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

Best overall: Nioxin Scalp Recovery Purifying Exfoliator — $27.00

One of Shamban’s recommendations, this product is made with FDA-approved zinc pyrithione and green tea extract that cleanses the scalp deeply but gently. It’s suitable for all hair types and moisturizes while it exfoliates.

Pros:

• Exfoliating
• FDA-approved ingredients
• Fast results

Cons:

• Small size
• Have to wear gloves

Best budget: Selsun Blue Moisturizing Dandruff Shampoo — $8.00

A longtime favorite for people with dandruff, Shamban says Selsun Blue may also work well for more mild psoriasis cases. It contains one percent selenium sulfide to combat dry and itchy flakes, plus aloe to soothe and nourish the scalp.

Pros:

• Lathers quickly
• Affordable

Cons:

• Some reviewers say the smell is medicinal

Best hydrating: Philip B Anti-Flake Relief Shampoo — $56.00

Shamban likes this shampoo as its main active is zinc pyrithione (also known as zinc omadine) and also includes sage, juniper, tea tree oil (which she recommends) and soothing aloe vera. Note: There is both an extra strength formula and this coal tar-free formula—coal tar is an effective treatment for scalp psoriasis, according to the AAD, but some people may want to avoid it, as there are potential side effects such as skin sensitivity.

Pros:

• Made with natural botanicals
• Amino acid complex strengthens hair
• Calms inflammation

Cons:

• Expensive

Best extra-strength: Head & Shoulders Clinical Strength Dry Scalp Rescue Shampoo — $19.00

The selenium sulfide formula relieves stubborn dandruff symptoms while leaving hair feeling soft and clean. “Another ingredient to make sure is included in your scalp regimen, is ZPT [zinc pyrithione], as it works with selenium sulfide to address the source of dandruff and its symptoms, an irritant resulting from a natural occurring fungus on the scalp,” says Wilkerson.

Pros:

• Contains 1 percent selenium sulfide
• FDA-approved ingredients
• Cooling sensation

Cons:

• Some reviewers complain about the smell

Best with salicylic acid: Dermarest Psoriasis Medicated Shampoo +Conditioner — $13.00

This fragrance-free shampoo contains three percent salicylic acid, plus a zinc complex that’s formulated to treat psoriasis. It also has nourishing botanicals such as green tea extract, kukui nut oil and safflower extract.

Pros:

• Contains 3 percent salicylic acid
• Dermatologist tested and recognized by the National Psoriasis Foundation
• Unscented

Cons:

• Some reviewers say it’s not very moisturizing

Best natural ingredients: Yes To Tea Tree Scalp Relief Soothing Shampoo — $15.00

If you’re looking for a formula packed with natural ingredients, try this formula, which is also loaded with tea tree oil, another ingredient Shamban recommends for scalp psoriasis.

Pros;

• pH balanced
• Contains tea tree oil, salicylic acid, and sage oil

Cons:

• Cons

Best shampoo and conditioner: Nizoral Scalp Psoriasis Shampoo & Conditioner — $21.00

Popular on Amazon, this two-in-one shampoo and conditioner contains salicylic acid as well as tea tree oil, green tea, and vitamins E, C, and B5.

Pros:

• Contains tea tree oil
• Contains three percent salicylic acid
• Can be used on color-treated, chemically processed, and gray hair

Cons:

• Some reviewers say it dries out the scalp

Best shampoo and conditioner: Nizoral Scalp Psoriasis Shampoo & Conditioner — $18.00

Dr. Garshick loves this pick because it contains three percent salicylic acid, tea tree oil, green tea extract, vitamin E, panthenol, and vitamin C to soothe and protect the scalp. “As a two-in-one, this is a good option for someone who is looking for a multitasking product,” she adds. 

Pros:

• 2-in-1 shampoo and conditioner
• Suds up nicely

Cons:

• Some reviewers report that their scalp felt stripped and dry after use

Best with coal tar: Psoriatrax Coal Tar Shampoo 5% Coal Tar — $20.00

Coal tar can help treat symptoms of psoriasis flare-ups like inflammation, redness, and itching. This pick has five percent strength to help clear symptoms and is steroid-free. Massage this onto the scalp and leave for one minute to achieve the best results. 

Pros:

• Fragrance and steroid-free

Cons:

• May make your hair feel dry after washing

Best unscented: Vanicream Medicated Dandruff Shampoo — $13.00

This Vanicream shampoo is a medicated yet gentle option that can help relieve itching, redness, flaking, and irritation, says Dr. Palm. Shampoos with salicylic acid help to lift and soften the scales on your scalp, but they can also make you more susceptible to sun damage, so Dr. Palm advises using SPF if you’re using shampoos that are medicated to treat psoriasis on your scalp.

Pros:

• Contains two percent pyrithione zinc
• Can be used on sensitive skin

Cons:

• Some reviewers say it dries out hair

Best daily use: Neutrogena T:Gel Extra Strength Therapeutic Shampoo — $41.00

This shampoo contains one percent coal tar to help relieve itchy scalps, and is gentle enough to be used every day. It’s also recognized by the National Psoriasis Foundation to help relieve symptoms.

Pros:

• Contains one percent coal tar
• Recognized by the National Psoriasis Foundation
• Gentle enough for daily use

Cons:

• Some reviewers complain about the smell

Best for color-treated hair: Jupiter Balancing Shampoo — $29.00

Another favorite of Dr. Garshick, this pick is suitable for red, flaky scalps and safe for color-treated hair. “This shampoo contains zinc pyrithione and can be used daily for those with mild to moderate dandruff as it helps to reduce flaking and associated itch,” she says. 

Pros:

• Color-safe
• Reduces flake

Cons:

• Reviewers report that it doesn’t lather up

Best for buildup: Dermarest Psoriasis Medicated Shampoo — $11.00

If your scalp feels full of buildup, opt for this medicated regimen with salicylic acid. It works to gently slough off dead cells to help reveal new, healthier skin underneath and also contains green tea extract, kukui nut oil, and safflower extract to calm and soothe irritation.

Pros:

• Controls buildup
• Reduces itching
• Fragrance-free

Cons:

• Recommended use is only twice per week

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.