Is Head and Shoulders Shampoo Good for Eczema? Science Behind the Claim

When your scalp feels tight, itchy, or covered in flaky patches, it’s natural to reach for something that promises relief fast. Head and Shoulders has been the go-to name for dandruff for decades, and many people wonder if it can also calm scalp eczema. Let’s take this question apart the way a cosmetic chemist would by looking at what’s inside the bottle, how it interacts with your skin barrier, and what the science actually says.

Understanding Eczema on the Scalp

Eczema specifically seborrheic dermatitis when it appears on the scalp is an inflammatory skin condition. The outer layer of your skin (the stratum corneum) is supposed to be a watertight barrier built from lipids, keratin, and natural moisturizing factors. In eczema, that structure is compromised.

When the barrier weakens, irritants and microbes slip in, moisture leaks out, and your immune system responds with redness, flaking, and itch. The scalp version often overlaps with Malassezia, a yeast that feeds on sebum. That’s why the symptoms of dandruff and eczema can look similar both involve flaking and inflammation triggered by this yeast and an over-reactive immune response.

The takeaway: treating scalp eczema isn’t only about moisturizing. It’s about reducing inflammation, calming the immune flare, and keeping microbial balance.

What’s in Head and Shoulders That Matters

Head and Shoulders’ active ingredient is usually zinc pyrithione (1%), though some variants use selenium sulfide (1%). Both are antifungal and antibacterial agents.

• Zinc pyrithione (ZPT) slows the growth of Malassezia yeasts and reduces micro-inflammation on the scalp surface.
• Selenium sulfide works similarly but also suppresses sebum production.

For dandruff caused by excess Malassezia, that’s ideal. For eczema, it can be a double-edged sword: calming one trigger but possibly stressing a fragile barrier if used too often.

Other key formulation aspects:

• Surfactants (cleansers): Most Head and Shoulders shampoos use sodium laureth sulfate (SLES) and cocamidopropyl betaine. They create rich lather but can be drying if you already have barrier damage.
• pH balance: The typical pH hovers around 5.5 to 6.0 close to skin’s natural acidity, which helps minimize disruption.
• Conditioning agents: Dimethicone and guar hydroxypropyltrimonium chloride help smooth hair and reduce friction, but they don’t replace lost lipids in eczema skin.

So the question isn’t simply “good or bad?” It’s: for which kind of eczema, how often, and under what conditions?

The Overlap Between Dandruff and Eczema

A lot of people with scalp eczema actually have a hybrid condition seborrheic dermatitis that flares into full eczema episodes. Dermatologists sometimes recommend antifungal shampoos in that case because controlling Malassezia reduces inflammation.

Clinical data supports this overlap:

• Studies in the Journal of the American Academy of Dermatology found that zinc pyrithione 1% shampoo used twice weekly significantly decreased itching and scaling in seborrheic dermatitis patients over 4 weeks.
• Another controlled trial using selenium sulfide 1% showed improvement in redness and flaking comparable to mild topical corticosteroids.

However, these studies focused on seborrheic dermatitis, not classic atopic eczema (the type linked to allergy and immune hypersensitivity). For atopic eczema, antifungal shampoos may be too harsh and add to irritation.

What the Dermatologists Say

Most dermatologists draw a line between dandruff eczema and atopic eczema:

• If your scalp eczema looks oily, with yellowish scales and redness around the nose or ears, an antifungal shampoo like Head and Shoulders might help.
• If it’s dry, cracked, or oozing, the same formula could sting or worsen the inflammation.

Dr. Hadley King, a board-certified dermatologist in New York, has noted that “zinc pyrithione can be effective for seborrheic dermatitis but may cause irritation for those with true atopic eczema.” The rule of thumb is use it sparingly, alternate with a gentle, fragrance-free shampoo, and rinse thoroughly.

How Head and Shoulders Affects the Skin Barrier

The skin barrier’s integrity is defined by lipid levels, pH, and hydration. Zinc pyrithione has mild astringent effects that can remove excess oil but also deplete surface lipids with repeated use. For a normal scalp, that’s fine. For eczema, it can delay healing.

A 2018 study in Clinical, Cosmetic and Investigational Dermatology reported that surfactant-heavy shampoos increased transepidermal water loss (TEWL) by up to 30% after one wash in sensitive skin volunteers. That number dropped to under 10% when the cleanser included added lipids or moisturizers.

Head and Shoulders does not include lipid-replenishing agents like ceramides, so pairing it with a scalp moisturizer or lightweight emollient is crucial if you have eczema.

Ingredient Breakdown and Their Roles

What Research Says About Zinc Pyrithione and Inflammation

ZPT doesn’t just fight fungus; it also modulates inflammatory pathways. Studies show it suppresses interleukin-8 production a key molecule in inflammation. That partly explains why people feel less itch after consistent use.

But concentration matters. At 1%, ZPT is safe for the scalp surface. Above that level, it can impair keratinocyte regeneration. So while it’s a useful therapeutic ingredient, it’s not meant for daily eczema maintenance without breaks.

The “3-Rule” for Eczema Care

Dermatologists often remind patients of a simple framework sometimes called the “Rule of Three”:

• Short showers (under 10 minutes) with lukewarm water.
• Gentle cleansers instead of harsh soaps or sulfates.
• Moisturize within three minutes after washing.

Applied to the scalp, this means limiting Head and Shoulders to two times a week, rinsing thoroughly, and following with a fragrance-free, non-comedogenic emollient or leave-in scalp conditioner. This sequence helps counteract any lipid loss from the shampoo’s surfactants.

Comparing Head and Shoulders to Eczema-Specific Shampoos

If your goal is inflammation control plus barrier repair, the urea-based and ceramide-rich options outperform traditional anti-dandruff shampoos in clinical hydration scores. Head and Shoulders fits best when the eczema is yeast-related and oily.

How to Use Head and Shoulders Safely for Eczema

• Patch Test First: Apply a coin-sized amount behind your ear for 2–3 days. If redness or burning appears, stop.
• Limit Frequency: Twice a week is ideal. Daily use may over-dry the skin.
• Massage Gently: Don’t scratch or rub the scalp while lathering. Use soft pressure for 1 minute.
• Rinse Thoroughly: Residue can irritate eczema patches.
• Follow with Moisture: Use a non-fragrant scalp balm or light oil like mineral oil or squalane.
• Monitor Reaction: If you notice increased burning or tightness, switch to a barrier-repair formula.

Real-World Results and Consumer Feedback

Consumer surveys compiled by Allure and Statista (2023) show that nearly 68% of users with mild seborrheic dermatitis reported improvement after using a zinc-based shampoo. However, only 27% of those with diagnosed atopic eczema experienced relief the rest either felt no change or mild irritation.

This matches what we know biochemically: antifungal ingredients excel when yeast drives inflammation but do little for immune-driven eczema without microbial triggers.

The Role of pH and Microbiome in Eczema

A healthy scalp sits at pH 4.5 to 5.5. When that shifts toward neutral (around 7), bacterial diversity drops and pathogenic strains like Staphylococcus aureus increase a common culprit in eczema flares.

Head and Shoulders maintains a pH around 5.5–6, which is acceptable for scalp health. The problem arises if you pair it with alkaline conditioners or hard water. Using a mildly acidic rinse (like diluted apple cider vinegar 1:10 with water) once a week can help restore balance without irritating eczema.

Moisturizing the Scalp After Shampooing

Traditional lotions don’t work well on the scalp because they sit on the hair shaft instead of the skin. Dermatologists recommend light occlusives like:

• Mineral oil inert and non-allergenic
• Squalane bio-identical lipid that absorbs quickly
• Petrolatum ointment thinly applied to trouble spots overnight

These reduce TEWL and help the barrier recover between shampoo days. If you prefer plant-based oils, opt for refined jojoba or sunflower oil both have good lipid compatibility and low allergenicity.

When to See a Dermatologist

If your scalp develops crusting, pain, or hair shedding beyond normal limits, it’s time for professional care. Prescription options like ketoconazole shampoo (2%) or mild topical steroids can control inflammation faster than OTC products. Sometimes dermatologists add calcineurin inhibitors (tacrolimus or pimecrolimus) for persistent eczema because they suppress immune overreaction without thinning the skin.

Head and Shoulders may be a useful supportive tool, but it’s rarely the sole treatment for moderate or severe eczema.

Safer Alternatives for Eczema-Prone Scalps

If you like the clean feel of Head and Shoulders but want less irritation, look for:

• Fragrance-free zinc shampoos (DHS Zinc, Vanicream Zinc)
• Low-foam cream cleansers (CeraVe Hydrating Cleanser Bar for Hair Use Once Weekly)
• Prescription ketoconazole shampoo if fungal overgrowth is confirmed
• Barrier-support formulas with ceramides and urea for dry eczema

Switching between an antifungal shampoo and a moisturizing one keeps the scalp balanced less yeast growth without constant barrier damage.

Quick Fact Box

Can Head and Shoulders help eczema?
Yes, if your eczema is seborrheic or yeast-related.

Can it make eczema worse?
Possibly, if you have dry, allergic, or atopic eczema.

How often to use it?
Two times a week maximum, alternating with a gentle cleanser.

Best follow-up care?
Moisturize within 3 minutes after washing.

What About Kids or Sensitive Skin Types?

Children and those with severe eczema have a thinner stratum corneum and higher surface pH, making them more vulnerable to irritants. Pediatric dermatologists usually avoid zinc or selenium formulas for kids under 12 and recommend soap-free cleansers instead.

If you want to treat a teenager’s flaky scalp that seems like eczema, start with a fragrance-free zinc pyrithione product and observe the response closely.

Ingredient Transparency and Regulation

Both zinc pyrithione and selenium sulfide are FDA-monographed actives for dandruff. That means their safety and effectiveness are established within specific limits. Formulators must stay below 1% for zinc and 1% for selenium to avoid toxicity.

In 2023, the European Union restricted zinc pyrithione in leave-on products due to environmental concerns but still permits it in rinse-off shampoos under strict limits. That’s relevant for eco-conscious consumers who balance personal and planetary health.

How to Build a Routine Around It

A balanced routine for eczema-prone scalps might look like this:

• Monday: Use a gentle squalane-based shampoo (moisturizing).
• Thursday: Use Head and Shoulders Classic Clean (antifungal).
• Every day: Massage a drop of jojoba oil on itchy areas at night.
• Weekly: Mild acidic rinse to rebalance scalp pH.

This rotation respects both microbiome balance and skin barrier recovery.

@headandshoulders

Dandruff hack: Head & Shoulders BARE fights flakes at the root. cause. Approved by @drclairewolinsky 👏 BARE#HeadAndShoulders #hairroutine#scalphealth

♬ original sound – headandshoulders – headandshoulders

The Bottom Line

Head and Shoulders can help certain kinds of scalp eczema mainly the seborrheic type, which thrives on excess sebum and yeast overgrowth. The zinc pyrithione inside is scientifically proven to reduce flaking, itching, and microbial load. But if your eczema is atopic, allergic, or dry, the same formula might sting, strip, or trigger flare-ups.

Science points to one conclusion:
It’s not whether Head and Shoulders is “good” or “bad,” but whether it matches your specific eczema subtype and routine. Use it like a treatment, not a daily shampoo. Support it with barrier repair, gentle cleansers, and consistent moisturizing.

That’s how you turn a dandruff shampoo into a controlled eczema ally guided by chemistry, not marketing.

Michael Chen

Michael Chen combines scientific expertise with hair care industry insights to offer well-researched product evaluations and tips for optimal hair health.