fragrance.
• Sulfate-free or SLS-free. The NHS leaflet calls sodium lauryl sulfate (SLS) a harsh detergent that can be very irritating to scalp eczema. SLS-free shampoos lather less but still clean.
• No essential oils if you react easily. The NHS leaflet lists fragranced products "including essential oils" as irritants, and DermNet lists botanicals such as lavender oil among shampoo allergens.
• Watch for these preservatives and fragrance components: methylisothiazolinone (MI), limonene and linalool, which the NHS leaflet suggests avoiding.
• Tree nut oils: the same leaflet suggests caution with oils like almond or macadamia, especially with a nut allergy.
• Soothing, moisturizing ingredients are a plus. The NEA mentions colloidal oatmeal, aloe vera and glycerin as common in shampoos that hydrate the scalp and support its barrier.
• Look for the NEA Seal of Acceptance. The NEA's product directory lists shampoos and conditioners it has reviewed for people with eczema and sensitive skin.

One more tip from Acibadem's dermatology guidance: introduce one new hair product at a time. If you notice burning, more itching, or a rash around your face or ears, rinse it out and stop using it. DermNet notes that a rash in a "rinse-off" pattern, around the hairline or behind the ears, can point to an allergy to something in your hair products.

Step 4: A scalp-friendly wash routine

1. Wash every 2 to 3 days. The NEA says most people with scalp eczema do well with this, since washing too often strips oil and washing too rarely lets buildup collect. Your dermatologist may adjust this for seborrheic dermatitis or for your hair type.
2. Use warm or cool water, not hot. DermNet notes hot water can be drying.
3. Massage gently with your fingertips, not your nails, for about 30 seconds, then rinse well. Medicated shampoos stay on longer (see above).
4. Condition the lengths. Conditioner is made to stay on the hair, so the NHS leaflet notes it is more likely to bother scalp eczema than shampoo. Focus it on the lengths and rinse thoroughly.
5. Pat, don't rub. The NEA suggests patting hair and scalp dry and air-drying when you can.
6. Moisturize dry patches between washes. The NEA recommends lightweight, non-greasy eczema creams or oils for dry, flaky spots on the scalp.
7. Simplify styling. Gels, sprays, dyes and chemical treatments can all irritate. Cut back, then add products back one at a time.

Scalp eczema in babies and kids

This is the part we care about most as parents. According to the AAD, cradle cap usually clears up on its own in a few weeks to months. If you want to care for it at home, the AAD recommends a baby shampoo and gently removing loosened scales, and it is clear that dandruff shampoo is not recommended for children. The NEA adds that a mild oil followed by a soft brush or cloth can help loosen flakes without irritating the skin.

For older kids with atopic dermatitis, the same gentle-shampoo checklist applies. Keep bath time short and lukewarm, rinse shampoo out well around the ears and neck, and check with your pediatrician or dermatologist before trying anything medicated.

Where Eczema Honey fits (and where it doesn't)

We want to be straightforward here. Our hair care is not medicated, so it is not a swap for a dandruff shampoo your dermatologist recommends for seborrheic dermatitis. Where it fits is the gentle, everyday side of the routine:

• Eczema Honey Nourishing Shampoo: a gentle, sulfate-free shampoo with no synthetic fragrance, made with aloe vera leaf juice, argan oil, rice amino acids, honey and oat extract. It gently cleanses and moisturizes a dry-feeling scalp, and it works well on the days in between medicated washes, if your doctor is on board.
• Eczema Honey Nourishing Conditioner: also sulfate-free with no synthetic fragrance, with coconut and jojoba oils, vitamin E and oat beta glucan to soften dry, brittle hair. Contains coconut oil. Both come together in our Shampoo & Conditioner Duo Pack.
• Eczema Honey Soothing Scalp Oil: a lightweight dropper oil with safflower, olive, jojoba and sunflower seed oils, aloe, oat kernel oil and honey. Please note: it also contains lavender and tea tree essential oils and naturally occurring linalool, so it is not fragrance-free. Given the advice above about essential oils, skip it if you react to fragrance or essential oils, and patch test first even if you don't.
• For dry patches along the hairline, behind the ears or on the neck, our Original Skin-Soothing Cream is the OTC eczema relief cream we reach for at home. Its 1% colloidal oatmeal temporarily protects and helps relieve minor skin irritation and itching due to rashes and eczema, and it is made with honey and carries the NEA Seal of Acceptance. It contains almond oil, so anyone with a nut allergy should use our Nut-Free Skin-Soothing Cream instead.

Want all three hair and scalp products together? Our Scalp Soothing Kit pairs the Nourishing Shampoo, Nourishing Conditioner and Soothing Scalp Oil in one box. Pair it with our bath-to-bedtime routine for kids.

Whatever you choose, patch test any new product on a small area first and add one new product at a time.

When to see a doctor

The NEA suggests talking to a healthcare provider if over-the-counter shampoos don't help, symptoms get worse, or you notice signs of infection such as increased redness, swelling, crusting, oozing or pain. Also check in if you notice hair thinning or patches of hair loss, if a rash spreads to your face, ears or body, or if you aren't sure whether you're dealing with eczema, psoriasis or a fungal infection. For babies, ask your pediatrician about any scalp rash that looks raw or oozes.

Frequently asked questions

What is the best shampoo for scalp eczema?

It depends on the type. For seborrheic dermatitis or dandruff, dermatologists usually start with a medicated shampoo containing an ingredient like ketoconazole, zinc pyrithione, selenium sulfide, salicylic acid or coal tar. For a dry, sensitive or atopic scalp, the NEA recommends a gentle, fragrance-free, non-soap shampoo without harsh detergents or dyes.

Is scalp eczema the same as dandruff?

Not exactly. The NEA explains that dandruff is a mild form of seborrheic dermatitis, which is one type of scalp eczema. Scalp eczema can also come from atopic dermatitis or contact dermatitis.

How often should I wash my hair if I have scalp eczema?

The NEA says most people with scalp eczema do well washing every 2 to 3 days. If you use a dandruff shampoo, the AAD notes people with straight or wavy hair may use it 2 to 3 times a week, and people with curly or coily hair may use it once a week. Follow your dermatologist's plan.

Can I use dandruff shampoo on my baby or child?

The AAD says dandruff shampoo is not recommended for children. For cradle cap, it recommends a baby shampoo and gently removing loosened scales. Ask your pediatrician before using any medicated product on a child.

Can scalp eczema cause hair loss?

According to the NEA, severe inflammation or heavy scratching can cause temporary hair shedding, and hair usually grows back once the scalp is under control. See a doctor if you notice thinning or bald patches.

What's the difference between "fragrance-free" and "unscented"?

The NEA notes that "unscented" products can still contain masking fragrances, while "fragrance-free" means no fragrance has been added. For a sensitive scalp, choose fragrance-free.

Is scalp eczema contagious?

No. The NEA confirms scalp eczema can't be spread from person to person.

Sources

• National Eczema Association: Scalp Eczema: Symptoms, Causes & Treatment
• National Eczema Association: Over-the-Counter Shampoos
• American Academy of Dermatology: Seborrheic dermatitis: Diagnosis and treatment
• Gloucestershire Hospitals NHS Foundation Trust, Dermatology: Hair care for eczema of the scalp (patient information)
• DermNet: Shampoos
• Tucker D, Masood S. Seborrheic Dermatitis. StatPearls, 2024.
• Acibadem Health Library: Eczema Shampoo: What Patients Need to Know
• Okokon EO, Verbeek JH, et al. Topical antifungals for seborrhoeic dermatitis. Cochrane Database Syst Rev. 2015.