These Are the Best Shampoos for Scalp Psoriasis, According to a Dermatologist

Living with a dry, itchy, and flaky scalp can be challenging, but even more so if you have scalp psoriasis—which is why a good shampoo for psoriasis comes in handy.

But we'll get to that shortly. It’s estimated that 125 million people worldwide have psoriasis (celebs like Kim Kardashian, Cara Delevingne, and Jonathan Van Ness all have the chronic autoimmune disease), with 45 to 56 percent having it on the scalp. The good news is, there are products out there that can help decrease the symptoms of scalp psoriasis, such as specially formulated shampoos, so we turned to experts for advice.

Our top shampoos for scalp psoriasis, at a glance:

• Best overall: Nioxin Scalp Recovery Purifying Exfoliator, $26
• Best budget: Selsun Blue Moisturizing Dandruff Shampoo, $8
• Best hydrating: Philip B Anti-Flake Relief Shampoo, $55
• Best extra-strength: Head & Shoulders Clinical Strength Dry Scalp Rescue Shampoo, $19
• Best with salicylic acid: Dermarest Psoriasis Medicated Shampoo +Conditioner, $13
• Best natural ingredients: Yes To Tea Tree Scalp Relief Soothing Shampoo, $13
• Best shampoo and conditioner: Nizoral Scalp Psoriasis Shampoo & Conditioner, $18
• Best with coal tar: Psoriatrax Coal Tar Shampoo 5% Coal Tar, $20
• Best unscented: Vanicream Medicated Dandruff Shampoo, $13
• Best daily use: Neutrogena T-Gel Shampoo, $41
• Best for color-treated hair: Jupiter Balancing Shampoo, $29
• Best for buildup: Dermarest Psoriasis Medicated Shampoo, $13

What is psoriasis?

According to Ava Shamban, MD, a board-certified dermatologist based in Beverly Hills, psoriasis causes the body to create an overproduction of new skin cells over the course of a few days rather than weeks like normal skin does, resulting in the immune system mistakenly attacking our normal, healthy skin cells.

“As our dermis goes into high defense mode, it rapidly produces new cells that accumulate. The overdrive in skin cell production can accumulate anywhere on the skin’s surface, producing thick red dry patches of skin on face, body, palms of the hands, bottoms of the feet, and even scalp,” she explains. “There are several types of psoriasis, with the most common form being plaque psoriasis which presents as thick and scaly patches that are most often red, raw, painful, extremely dry, flaky, cracking and itchy. In extreme cases they can even bleed.”

The exact cause of psoriasis is not fully understood, but studies suggest that it may involve a combination of genetic predisposition and environmental factors. Like other forms of psoriasis, scalp psoriasis can be triggered by stress, infections, certain medications, or injury. "While it's not contagious, scalp psoriasis can be uncomfortable and may require ongoing management to alleviate symptoms and prevent flare-ups," Dr. Marisa Garshick, MD, a board-certified dermatologist based in New York City says.

What does scalp psoriasis look like?

Scalp psoriasis, Dr. Shamban explains, occurs on the scalp and nape of the neck, and thick patches can sometimes lead to hair loss. “Conditions are different in that our dermis is thicker naturally on the scalp and we have a significantly more active sebaceous network and millions of follicles unlike any other place on the body.” It’s also important to rule out other scalp conditions first. For example, Dr. Shamban says that psoriasis and seborrheic dermatitis share some similar presentations in the forms of red, scaly skin. “Seborrheic dermatitis is usually very itchy and often a yellow accompanied by dandruff flakes down the hair shaft,” she says. “Psoriasis however has a tendency to extend beyond the scalp while seborrheic dermatitis is usually confined to the scalp. In addition, the scales may be thicker lesions and somewhat drier in appearance than seborrheic dermatitis.”

How do you treat scalp psoriasis?

There are a few options for treating scalp psoriasis. Still, the experts agree that incorporating an over-the-counter shampoo to address psoriasis symptoms is a good place to start. Shampoos with exfoliating actives or medication can help reduce inflammation and itching.

If over-the-counter shampoos are not improving your scalp psoriasis symptoms, the experts recommend visiting your dermatologist for a scalp exam to determine the most appropriate treatment. "Commonly prescribed medications include topical steroids shampoos, solutions, sprays or foams as well as vitamin D analogs such as calcipotriene," says Margarita Lolis, MD, a board-certified dermatologist based in Hackensack, NJ. Other in-office methods might include laser light therapy, which can treat psoriasis, or systemic medication, which might be required for severe cases, like oral pills or injections. "These biologic drugs target specific immune mediators and pathways involved in developing psoriasis," she says. Of course, it's best to consult with your dermatologist to create a plan tailored to your specific scalp psoriasis needs.

It's also important to avoid stressors that can increase scalp psoriasis flare-ups, like touching or scratching plaques. "Picking at lesions can make the plaques worse and susceptible to infection," says Dr. Greenfield. Extreme temperatures or cold, dry air exposure can also trigger a psoriasis flare-up.

What ingredients to look for in shampoos for scalp psoriasis

Shamban says that when looking for products, keep an eye out for gels and shampoos or pre-treatments containing salicylic acid, as it can help soften thick patches of skin on the scalp. Another good thing about salicylic acid? It penetrates into skin and pores, allowing other medications for other symptoms to get in deeper. “Look for products with antibacterial, antimicrobial, and anti-fungal properties that can help treat seborrheic dermatitis and scalp psoriasis,” she adds. “Antifungals also inhibit yeast growth, a main factor in dandruff which is a secondary outcome with the condition.”

Anna Chacon, MD, a board-certified dermatologist, also recommends considering these other ingredients:

• Coal tar: This is a thick liquid that can help reduce the itch brought by scalp psoriasis. A dermatologist can suggest how often this should be used.
• Coconut oil: An effective and all natural moisturizer that can reduce dryness and inflammation.
• Clobetasol propionate: This can be found in prescription-strength scalp psoriasis shampoos. This is a topical steroid that can reduce all the symptoms of scalp psoriasis, including redness, dryness, and swelling.
• Ketoconazole: Effective in reducing the inflammation caused by scalp psoriasis, and may also prevent infection.
• Zinc pyrithione: Can help normalize the way skin cells grow and work, and also moisturize the scalp. This can reduce flaking and scale buildup.

What ingredients to avoid in shampoos for scalp psoriasis

There are also certain shampoo ingredients to avoid, such as sulfates and alcohol and other drying agents, according to Dr. Shamban. And if you didn't guess already, fragrance-free formulas are best. Meanwhile, Rolanda Wilkerson, principal scientist at Procter & Gamble, says that chemical treatments can cause dryness on the scalp. “I would not say it has to be avoided, however, it is best to make sure you are following the proper protocol and recommended frequency for using them so that the health of the scalp is not negatively impacted,” she says. “Dry shampoos, although can be helpful while trying to prolong styles, can cause build up and dryness with daily use and no washes in between.”

How often should you shampoo with scalp psoriasis?

"In general, it's recommended to shampoo regularly to help manage scalp psoriasis, but not excessively, since overwashing can exacerbate dryness and irritation," says Dr. Garshick. If you're using a medicated shampoo, the experts recommend using it two to three times weekly, depending on the active ingredients and strength. Dr. Garshick recommends shampooing every one to three days to help keep symptoms under control, but she explains that it's possible to reduce that amount to less frequent washing should you get irritated.