It can be frustrating to deal with the itchy, flaky scalp of dandruff and even a bit embarrassing when those tell-tale white flakes scatter across the front of your new black blouse. It’s enough to make you want to put away your dark clothing! Fortunately, dandruff is easier to deal with these days with the many shampoos available to treat this common condition. One shampoo that’s been shown to be effective for treating the symptoms of dandruff is ketoconazaole dandruff shampoo, known by the brand name Nizoral AD. This shampoo was previously available only by prescription, but a less concentrated form was manufactured for over-the-counter use in the 1990’s. Is this shampoo more effective for dandruff than Head and Shoulders dandruff shampoo?
How does ketoconazole dandruff shampoo work? Ketaconazole dandruff shampoo exerts its effects by stopping the growth of a yeast known as Pityrosporum ovale which is thought to cause the symptoms associated with dandruff. While everyone has some of this yeast growing on their scalp, people who suffer from dandruff have more. It’s thought that the scalps of people who are susceptible to dandruff are unusually sensitive to the metabolic products produced by this yeast. This sets up an inflammatory reaction that causes the scalp to itch and flake giving rise to the symptoms of dandruff.
Ketoconazole dandruff shampoo which contains one percent ketoconazole has been demonstrated to be effective at stopping the growth and replication of this dandruff causing yeast. Unfortunately, ketoconazole has been shown in animals to cause fetal abnormalities when taken during pregnancy, meaning it should be avoided if you’re pregnant. When taken orally it can cause liver abnormalities although this is unlikely to be a problem at the low concentrations found in anti-dandruff shampoo.
In contrast to Ketoconazole dandruff shampoo, Head and Shoulders dandruff shampoo has pyrithione zinc as its active ingredient. This ingredient works by moderating the growth of scalp skin cells which helps to reduce flaking and shedding. Interestingly, Head and Shoulders dandruff shampoo appears to slow the growth of the Pityrosporum ovale yeast which isn’t surprising since this ingredient is used in industry to prevent the growth of microorganisms. It also contains sulfur, salicylic acid, and coal tar which help to slow down the growth rate of scalp cells and prevent them from clumping together. Coal tar is thought to be a carcinogen at high doses, although this isn’t thought to be a problem at the low doses found in anti-dandruff shampoos.
When comparing the two shampoos in terms of price and effectiveness, in most cases Head and Shoulders dandruff shampoo will work just as well as the more expensive Ketoconazole dandruff shampoo. They both seem to be effective for slowing down the growth of the dandruff causing yeast and both help to stop itching and flaking. Since Head and Shoulders dandruff shampoo is significantly less expensive, try this product first. If you find you aren’t getting the results you expected, you can always switch over to the Ketoconazole dandruff shampoo. Once you have your dandruff under control, try to limit use of these products since the safety of their ingredients for long term use hasn’t been established.
Dr. Kristie