Psoriasis Shampoo: Which Shampoos Work for Scalp Psoriasis?
Coal tar, steroid and medicated shampoos for scalp psoriasis compared: what each does, how to use it, what's on prescription, and when a shampoo isn't enough.
Part of our scalp psoriasis health guides.
Key fact: A shampoo is in contact with your scalp for only a few minutes, so for mild scalp psoriasis a coal tar shampoo can be enough, but thicker patches usually need a leave-on steroid scalp lotion or gel. Anti-dandruff shampoos don't treat psoriasis on their own.
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See scalp psoriasis treatments →Can a shampoo treat scalp psoriasis?
Yes, for some people. A medicated psoriasis shampoo can loosen scale, ease itching and, in the case of a steroid shampoo, reduce inflammation. But a shampoo is rinsed off after a few minutes, so it has less time to work than a lotion or gel left on the scalp.
That's why NICE guidance for adults starts with a leave-on potent steroid scalp application, and uses shampoos as a different form of steroid, or to help remove scale, if that first step isn't enough. NICE also advises against using a coal tar shampoo alone for severe scalp psoriasis.
Types of psoriasis shampoo
Coal tar shampoos
Slow down skin cell build-up and ease itching. Pharmacy or general sale medicines. Example: Psoriderm Scalp Lotion Shampoo.
Steroid shampoo
A very potent steroid in a shampoo, left on for 15 minutes. Prescription-only, adults only. Example: Etrivex.
Descaling shampoos
Combine ingredients such as salicylic acid or coconut oil with coal tar to lift thick scale. Example: Capasal.
Antifungal shampoos
Ketoconazole (such as Nizoral) treats dandruff and seborrhoeic dermatitis, not psoriasis itself.
Psoriasis shampoos compared
| Shampoo | Type | Prescription? | How it's used | Best for |
|---|---|---|---|---|
| Psoriderm Scalp Lotion Shampoo | Coal tar | No (pharmacy medicine) | As a shampoo, as the leaflet directs | Mild scalp psoriasis; itch and scale |
| Etrivex Shampoo | Very potent steroid (clobetasol propionate 0.05%) | Yes; adults only | Once a day on a dry scalp, left on for 15 minutes, then rinsed; up to 4 weeks | Moderate scalp psoriasis in adults |
| Capasal Shampoo | Coal tar, salicylic acid and coconut oil | No | As a shampoo, as the leaflet directs | Scaly scalp; not yet available through our online service |
| Ketoconazole 2% (Nizoral) | Antifungal | Available without one | As a shampoo, left on for a few minutes | Dandruff and seborrhoeic dermatitis, not psoriasis |
| Cocois Ointment | Coal tar, salicylic acid and sulphur (an ointment, washed out with shampoo) | No (general sale) | Rubbed into the scalp and washed out, as the leaflet directs | Softening thick scale before treatment |
Steroid shampoo: Etrivex
Etrivex is a prescription shampoo containing clobetasol propionate 0.05%, a very potent steroid. It's licensed for moderate scalp psoriasis in adults, and it's the only steroid shampoo we supply. Its product information says to:
1
Apply to a dry scalp
Use about half a tablespoon (7.5ml) once a day, straight onto dry hair and scalp, and massage it into the patches.
2
Leave it for 15 minutes
Don't cover your head while it's on.
3
Rinse and wash your hands
Wet your hair, lather, rinse well with water, and wash your hands. You can then use your normal shampoo if you like.
4
Stop by 4 weeks
Use it for no more than 4 weeks at a time, and no more than 50g a week. Once your scalp improves, your prescriber may reduce how often you use it.
Through our service, Etrivex is supplied only to adults whose scalp psoriasis a doctor has diagnosed, one bottle per order. Read more in our Etrivex shampoo guide.
How to use a medicated shampoo
For coal tar and other medicated shampoos, follow the leaflet. In general:
- Wet your hair and massage the shampoo into your scalp, not just your hair
- Leave it on for 5 to 10 minutes before rinsing, so it has time to work
- Use your normal shampoo afterwards if you want to reduce the smell of tar
- Don't scrub or scratch; let the shampoo loosen the scale
- Keep it out of your eyes, and rinse well with water if it gets in
If the scale is thick, softening it first with an oil or ointment helps a shampoo reach the skin. See our guide to removing scale.
Does Nizoral or ketoconazole shampoo work for psoriasis?
Not on its own. Ketoconazole shampoos such as Nizoral treat the yeast linked to dandruff and seborrhoeic dermatitis. Scalp psoriasis is driven by the immune system, so an antifungal shampoo won't clear psoriasis patches.
Some people have features of both psoriasis and seborrhoeic dermatitis (sometimes called sebopsoriasis), and a prescriber may suggest an antifungal shampoo alongside psoriasis treatment. If your scalp is flaky without thick, raised patches, it may be dandruff: see our Nizoral shampoo guide and how to tell scalp psoriasis from dandruff.
Prescription, NHS and over-the-counter shampoos
Coal tar shampoos can be bought without a prescription, and a pharmacist can help you choose one. Etrivex is prescription-only. Your GP can prescribe psoriasis shampoos and scalp treatments on the NHS: prescriptions are free in Scotland, Wales and Northern Ireland, and in England the usual prescription charge applies unless you're exempt.
You can also order scalp psoriasis treatment online from us after a consultation with one of our pharmacist prescribers. Our service is for adults 18 and over, and we don't supply in pregnancy or while breastfeeding.
When a shampoo isn't enough
If your scalp psoriasis has thick, raised patches, or a shampoo hasn't helped after about 4 weeks, a leave-on treatment usually works better. Options include:
- A potent steroid scalp lotion, such as Betacap, Betnovate Scalp or Elocon: see our steroid scalp lotions compared
- Dovobet gel, which combines calcipotriol with a steroid, for 4 weeks on the scalp
- A short course of a very potent steroid, for adults only
Using psoriasis shampoos safely
- Coal tar can stain light-coloured or dyed hair, skin and fabrics, and can make your skin more sensitive to sunlight
- Don't use a steroid shampoo for longer than your prescriber advises, or on broken or infected skin
- Keep steroid shampoos away from your eyes; see a doctor if your vision becomes blurred
- Stop and get advice if your scalp becomes more red, sore or spotty
- Report side effects through the MHRA Yellow Card scheme
Frequently asked questions
Which psoriasis shampoo should I try first?
For mild scalp psoriasis, a coal tar shampoo is a common first choice, and you can buy one without a prescription. If you have thick, raised patches, a leave-on steroid scalp lotion usually works better than a shampoo, and NICE recommends it as the first treatment for adults.
Is there a steroid shampoo for scalp psoriasis?
Yes. Etrivex contains clobetasol propionate, a very potent steroid, and is licensed for moderate scalp psoriasis in adults. It's applied to a dry scalp once a day, left on for 15 minutes and rinsed off, for no more than 4 weeks at a time. It's prescription-only.
Can I get a psoriasis shampoo on prescription?
Yes. Your GP can prescribe psoriasis shampoos and other scalp treatments on the NHS, and adults can get a private prescription online after a consultation with a pharmacist prescriber. Coal tar shampoos can also be bought without a prescription.
Does Nizoral shampoo work for scalp psoriasis?
Not on its own. Nizoral contains ketoconazole, an antifungal that treats dandruff and seborrhoeic dermatitis. Scalp psoriasis is driven by the immune system, so it usually needs a steroid scalp treatment, coal tar or Dovobet gel. Some people with features of both conditions use an antifungal shampoo alongside psoriasis treatment.
Can I buy psoriasis shampoo over the counter?
Yes, coal tar shampoos are sold in pharmacies without a prescription, and a pharmacist can help you choose one. Steroid shampoos such as Etrivex are prescription-only.
How often should I wash my hair if I have scalp psoriasis?
As often as you normally would. Washing doesn't cause or worsen psoriasis. Use a medicated shampoo as often as its leaflet says, and a gentle shampoo in between.
How long does a psoriasis shampoo take to work?
It varies, but you should see some improvement within 4 weeks. If you haven't, NICE advises moving to the next step of treatment, so speak to your GP or a pharmacist prescriber.
Can I use a psoriasis shampoo with a steroid scalp lotion?
Often, yes. A coal tar or gentle shampoo can be used to wash out scale before you apply a leave-on steroid lotion. Don't use a steroid shampoo and a steroid lotion together unless your prescriber has told you to, because that increases the amount of steroid on your scalp.
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Start Scalp Psoriasis Consultation →References
- NICE. Psoriasis: assessment and management (CG153), recommendations 1.3.1 and 1.3.4 (scalp psoriasis). nice.org.uk/guidance/cg153
- Guy's and St Thomas' NHS Foundation Trust. Treating scalp psoriasis. guysandstthomas.nhs.uk
- Etrivex 500 micrograms/g Shampoo: summary of product characteristics. medicines.org.uk/emc
- NHS. Psoriasis. nhs.uk/conditions/psoriasis
- MHRA Yellow Card scheme. yellowcard.mhra.gov.uk
Medical disclaimer: This page is for information only and isn't a substitute for medical advice. Steroid scalp treatments, Etrivex and Dovobet are prescription-only, so a clinical consultation is needed before they can be supplied. Always follow your prescriber's advice and the leaflet. In a medical emergency, call 999.