A flaky, irritated scalp is more than just an aesthetic issue—it can contribute to hair loss and scalp discomfort. Many conditions, including seborrhoeic dermatitis, scalp psoriasis, and fungal infections, can trigger excessive flaking and inflammation. Left untreated, these conditions may impair hair growth by causing chronic irritation, increased shedding, and poor scalp health. In such cases, prescription-strength shampoos play a vital role in managing these scalp disorders and mitigating hair loss.
As a trichology-focused prescribing clinic, we offer expert consultations to assess scalp and hair health before recommending the most suitable prescription treatment. Below, we explore the best prescription shampoos available in the UK, their clinical indications, and how they can support hair retention and scalp health.
Prescription-Strength Shampoos and Their Uses
Prescription-strength dandruff shampoo
1. Ketoconazole 2% Shampoo (Nizoral 2%) – Antifungal & Anti-Inflammatory
Indications: Seborrhoeic dermatitis, dandruff, and fungal-related hair shedding (Malassezia overgrowth)
Mechanism: Ketoconazole (prescription-strength dandruff shampoo) is an azole antifungal that targets Malassezia, a yeast that exacerbates dandruff and seborrhoeic dermatitis. By reducing the fungal burden, it alleviates inflammation, itching, and excessive shedding.
How It Helps Hair Loss: Chronic inflammation from seborrhoeic dermatitis can contribute to telogen effluvium and androgenetic alopecia (AGA) by triggering scalp micro-inflammation. Studies suggest ketoconazole may also have mild anti-androgenic properties, making it beneficial for AGA patients.
Usage: Apply twice weekly for 4 weeks, then reduce to once weekly as maintenance.
Evidence: A study by Piérard-Franchimont et al. (1998) found that ketoconazole 2% shampoo improved hair density in AGA patients by reducing inflammation and seborrhoeic activity.
2. Coal Tar Shampoo (Polytar) – Keratolytic & Anti-Inflammatory
Indications: Scalp psoriasis, stubborn dandruff, seborrhoeic dermatitis
Mechanism: Coal tar reduces scalp inflammation, suppresses excessive skin cell proliferation, and slows desquamation.
How It Helps Hair Loss: Scalp psoriasis can cause scarring alopecia if left untreated. Coal tar shampoos help to manage scaling and irritation, reducing secondary hair loss due to persistent inflammation.
Usage: Use twice weekly for 6 weeks, then as needed.
Evidence: Research indicates coal tar is as effective as topical corticosteroids for treating psoriasis (Charman et al., 2004).
3. Ciclopirox Olamine Shampoo (Sebiprox) – Broad-Spectrum Antifungal & Anti-Inflammatory
Indications: Moderate-to-severe seborrhoeic dermatitis and resistant fungal dandruff
Mechanism: Unlike ketoconazole, ciclopirox has anti-inflammatory properties in addition to its antifungal action, making it suitable for patients with severe irritation.
How It Helps Hair Loss: Reduces scalp inflammation linked to seborrhoeic dermatitis-related telogen effluvium.
Usage: Use twice weekly for 4 weeks.
Evidence: Studies demonstrate ciclopirox is more effective than ketoconazole for seborrhoeic dermatitis, with significant reductions in scaling and itching (Gupta & Foley, 1999).
4. Selenium Sulfide Shampoo (DERCOS) – Antifungal & Exfoliating
Indications: Oily dandruff, seborrhoeic dermatitis, tinea versicolor
Mechanism: Selenium sulfide suppresses Malassezia growth, slows excessive skin shedding, and reduces sebum production.
How It Helps Hair Loss: Reduces seborrhoeic-induced excess shedding and scalp oiliness, which can exacerbate AGA.
Usage: Apply twice weekly for 2 weeks, then once weekly.
Evidence: Clinical trials confirm selenium sulfide significantly reduces dandruff severity (Shuster, 1985).
5. Clobetasol Propionate Shampoo (Etrivex) – Corticosteroid for Severe Inflammation
Indications: Scalp psoriasis, resistant seborrhoeic dermatitis
Mechanism: A potent topical steroid that reduces scalp inflammation, itching, and excessive skin turnover.
How It Helps Hair Loss: Chronic inflammation from psoriasis can cause localised scarring alopecia. Clobetasol reduces this risk by controlling the immune response.
Usage: Short-term only – use once daily for up to 4 weeks.
Evidence: Clinical studies confirm clobetasol is the most effective topical steroid for scalp psoriasis, significantly reducing plaques and inflammation (van der Kerkhof et al., 1992).
6. Dermax Therapeutic Shampoo – Antimicrobial & Keratolytic
Indications: Scalp conditions with excessive scaling, including seborrhoeic dermatitis and dry scalp disorders
Mechanism: Contains benzalkonium chloride, which acts as an antimicrobial agent, reducing bacterial and fungal proliferation while also providing keratolytic effects to remove excessive scaling.
How It Helps Hair Loss: By maintaining a balanced scalp microbiome and reducing persistent flaking, it can help prevent inflammation-induced hair shedding.
Usage: Use daily or as directed by a healthcare professional.
Evidence: Studies support its effectiveness in reducing microbial overgrowth and improving scalp conditions associated with dandruff.
7. Cocois Scalp Application – Coal Tar & Salicylic Acid for Scalp Conditions
Indications: Scalp psoriasis, seborrhoeic dermatitis, and thick dandruff plaques
Mechanism: Combines coal tar to reduce inflammation and scaling with salicylic acid, a keratolytic agent that softens and removes thickened plaques.
How It Helps Hair Loss: By managing scalp inflammation and excessive flaking, Cocois prevents irritation-induced shedding and maintains a healthy scalp environment for hair growth.
Usage: Apply to affected areas of the scalp, leave on for one hour, then rinse thoroughly. Use as directed by a healthcare professional.
Evidence: Clinical studies support its efficacy in reducing thick plaque formation and improving scalp psoriasis symptoms.
8. Dermovate and Betnovate Scalp Applications – Potent & Moderate Topical Steroids
Indications: Scalp psoriasis, eczema, and severe seborrhoeic dermatitis
Mechanism: Contain clobetasol propionate (Dermovate), a potent corticosteroid, and betamethasone valerate (Betnovate), a moderate-strength corticosteroid. These work by reducing inflammation, itching, and excessive skin turnover in the scalp.
How They Help Hair Loss: By controlling inflammation, they prevent scalp conditions from worsening and leading to inflammatory hair shedding or scarring alopecia.
Usage: Apply a thin layer once or twice daily, as directed by a healthcare professional. Long-term use should be monitored.
Evidence: Clinical studies confirm topical corticosteroids are effective in reducing inflammation and improving symptoms of scalp psoriasis and dermatitis.
9. Capasal Therapeutic Shampoo – Coal Tar, Coconut Oil & Salicylic Acid
Indications: Scalp psoriasis, seborrhoeic dermatitis, and stubborn dandruff
Mechanism: Combines coal tar to reduce inflammation, coconut oil to moisturise, and salicylic acid to remove excessive scaling and flaking.
How It Helps Hair Loss: By reducing persistent scalp inflammation and preventing excessive scaling, it supports scalp health and minimises hair loss caused by chronic irritation.
Usage: Use as directed, typically two to three times per week.
Evidence: Studies support its effectiveness in reducing inflammation and scaling associated with scalp psoriasis and seborrhoeic dermatitis.
10. Eucerin DermoCapillaire Calming Urea Shampoo – Moisturising & Soothing
Indications: Dry, itchy scalp, atopic dermatitis, and eczema-prone scalp
Mechanism: Contains urea and lactate, which help retain moisture and soothe irritation. It also restores the scalp's natural barrier function, reducing flaking and itchiness.
How It Helps Hair Loss: Prevents scalp dryness and irritation that can contribute to excessive shedding. A healthy scalp environment supports optimal hair growth.
Usage: Suitable for daily use.
Evidence: Clinical studies show that urea-based shampoos improve scalp hydration and reduce itchiness in patients with atopic dermatitis and dry scalp conditions.
Consultation and Prescription Requirements
All prescription-strength shampoos require an assessment and consultation before they can be prescribed. If you are experiencing persistent dandruff, scalp inflammation, or hair loss linked to a scalp condition, we offer tailored treatment plans based on clinical evidence and your specific needs.
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