SCALP ITCH OF DOOM (but no dandruff)
May 2, 2016 7:44 PM   Subscribe

Can you please recommend a shampoo that will help me with my itchy scalp? No-poo is not an option - reasons why and other hair details inside.

- short hair, cut in a bob
- hair itself is shiny/healthy/not fried
- roots get oily pretty fast
- I wash my hair every other day in lukewarm water
- I occasionally blowdry/flat iron my hair (maybe once or twice a week max) but other than that I let it dry naturally
- I don't use hairspray or other styling products
- my scalp is itchy A LOT, all the time, no matter what time of year
- specifically there are two spots on my scalp near the front of my hairline that TORMENT me with awful awful awful itching which I do my best not to scratch but I know I probably scratch in my sleep
- that said I have no visible signs of dandruff so my doctor doesn't want me to use harsh dandruff shampoo (T-Gel, T-Sal, Nizoral, etc)
- the water I bathe in is not hard and doesn't have any other mineral weirdness that I am aware of

Does anyone know of any shampoo that might help me keep my hair clean and soothe my scalp itch? There's gotta be SOMETHING out there, right?

And yes, I have heard about the no-poo method and know that it has helped many people with their hair issues. I did try it for two months and the itching became UNBEARABLE, so I don't think it's for me. I'm happy to hear other any other suggestions you may have.

Thanks in advance!
posted by thereemix to Health & Fitness (29 answers total) 13 users marked this as a favorite
Wow, your doctor couldn't recommend something? This sounds like an infection of some sort - fungal or otherwise. Can you see a dermatologist?
posted by Toddles at 7:45 PM on May 2, 2016 [2 favorites]

Odd that your doctor doesn't want you to use OTC dandruff shampoos (??). IANAD, but I'd use T-Sal, T-Gel, and Nizoral (ideally the 2% prescription version) in rotation and see whether it kicks the itch. You mention that your scalp is oily and you have itchy spots, which sounds to me like seborrheic dermatitis, especially given the horror story with no poo (no poo makes seborrheic dermatitis go wild). I have seborrheic dermatitis and in my experience it responds quite well to dandruff shampoos (particularly the three mentioned above), especially if you make sure to wash your hair every day. Also, you should probably see a dermatologist.
posted by ClaireBear at 7:47 PM on May 2, 2016

I would definitely try T-Gel, IIRC it is for dry scalp, not necessarily dandruff (so it gets at your problem without being too harsh). The smell is not my personal taste but if it helps with the itch it might be worth it.
posted by slmorri at 7:51 PM on May 2, 2016

Check your shampoo/conditioner for propylene glycol. I developed a bad allergy to it and the itching was indescribable, with no sign of irritation or dandruff. Switching to propylene glycol free hair products made it vanish.
posted by cecic at 7:56 PM on May 2, 2016 [2 favorites]

I have a similiar issue with my scalp, and so do my brother and sister. We think it's because our mother over treated us for lice as children, instead of using Quell once a week as directed, she washed our hair in it every night for two weeks. The pediatrician threatened to call social services when he saw our scalps. I digress. I have been using Maple Holistics Shampoo for Oily, Itchy & Greasy Hair with Organic Rosemary, Peach Kernel and Jojoba. Amazon sells it, but if you go to their website first they have a 30% off coupon.
posted by momochan at 8:13 PM on May 2, 2016 [1 favorite]

I'm recommending this again...because i had tried all the OTC shampoos and they were too harsh!

The NIOXIN "Scalp Recovery" line for dandruff. It feels very gentle and yet it cleans my hair just fine. they sell a set called, "Nioxin Scalp Recovery System Kit" it includes:
-Scalp Recovery Medicating Cleanser [aka shampoo]
-Scalp Recovery Moisturizing Conditioner
-and Scalp Recovery Soothing Serum
posted by calgirl at 8:15 PM on May 2, 2016

Try dial antimicrobial bar soap once, rinse well and see if the itch goes away, the shampoo you are currently using may be too harsh for your follicles, you over produce sebum in response
If you can find a light oil free conditioner like Mastey frehair use it instead of detergent shampoo, your sebum production may normalize.
posted by hortense at 8:25 PM on May 2, 2016

T-Sal isn't really harsh, in my experience. I've used it before for a scalp itch of doom when I've had very raw irritated patches and it helped almost immediately. I don't have acute scalp itch problems these days, but my scalp does seem to be generally sensitive and it helps to use shampoos and conditioners that have either tea tree oil, no sulfates, or both. The baking soda part of the shampoo-free method is also not great for my scalp, but the vinegar rinses are good.

I saw a dermatologist once or twice for a bad acute case of eczema including seborrheic dermatitis, and while the topical steroids I got for my skin weren't great because they would stop working eventually, I got a separate steroid for my scalp that helped a lot. (It was liquid betamethasone in a squirt bottle.)
posted by clavicle at 8:26 PM on May 2, 2016

I agree that the "no dandruff shampoo" dictate is odd. 2% Nizoral shampoo (prescription, or OTC in Canada) has given me a lot of relief. But if you want to stick to that, you can try Scalpicin. It's liquid (either hydrocortisone or 2% salicylic acid) so it's relatively easy to apply to your scalp.
posted by praemunire at 8:35 PM on May 2, 2016 [1 favorite]

Because this happened even when the OP was trying no poo, I don't think it has anything to do with the shampoo they use being too harsh.

Because of the tenacity of it, and because the itching is the worst at certain spots, I'm wondering if the OP has some sort of persistent infection.

Personally, I would try rubbing a small amount of coconut oil in once or twice a day. If this is in fact dry scalp, that should help. It should also help with an infection since it's antiviral, antibacterial and antifungal.

Upon Googling, coconut oil is even recommended for sebborheic dermatitis.
posted by mysterious_stranger at 8:57 PM on May 2, 2016

Count me as yet another person wondering at your doctor nixing T-Sal. I use it twice a week (don't shampoo other days because I have curly hair), and I don't find it harsh at all. Other steps I took to reduce scalp itch: went sulfate free and cut out almost all silicone products (I think this made the biggest difference). I also used Lush's Soak and Float shampoo bar for a while, but it looks like they've reformulated it since. Probably because the strong campfire scent it used to have was...a difficult sell. The smell didn't linger in my hair, but it was real intense in the shower. Anyway, can't speak to the new formulation, but it worked out okay for me. I prefer T-Sal though.
posted by yasaman at 9:05 PM on May 2, 2016 [1 favorite]

I would give Nature's Gate Tea Tree oil shampoo a try because of Tea Tree oil's effectiveness against Demodex mites, and because the Nature's Gate product seems to have more of it than any other brand.
posted by jamjam at 9:16 PM on May 2, 2016

I really hate using things tested on animals or by companies that test on animals, and while I have suffered for a long time from an itchy, dermatitisy, dandruffy scalp (to the point where I used to unconsciously scratch it bloody at night) I have gotten it reasonably under control recently using a range of natural, vegan, animal-friendly stuff like Thursday Plantation Tea Tree Shampoo and castile shampoo bars (e.g. Dr Bronner), and stuff with plenty of vitamin E in it. I shampoo every day or, at most, every two or three days.

Sometimes I get flare ups, though, and when they're really bad and I feel like I'm about to cry, I get immense and lasting relief from T-Gel 2-in-1. The active ingredient in that stuff is pyrithione zinc, but others that have similar ingredients don't work as well.

There used to be a "T-Gel Plus" that I used, and it was 100% effective, but it isn't available any more and I don't know what was in it that made it different from normal T-Gel. No other tar shampoos work particularly well either.
posted by turbid dahlia at 9:45 PM on May 2, 2016 [2 favorites]

If it's just in a couple of spots, maybe put some tea tree oil just on those after washing and see if that helps - if it's fungal, tea tree oil should clear it up unless it's a really bad infection. Tea tree oil is very drying, as are shampoos / conditioners that contain it, and you don't want to over-dry your whole scalp. You can also try it diluted with some coconut oil if straight tea tree oil is too harsh. Coconut oil is very soothing and might even work just on its own.

I do think you should go back to the doctor and see if they will do a patch test to see if it's fungal. What happens if you put cortisone cream on it?
posted by ananci at 10:12 PM on May 2, 2016

I also have seborrheic dermatitis, and your symptoms are very like mine. I use Aveda's scalp remedy for the itching. I've used Nizoral (both Rx and the 2% OTC), T-Sal, and T-Gel; Lush's Soak & Float shampoo, and pine tar soap. The pine tar soap's my go-to soap for maintenance, along with the Aveda stuff. I also don't wash my hair daily, just every other day, and when I do, I use Trader Joe's shampoo and conditioner. It's made a big difference, not using whatever's on sale at the grocery store. Aveda's shampoos are also excellent and non-irritating, but spendy.
posted by culfinglin at 11:48 PM on May 2, 2016

not a shampoo recommendation BUT: in some other itchy scalp question earlier this year someone recommended this scrubby brush thing to use when shampooing and it is so great that i would probably stop to grab it if my house was on fire. my head is definitely less zitty along the hairline and less itchy in general even during high sweat/low hairwashing weeks when i am working out and saunaing every day.
posted by poffin boffin at 12:13 AM on May 3, 2016 [4 favorites]

Another thing to try - which you can try in addition to other options - is using apple cider vinegar as a last rinse when you've finished washing and conditioning your hair. I sometimes get scalp itch and that keeps it under control. The recommended method is to pour a half cup of it into two cups of water and pour that all over your head, but I just keep a bottle in the shower, and glug a little of it straight onto my head, targeting the itchy spots, and massage it through and then rinse with water well.

The bonus is that it also helps rinse away any built-up styling gak and excess conditioner, it balances your hair's ph and it helps keep things shiny. Plus it's way cheap.
posted by EmpressCallipygos at 3:56 AM on May 3, 2016 [1 favorite]

As I said above, this sounds to me quite likely to be seborrheic dermatitis. If so, I would caution against the people suggesting coconut oil or any sort of oil. There is reasonable scientific evidence that seborrheic dermatitis is related to scalp irritation from the byproducts of the metabolization of sebum/oil by yeasts ("lipid-dependent micro-organisms", as some of the literature calls it). Adding more oil onto your scalp is thus unlikely to fix the problem and quite likely to make it worse by providing more oil for the yeasts to feed on. See this article, especially the bit that I have excerpted below. Coconut oil in particular has high amounts of medium-chain triglycerides, and I also believe it has high amounts of fatty acids - both of these have been singled out as things these yeasts feed on especially:

Although the causes of SD are not completely understood, it appears to result from a combination of the following three factors: sebaceous gland secretion, presence of Malassezia yeast, and the host immune response.6

Sebum is an important component of skin surface lipids and contains high amounts of squalene, wax esters, and triglycerides.10 Persons with SD do not necessarily have excess sebaceous gland activity, but the composition of their skin surface lipid may be altered, creating a more supportive environment for growth of lipid-dependent micro-organisms.10

The role of Malassezia yeasts in SD is somewhat controversial, although most researchers believe they play an important role.9 Malassezia yeasts are normally commensal species found primarily in follicular infundibula and commonly isolated from sebum-rich areas of the body, such as the face, scalp, trunk, and back.11 They produce abundant lipases that hydrolyze triglycerides and free saturated fatty acids on which the yeast is dependent.12 These fatty acids may have irritant effects that induce scaling or may cause release of arachidonic acid, which promotes inflammation in skin.
9 There are seven primary species: M. globosa, M. restricta, M. obtusa, M. sloojjiae, M. sympodialis, M. jurjur, and M. pachydermatis (the last occurs only on animals).9 M. globosa and M. restricta are thought to be the species most commonly associated with SD, although M. jurjur and other species have also been implicated.9,13,14 Some studies have found high numbers of Malassezia yeasts on the scalp of persons with SD, but others have found no difference in the density of these yeasts between the skin of persons with SD and that of persons without it.1 Differing sampling methods may contribute to these contradictory findings. Malassezia exist not only on the skin surface, but also within the layers of the stratum corneum, and a true count would require examining the full thickness of the skin squama.1 Support for the role of Malassezia in SD comes from studies demonstrating that use of various antifungal treatments results in reduction of Malassezia, which is accompanied by improvement in symptoms.6,9

posted by ClaireBear at 4:17 AM on May 3, 2016 [1 favorite]

In addition to the scientific evidence above, anecdotal evidence from seborrheic dermatitis sufferers suggests that coconut oil can make the problem a lot worse. See, for instance, this thread. A few key excerpts include:

QUESTION: Hi first time on this forum so i thought i would post here. I was told i had SD early this year. I was put on steroid creams and nizoral shampoo with mixed results. I had a really bad allergic reaction to some types of steroids, and now i"ve given up all hope on them and have been looking for more natural solutions.

I noticed the thread about honey and coconut oil and thought I would give it a try. I have applied coconut oil after a wash to the affected areas such as around the nose, chin and forehead last night before i went to sleep, and woke up to find all the areas i applied it to are terribly inflamed and i have a horrible burning feeling in all the areas, it really stings. It was better before i applied the oil. Along with the inflammation I've noticed a layer of oily white skin or something similar over the worst Seb affected areas. Could i have used to much coconut oil?


Oleic acid is a known Malassezia carbon source and metabolite. Jojoba oil can worsen seb derm because of its oleic acid content. If you search this forum and elsewhere, you'll find many reports addressing this issue. There's also this study:

Moreover, olive oil disks are used in labs to grow Malassezia furfur, the causative agent of seb derm, because olive oil has a high oleic acid content.

Obviously YMMV, but with seborrheic dermatitis I'd be very wary of putting oil on my head for the same reason that I'd be wary of going no poo. I'd be especially cautious of oils with proportionately high amounts of the things that the yeasts in question feed on (perhaps especially coconut oil). Despite internet folk wisdom, I'd also be wary of other kitchen remedies like honey or anything else containing sugars. I'd stick with anti-fungals (Nizoral shampoo, T-Gel or generic coal tar shampoo) and shampoos that help normalize dead skin shedding (salicylic acid shampoo - T-Sal and the generics). I also think a visit to a dermatologist is in order.
posted by ClaireBear at 4:26 AM on May 3, 2016

Another targeted shampoo is Selsun Blue, or generic version, which contains selenium. It was recommended by a GP and has been more helpful to me than the others. Seconding Scalpicin and apple cider vinegar; I use ACV as a pre-wash to treat hot spots for 10-15 minutes before shampooing. Also, Kiehl's amino acid conditioner.
posted by mmiddle at 6:55 AM on May 3, 2016 [1 favorite]

I'm sure this is anecdata, as much as most of these individual answers will be, but I have struggled with scalp itch, a combination of seborrheic dermatitis and eczema, which ranged from mild to severe,over the last few years. At its worst, I was scratching my scalp until it bled- and if I didn't have thick, long hair, you'd be able to see the dry, scaled patches on my scalp. I didn't have dandruff so much as I had gross, flat pieces of dry scalp skin that would flake off when I scratched.

On a whim, I picked up some combo shampoo/body wash marketed to babies: The Honest Co Shampoo/Body (Gentle version.)

Let me tell you, not only is my hair shiny, more voluminous, and consistently healthy, but basically every shampoo I'd tried in the 2 years prior made my scalp itch either while massaging it into my scalp, or immediately after leaving the shower. This does none of that, and I didn't have to make any sacrifice with regards to smelling like baby products, having clean and non-itchy but possibly not-great looking hair, and it's pretty cheap compared to mid-range shampoo. I do not use any conditioner, nor do I need to, with this product.

Medicated dandruff shampoos never did much for me, and I've tried pretty much all of them. Nizoral, Head & Shoulders, T-Gel, Selsun. Tried 'natural' brands like Lush, organic shampoos. I might get some improvement for a little while, (or an awful allergic reaction) but the effect never lasted.

I'm not kidding when I say something as silly as a hair product improved my life significantly.
posted by rachaelfaith at 7:13 AM on May 3, 2016

According to your post you have a medical condition and it's not being treated. That's the problematic part of your question as I see it. See a dermatologist. In my case itching=eczema and it's treated with a steroidal foam like clobetasol proprionate. I'm sure there are others. IANAD and a dermatologist is what you need, not OTC folk remedies from AskMeFi.
posted by JimN2TAW at 7:27 AM on May 3, 2016 [4 favorites]

I have to agree with JimN2TAW. We don't actually know what your diagnosis is.

That said, depending on the health service where you live, your GP may not be qualified to diagnose you properly or else just not interested enough, and getting you a dermatologist might be as feasible as getting you a unicorn. If you're in the UK, it might be worth looking for a dermatologist who could examine you privately.

As pricey as that sounds, it's probably not more than it will cost you to try 191859674246434867450 different remedies that we could suggest to you, working from trial and error.
posted by tel3path at 7:44 AM on May 3, 2016 [1 favorite]

PS - if you decide to look for propylene glycol free shampoo it goes by several names: α-Propylene glycol; 1,2-Propanediol; 1,2-Dihydroxypropane; Methyl ethyl glycol (MEG); Methylethylene glycol
posted by cecic at 8:43 AM on May 3, 2016 [2 favorites]

I switch off between a couple of the over the counter medicated shampoos listed here, but i only use shampoo once or twice a week. The only thing that really helps with the itch and keeping it under control is Scalpicin, which I also only try to use once or twice a week. 'natural' remedies...well, i'm allergic to most plants. so rubbing stuff made from them on my skin is literal torture for me.
posted by th3ph17 at 8:54 AM on May 3, 2016 [1 favorite]

I have SB and am about to go back on clobetasol shampoo (a steroid prescription) to treat a flare. My flares are stress-triggered, but when I'm less stressed I can get by with a 2% anti fungal (also prescription) for maintenance. Definitely see a dermatologist.
posted by serelliya at 9:51 AM on May 3, 2016 [1 favorite]

When you say that your doc doesn't think it's "dandruff," are you talking about a GP or a dermatologist? You would probably benefit from seeing a dermatologist. I do, however, agree that it sounds like seborrheic dermatitis -- I don't get "dandruff" but I do get oily scalp and some buildup, and it responds well to dandruff shampoos. I currently wash my hair daily and switch between T-Sal (OTC) and Cicloporox (RX). I use Nizorol and Selsun occasionally too.

One thing they don't tell you about dandruff "shampoo" -- it's not really shampoo. It's really leave-in-5-minutes-and-wash-out treatment. Most don't cleanse your hair that well (and are expensive, so you're wasting them on your hair!). Best practice is to wash your hair with your regular shampoo, rinse, then apply the dandruff shampoo to the scalp and follow the directions.
posted by radioamy at 10:52 AM on May 3, 2016 [1 favorite]

I had the same exact symptoms as you from about age 16 to 38. I had to wash my hair everyday, sometimes even twice. Shampoos like T-Gel would work for a while but then stop working after a while. It made my life miserable. The only thing that made it drastically better for me was lowering my testosterone, but that's a pretty extreme thing to just casually suggest someone go do. I now wash my hair maybe once a week. To directly answer your question though, I use Smooth As Silk Deep Moisture Shampoo and Conditioner by Giovanni. It takes care of any remaining problems I have.
posted by Annika Cicada at 12:29 PM on May 3, 2016

My itchy, scaly scalp didn't get better until I started using Head & Shoulders conditioner. I had tried T-Sal, T-Gel, the scalp scrubber, tea tree shampoo, hippie health food store organic shampoo, etc. with zero relief. The conditioner every day and regular shampoo every other did the trick, no idea how or why.
posted by Maarika at 1:55 PM on May 3, 2016

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