Medicated Shampoos: What They Do and Which Ones Actually Work

When you think of medicated shampoos, shampoos formulated with active pharmaceutical ingredients to treat scalp and skin conditions. Also known as therapeutic shampoos, they're not just fancy hair cleaners—they're topical treatments backed by science. Unlike regular shampoos that clean, these are designed to fix problems: dandruff, seborrheic dermatitis, fungal infections, and even psoriasis on the scalp. They work by targeting the root cause, not just hiding symptoms.

One of the most common active ingredients is ketoconazole, an antifungal agent that reduces yeast overgrowth on the scalp. It’s in brands like Nizoral and is clinically proven to calm flaking and itching. Then there’s pyrithione zinc, a mild antifungal and antibacterial compound used in Head & Shoulders and other OTC options. It’s less potent than ketoconazole but works well for mild cases. For stubborn cases, salicylic acid, a keratolytic that breaks down dead skin buildup helps loosen scales. And for psoriasis, coal tar, a natural substance that slows skin cell turnover is still used, even though it smells strong and stains fabrics.

These shampoos aren’t meant for daily use. Overuse can dry out your scalp or cause irritation. Most doctors recommend using them 2–3 times a week, leaving them on for 5–10 minutes before rinsing. If you’re using one for dandruff and it stops working after a few weeks, that’s not unusual—your scalp can adapt. Switching between different active ingredients can help prevent resistance.

What you won’t find in these shampoos are miracle cures. No shampoo will permanently cure psoriasis or stop hair loss caused by genetics. But they can manage symptoms effectively when used right. And they’re often the first line of defense before moving to stronger treatments like topical steroids or oral meds.

There’s also a growing trend of combining medicated shampoos with other therapies. For example, if you’re dealing with fungal folliculitis, your doctor might pair ketoconazole shampoo with an oral antifungal. Or if you have seborrheic dermatitis, you might use a medicated shampoo in the morning and a moisturizing scalp serum at night.

What you’ll find in the posts below are real, practical insights on how these shampoos interact with other medications, how they affect liver function in long-term users, and why some people swear by them while others see no change. You’ll learn what’s backed by evidence and what’s just marketing. No fluff. No hype. Just what works—and what doesn’t.