Dandruff & Scalp Psoriasis Treatment Options: Finding the Right Treatment
A comparison hub for every treatment we cover — antifungal shampoos, steroid scalp applications, descaling ointments and combination gels — with links to the full guide for each.
Part of the Dandruff & Psoriasis Health Guide.
Key fact: There is no single best scalp treatment — the right choice depends on the cause. Fungal-driven dandruff needs an antifungal shampoo, inflamed scalps need a corticosteroid, and thick scale needs descaling before anything else can work.
Not Sure Which Treatment You Need?
Access Doctor provides prescription scalp treatments following a GPhC-regulated online consultation. Our pharmacist independent prescribers will recommend the right option for your symptoms.
Start Free Consultation →Match the treatment to the cause
Flaking, itching and scaling look similar on the surface, but the driver differs: dandruff and seborrhoeic dermatitis are linked to an overgrowth of Malassezia yeast, while scalp psoriasis is an immune-driven condition of accelerated skin cell turnover. Picking the treatment that matches your cause is the whole game — our guide on what causes dandruff and our scalp psoriasis explainer cover the diagnosis side in detail.
50%
Of adults experience dandruff at some point
2%
Of the UK population lives with psoriasis
80%
Of people with psoriasis get scalp involvement
The treatments in this cluster fall into four classes:
Antifungal shampoos
Ketoconazole and Nizoral — reduce the Malassezia yeast behind dandruff and seborrhoeic dermatitis.
Steroid scalp applications
Betacap, Betnovate and Etrivex — switch off inflammation, redness and itch.
Descaling ointments
Cocois — coal tar and salicylic acid soften and lift thick, stubborn scale.
Combination gels
Dovobet — a vitamin D analogue plus a potent steroid for plaque psoriasis.
Antifungal shampoos: ketoconazole & Nizoral
For most dandruff and seborrhoeic dermatitis, an antifungal shampoo is the first-line treatment. Ketoconazole 2% reduces the yeast population on the scalp, typically used two to three times a week with a 3–5 minute contact time, then weekly for maintenance.
- Ketoconazole 2% shampoo (generic) — the prescription-strength standard. Learn more in our ketoconazole shampoo guide.
- Nizoral — the best-known ketoconazole brand. Learn more in our Nizoral guide.
Steroid scalp applications: Betacap & Betnovate
When the scalp is red, sore and itchy — not just flaky — the problem is inflammation, and antifungal shampoos alone will not settle it. Betamethasone valerate 0.1%, a potent topical corticosteroid, is the usual first-line prescription choice, formulated as a quick-drying liquid for hair-bearing skin.
- Betacap scalp application — betamethasone valerate 0.1%. Start with our Betacap product guide, or the focused guides on soothing an inflamed scalp, itchy scalp relief and stubborn dandruff.
- Betnovate scalp application — the same potent active in GSK's branded formulation. Learn more in our Betnovate condition guide, and see the step-by-step application guide.
Steroid stewardship: potent corticosteroids are typically used for up to 2–4 weeks, then reviewed. They settle flares; they are not long-term daily maintenance. Your prescriber will set the course length.
Stepping up: Etrivex shampoo
If a potent steroid has not controlled a scalp psoriasis flare, Etrivex delivers clobetasol propionate 0.05% — a very potent corticosteroid, the strongest topical class — in a short-contact shampoo: applied to the dry scalp, left for 15 minutes, then rinsed. Learn more in our Etrivex guide, or read what to expect from clobetasol shampoo.
Descaling first: Cocois ointment
Thick, compacted scale acts as a physical barrier — steroids and antifungals cannot penetrate it. Cocois (coal tar 12%, salicylic acid 2%, sulphur 4% in a coconut-oil base) is the descaling step: massaged in, left for an hour or overnight, then washed out, lifting softened scale with it. Many treatment plans run Cocois first, then follow with a steroid once the skin is reachable. Learn more in our Cocois guide.
Combination treatment: Dovobet gel
Dovobet combines calcipotriol (a vitamin D analogue that slows skin cell turnover) with betamethasone dipropionate (a potent corticosteroid) in a once-daily gel for plaque psoriasis of the scalp and body — treating both the cell turnover and the inflammation in one product. Learn more in our Dovobet guide.
Full comparison table
| Treatment | Active ingredient(s) | Best for | How it is used |
|---|---|---|---|
| Ketoconazole 2% shampoo | Ketoconazole (antifungal) | Dandruff and seborrhoeic dermatitis | 2–3× weekly, 3–5 minute contact, then rinse |
| Nizoral shampoo | Ketoconazole 2% (brand) | Dandruff and seborrhoeic dermatitis | As ketoconazole; branded formulation |
| Betacap scalp application | Betamethasone valerate 0.1% (potent steroid) | Inflamed, itchy scalp; persistent dandruff with inflammation | Once or twice daily; left on |
| Betnovate scalp application | Betamethasone valerate 0.1% (potent steroid) | Scalp psoriasis, seborrhoeic dermatitis, scalp eczema | Once or twice daily; left on |
| Etrivex shampoo | Clobetasol propionate 0.05% (very potent steroid) | Scalp psoriasis flares not controlled by potent steroids | Daily on dry scalp, 15 minutes, then rinse; max 4 weeks |
| Cocois ointment | Coal tar 12% + salicylic acid 2% + sulphur 4% | Thick, stubborn scale (descaling step) | Leave on 1 hour or overnight, wash out; daily for 3–7 days, then weekly |
| Dovobet gel | Calcipotriol + betamethasone dipropionate | Plaque psoriasis of scalp and body | Once daily; left on |
Other options our prescribers may consider include Psoriderm and Dermax medicated shampoos, Elocon scalp lotion and Dermovate scalp application (a very potent clobetasol liquid) — your consultation covers these where relevant.
Where to start: OTC or prescription?
A sensible escalation path saves time and money — our dandruff treatment guide walks the full ladder. In short:
1
Start with an OTC medicated shampoo
Zinc pyrithione, selenium sulphide or coal tar shampoos, used correctly with 3–5 minutes of contact time, control most mild dandruff.
2
Step up to prescription-strength antifungal
If four weeks of regular OTC use has not worked, ketoconazole 2% targets the underlying yeast more effectively.
3
Treat inflammation or scale when present
Red, sore, itchy scalp: a potent steroid application. Thick built-up scale: Cocois first. Psoriasis plaques: steroid, Etrivex or Dovobet per your prescriber.
See a clinician promptly if your scalp develops crusted or weeping patches, you notice significant hair loss, flaking spreads to the face or chest, or you develop ring-like patches (possible scalp ringworm needing oral antifungals). In an emergency, call 999.
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Answer a few clinical questions and our pharmacist independent prescribers will match you to the right treatment — dispensed from our GPhC-registered UK pharmacy with discreet delivery.
Start Free Consultation →Frequently Asked Questions
What is the best treatment for dandruff?
Most dandruff responds to an antifungal shampoo such as ketoconazole 2%, used two to three times a week. If flaking persists after four weeks, or your scalp is inflamed and itchy, a prescription treatment such as a steroid scalp application may be needed.
What is the best treatment for scalp psoriasis?
Potent topical corticosteroids such as Betnovate or Betacap scalp applications are the usual first-line treatment for scalp psoriasis. Thick scale may need softening with a descaling ointment such as Cocois first, and stubborn cases may step up to Etrivex (a very potent steroid shampoo) or Dovobet gel.
How do I know if I have dandruff or scalp psoriasis?
Dandruff causes fine white or yellowish flakes with little redness. Scalp psoriasis causes well-defined, raised red plaques with silvery scale that may extend beyond the hairline. If you are unsure, get a diagnosis before treating — our prescribers assess this during your consultation.
Do I need a prescription for these treatments?
Some options, such as coal tar shampoos and ketoconazole 1% shampoo, are available over the counter. Stronger treatments — steroid scalp applications, Etrivex, Dovobet and prescription-strength ketoconazole 2% — require assessment by a prescriber, which Access Doctor provides through a short online consultation.
What should I do if my dandruff shampoo is not working?
If four weeks of regular use with correct contact time (three to five minutes) has not controlled your symptoms, step up. Options include prescription-strength ketoconazole, a steroid scalp application to settle inflammation, or a descaling treatment if scale has built up.
Can I combine different scalp treatments?
Yes, many treatment plans combine approaches — for example, Cocois to remove thick scale, followed by a steroid application, with an antifungal shampoo for maintenance. Your prescriber will confirm the right combination and sequence.
Every treatment above is available through Access Doctor following a short online consultation reviewed by our GPhC-registered pharmacist independent prescribers. These are the options most commonly prescribed:
Antifungal · Rx
Ketoconazole 2% Shampoo
Prescription-strength antifungal shampoo for dandruff and seborrhoeic dermatitis.
View product →Scalp Inflammation · Rx
Betacap Scalp Application
Potent betamethasone valerate 0.1% liquid for inflamed, itchy scalp conditions.
View product →Descaling · Rx
Cocois Ointment
Coal tar, salicylic acid and sulphur ointment for thick, stubborn scalp scale.
View product →Scalp Psoriasis · Rx
Dovobet Gel
Calcipotriol and betamethasone dipropionate gel for plaque psoriasis.
View product →References
- NICE Clinical Knowledge Summaries. Psoriasis: management of scalp psoriasis. 2025. cks.nice.org.uk
- NICE Clinical Knowledge Summaries. Seborrhoeic dermatitis. 2025. cks.nice.org.uk
- British National Formulary. Topical corticosteroids: potency classification. bnf.nice.org.uk
- NICE. Psoriasis: assessment and management (CG153). nice.org.uk
- Primary Care Dermatology Society. Seborrhoeic dermatitis of the scalp. pcds.org.uk
Medical disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional for diagnosis and treatment. In a medical emergency, call 999.