There has been a rise in scalp problems over the past 18 months, suggest experts.
‘We’ve seen an increase in many inflammatory skin conditions, and I’m sure this is due in part to an increase in stress owing to Covid,’ says Dr Justine Hextall, a consultant dermatologist at Tarrant Street Clinic in Arundel, West Sussex.
From psoriasis to dandruff and folliculitis (inflamed hair follicles), a host of health problems can affect the delicate skin covering the head.
But will a medicated shampoo — which can cost up to four times as much as standard shampoo — help? We asked experts to review a selection of the latest products. We then rated them.
Moksha Beauty London Tea Tree & Lavender Anti-Dandruff Shampoo
For itchy/flaky scalpsMoksha Beauty London Tea Tree & Lavender Anti-Dandruff Shampoo
250ml, £9, amazon.co.uk
Claim: Uses lavender, as well as antifungal and antibacterial tea tree oil to ‘help to prevent dandruff and alleviate dry and itchy scalps’.
Expert verdict: ‘Small studies support the anti-dandruff benefits of tea tree oil in a relatively high 5 per cent concentration, as it’s thought to kill the scalp-dwelling malassezia yeast,’ says Dr Hextall.
‘But it’s not clear from the label how much this contains. Tea tree oil can also be an irritant for sensitive skins. You can find much better studied anti-dandruff ingredients such as zinc pyrithione in pharmacy-bought shampoos.’
5/10Alphosyl 2-in-1 Medicated Shampoo 
Alphosyl 2-in-1 Medicated Shampoo
250ml, £9, boots.com
Claim: A shampoo containing coal tar for scalp conditions such as psoriasis and seborrheic dermatitis, ‘reducing the skin scaling caused by these conditions’. Psoriasis usually causes red skin with white and thick scales of skin; seborrheic dermatitis (dandruff) leads to a red, itchy scalp with greasy-looking white/yellow flakes along the hair shaft.
Expert verdict: ‘The scalp is a common place for psoriasis, which not only feels sore but can cause skin scales to fall on to hair and clothes, making people very self-conscious,’ says Dr Hextall.
‘Coal tar has been used for more than 100 years to treat psoriasis. The mechanism isn’t fully understood but it seems to reduce the excess skin cell turnover causing itchy patches. This shampoo contains a high concentration (5 per cent).
Studies have shown much lower concentrations (0.5 per cent) can be effective. High doses of coal tar can cause skin irritation and increased sensitivity to sunlight [and sunburn].’
6/10 
Green People Men’s, No 10 Itch Away Shampoo
Green People Men’s, No 10 Itch Away Shampoo
150ml, £15, greenpeople.co.uk
Claim: ‘Natural’ shampoo with tea tree oil, chamomile, aloe vera and pineapple enzymes to relieve an ‘itchy, flaky and irritated scalp’.
Expert verdict: ‘While tea tree oil is sensible, it’s not clear from the label exactly how much this contains,’ says Dr Hextall.
‘The pineapple extract bromelain is a fruit acid with antibacterial properties — it can help encourage skin exfoliation by dissolving the glue-like bonds between dead skin cells, reducing flaking. The skin-soothing benefits of aloe vera and chamomile are well established. A nice product.’
7/10Healpsorin Shampoo for dermatitis
500ml, £20.99, amazon.co.uk
Healpsorin Shampoo for dermatitis
Claims: Contains salicylic acid to exfoliate the scalp, ‘antimicrobial’ dermosoft decalact and comfrey extract to ‘stimulate skin cell proliferation’, and claims to ‘minimise dandruff, seborrheic dermatitis and psoriasis’.
Expert verdict: ‘Eczema, or dermatitis, is very common and affects skin anywhere — including the scalp,’ says Dr Sharon Wong, a consultant dermatologist at Homerton University Hospital, London.
‘The most common scalp form is seborrheic dermatitis, caused by an overgrowth of malassezia yeasts.
‘These feed off sebum naturally released from oil glands attached to hair follicles, releasing oleic acid, which causes skin irritation in some people. Stress and cold weather can worsen symptoms.
‘Dermosoft decalact is a palm oil derivative with cleansing and antibacterial properties — research shows it can reduce malassezia.
‘There’s no research showing if comfrey has specific exfoliation benefits, as the company suggest. The salicylic acid helps dissolve the bonds of dead skin cells, removing excess flaking.
6/10Reduce Flaky Scalp + Promote Hair Growth Shampoo Bar
£15.54, bundleoforganic.co.uk
Reduce Flaky Scalp + Promote Hair Growth Shampoo Bar
Claim: A shampoo bar containing castor oil, shea butter, coconut oil, baobab seed oil, rosemary, lavender and turmeric. ‘Our selected oils stimulate the scalp and increase circulation, reducing flaky scalp and promoting hair growth,’ says the maker.
Expert verdict: Dr Catherine Borysiewicz, a consultant dermatologist at the Cadogan Clinic and Imperial College Healthcare NHS Trust in London, says: ‘The castor, olive, baobab and coconut oils in this are all pretty effective moisturisers so will help improve scalp dryness. Rosemary oil has been used historically to boost hair growth and, along with lavender, reportedly has anti-inflammatory properties, and may help itchy skin and boost circulation to the scalp.
‘But there are no robust studies to currently support any of these claims and I’m cautious of essential oils which can cause irritation. Coconut oil can also block pores and trigger acne, so best avoided for those with spotty or oily scalps.’
5/10For receding hairSons DHT Blocking Shampoo
250ml, from £10, sons.co.uk
Sons DHT Blocking Shampoo
Claim: A shampoo for ‘men with mild hair loss experiencing early signs of a receding hairline’, this is made with the plant extract saw palmetto, which, the maker says, is a ‘proven DHT blocker, reducing scalp levels of this hormone’. High levels of the male hormone dihydrotestosterone (or DHT) are linked to hair loss.
Expert verdict: ‘The maker recommends combining this with a topical minoxidil 5 per cent [the same chemical and strength found in over-the-counter hair-loss treatment Regaine],’ says Dr Borysiewicz.
‘Research shows minoxidil boosts baby hair growth on the scalp, but this is not permanent. It’s normally recommended by specialists to boost hair growth while addressing underlying causes of hair loss, which can range from hormone fluctuations to stress.
‘I can’t see that the shampoo alone will have the same effect as using minoxidil.’
3/10For hair lossMr Jamie Stevens Anti Hair-Loss Shampoo
300ml, £7.50, boots.com
Mr Jamie Stevens Anti Hair-Loss Shampoo
Claim: Containing pea peptide and hexapeptide-11, this promises to ‘effectively remove dirt, grease and product build-up and reduce the rate of hair loss’.
Expert verdict: ‘Hair loss affects 40 to 80 per cent of people at some point,’ says Dr Wong. ‘The most common cause is genetic but hormonal changes and illnesses can also contribute.
‘The pea sprout protein extract has been shown to stimulate signalling responsible for hair growth in a study on plucked hair follicles [funded by the company behind the compound].
‘Hexapeptide-11 is made from amino acids derived from yeast; there’s limited research on this in relation to hair.
‘Both ingredients need much more robust data and independent clinical research to validate claims of reducing the rate of hair loss. Minoxidil is the only topical treatment licensed for treating “genetic” hair loss and is used as a leave-in foam so the ingredient stays on the scalp.
‘Regular washing is important with hair loss. Removing dirt and product build-up reduces irritation and flaking, and prevents blocked follicle openings, both of which can cause secondary hair fall-out.
5/10For scalp acneCLn Shampoo for scalps prone to folliculitis
240ml, £28.50, landyschemist.com
CLn Shampoo for scalps prone to folliculitis
Claim: Made with salicylic acid to ‘eliminate flakes and unclog pores’ for scalps and beards prone to blocked pores and folliculitis, says the maker.
Expert verdict: ‘Acne and folliculitis are both very common on the scalp and beard,’ says Dr Wong. ‘Both areas are densely packed with sebaceous glands and hair follicles which can become blocked.
‘While acne on the scalp tends to be caused by excess oil production blocking pores, folliculitis can have a number of causes, including ingrown hairs, product build-up and infection.
‘Salicylic acid is highly effective in penetrating skin pores and hair follicles to exfoliate more deeply by dissolving the glue that holds dead skin cells together so they can be washed away, as well as regulating sebum production, helping to control acne. It also has anti-inflammatory and anti-microbial properties.
‘Overall, a product with effective active ingredients.
‘However, it could also be drying on your hair, so ensure you use a moisturising conditioner.’
7/10 For bed-bound patients Nilaqua Rinse Free Shampoo Cap
£2.71, boots.com
Claim: For use after surgery, or ‘for bed-bound patients, or anyone who finds bending their neck difficult’, this ‘shampoo cap’ is impregnated with a towel-off shampoo, so you can wash your hair without water. Apply cap to head, massage until scalp feels saturated, then remove it and towel-dry.
Expert verdict: ‘This is a clever idea for people who are unable to wash hair conventionally, particularly patients confined to bed,’ says Dr Catherine Borysiewicz, a consultant dermatologist at Imperial College Healthcare NHS Trust, London.
‘The cap claims to remove dirt, odours, hair products and even blood.
‘Its main ingredient, tea-lauryl sulfate, is found commonly in shampoo, body wash and facial cleansers and works effectively to allow oil and dirt to mix and be wiped away. But it can be drying — so look out for signs of skin irritation.’
8/10 
Nilaqua Rinse Free Shampoo Cap
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