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Getting rid of dandruff can be difficult. If you’ve experienced the frustration of buying expensive over-the-counter scalp products that fall short of their promise to banish those pesky flakes and itching, you’re not alone. Close to 50% of people are thought to have dandruff—small pieces of dry skin that flake off your scalp (Tucker, 2022).
When over-the-counter products aren’t helping, talk to a dermatologist or other healthcare provider. They can check if your flakes could be caused by an inflammatory skin condition called seborrheic dermatitis. If so, you may benefit from trying an antifungal treatment, such as ciclopirox shampoo. Read on to learn more about ciclopirox, how to use it, its possible side effects, and other dandruff treatments to consider.
What is ciclopirox shampoo?
Ciclopirox shampoo (brand name Loprox) is a medicated shampoo available by prescription only. Its active ingredient is ciclopirox olamine and it comes in a concentration of 1%. The US Food and Drug Administration (FDA) approves it to treat seborrheic dermatitis of the scalp in people 16 and up (DailyMed, 2019).
Seborrheic dermatitis (SD) is a common skin condition that causes inflammation, itching, and white or sometimes yellowish waxy flakes. SD is thought to be caused by an imbalance of the skin’s microbiota (the “good bacteria ” that live on our skin). The condition most often affects the scalp, face, or ears of infants (also known as “cradle cap”) and middle-aged adults (Tucker, 2022; Clark, 2015). (Though this condition happens in infants, ciclopirox is only approved for use in individuals over 16).
Ciclopirox belongs to a class of drugs called antifungals. While this drug class is named for its fungus-killing action, it also has anti-inflammatory effects that can ease the symptoms of SD (Sonthalia, 2019).
If you use ciclopirox shampoo according to your provider’s instructions, you should notice your symptoms improve after 4 weeks of use (DailyMed, 2019).
Ciclopirox shampoo comes as a generic drug that retails for around $138 per bottle (GoodRx, 2022). However, discount programs are widely available to help lower the cost substantially.
How to use ciclopirox shampoo
Note that ciclopirox shampoo is meant for use on the scalp only. If you have flaky, itchy skin in other areas of your body, talk to your dermatologist or healthcare provider about other treatment options, such as ciclopirox topical solution.
Here’s an overview of how to use ciclopirox shampoo (DailyMed, 2019):
- Wet hair and apply about 1 teaspoonful (5 mL) of the shampoo to your hair and scalp. If you have long hair, you may need 2 teaspoons (10 mL) to completely cover your hair.
- Lather and leave on for 3 minutes.
- After 3 minutes, rinse the ciclopirox shampoo out of your hair and off your scalp.
Try to avoid getting the product in your eyes and mouth. Rinse thoroughly with water if contact occurs.
Ciclopirox shampoo schedule
Healthcare providers typically recommend washing with ciclopirox shampoo twice weekly for four weeks. You’ll want to take a 3-day break between applications of ciclopirox. Here’s an example schedule you could follow:
- Monday: Use ciclopirox shampoo.
- Tuesday, Wednesday, Thursday: Skip the ciclopirox. Use regular shampoo if you wash your hair on these days.
- Friday: Use ciclopirox shampoo.
- Saturday, Sunday, Monday: Skip the ciclopirox. Use regular shampoo if you wash your hair on these days.
- Tuesday: Use ciclopirox shampoo.
After continuing this pattern for 4 weeks, you should notice a clearer-looking scalp. But, if you’re not getting results within this time or experience uncomfortable side effects, talk to your healthcare provider (DailyMed, 2019).
Side effects of ciclopirox shampoo
Possible side effects of ciclopirox shampoo include increased itchiness, a burning sensation, or blistering at the application site. Also, hair discoloration may occur if you have light-colored hair (DailyMed, 2019).
Adverse effects from ciclopirox are usually mild and temporary. If your symptoms seem severe or if you think you may be having an allergic reaction, stop using ciclopirox and contact a healthcare professional for medical advice.
Some people have reported having hair loss or changes in their hair texture with ciclopirox use. But, because these reports occurred outside of formal clinical trials, it isn’t known for sure how common this was or if the ciclopirox was the cause (DailyMed, 2019).
Ciclopirox isn’t known to have drug interactions. However, it’s still a good idea to check with your dermatologist or provider before using any other scalp treatments while you’re using this shampoo.
It’s important to tell your provider if you’re pregnant before use. It also isn’t known for sure if the drug could affect breast milk. Be sure to store Loprox shampoo at room temperature, out of reach of children and pets.
Other treatments for dandruff
Other shampoos and scalp products are available with or without a prescription to help get rid of dandruff and relieve related itching. Examples include (Borda, 2015; Clark, 2015):
- Ketoconazole shampoo (Nizoral A-D)
- Selenium sulfide (Selsun, Exelderm)
- Zinc pyrithione (Head and Shoulders)
- Coal tar shampoo (Neutrogena T/Gel, DHS)
- Corticosteroids, such as hydrocortisone, clobetasol (Clobex), or fluocinolone (Capex)
Some people with mild dandruff may see improvement with the use of coconut oil to moisturize their hair and scalp (Saxena, 2021). Limited evidence suggests that tea tree oil or other essential oils may be beneficial (Jain, 2022).
Seborrheic dermatitis and dandruff can be stubborn, so it’s common to try different products before you get some relief. Some providers recommend using different products in a rotation to better manage the symptoms. To help keep flakes at bay, common advice is to continue using a scalp treatment or shampoo intermittently over the long term (Tucker, 2022).
If you have any medical questions or concerns, please talk to your healthcare provider. The articles on Health Guide are underpinned by peer-reviewed research and information drawn from medical societies and governmental agencies. However, they are not a substitute for professional medical advice, diagnosis, or treatment.
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Dr. Chimene Richa is a board-certified Ophthalmologist and Senior Medical Writer/Reviewer at Ro.