Detailed information on medicated shampoos and special hair care products

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Medicated Shampoos
Medicated shampoos are the best hair care products for dandruff treatment, a major hair problem that affects a large number of people. Even though it is a major hair problem, very little is known about the mechanism of dandruff, its immediate biochemical changes and how it is manifested on the scalp.

Dandruff (Pityriasis capitis) in general means the excessive flaking of dead skin on the scalp. This flaking is thought to be triggered either by seborrheic dermatitis or fungal infections or by both. The dandruff formation is also associated with significant reduction in ceramides, fatty acids, cholesterol and lipid levels in the skin.

Dandruff is not contagious and it is not serious, but it can cause significant itching on the scalp which can be quite embarrassing. Use of medicated shampoos are able to prevent dandruff formation and save you from embarrassment.

Other than dandruff prevention, these useful hair care products with various formulations perform several other functions. These special hair care products also help to remove the sebum efficiently, decrease scalp scale production, and also act as antibacterial and antifungal agents. These combined functions help to combat diseases like psoriasis and seborrheic dermatitis<#> as well as dandruff.

Seborrheic dermatitis is a disease that causes flaking of the skin which is a more severe form of dandruff formation.. Other than the scalp seborrheic dermatitis can occur in the other parts of the body like face, chest, creases of the arms, legs and groin. It involves more flaking of the skin and can be itchy and even painful as compared to dandruff.

Given below are some active ingredients of these special medicated hair care products
  • Ketoconazole
  • Zinc pyrithione
  • Selenium
  • Sulfur
  • Piroctone olamine
Mechanism of action

Most of these anti-fungal agents present in the medicated shampoos help to combat with dandruff or seborrheic dermatitis though their efficiency to fight the disease may vary. For example, zinc pyrithione may be helpful in preventing both dandruff and seborrheic dermatitis but selenium based shampoos are best to combat dandruff only.

The most effective agent of medicated shampoos

The most effective anti-fungal agent in medicated shampoos that can prevent dandruff and seborrheic dermatitis is ketoconazole. Other than dandruff, some medicated shampoos formulated with Ketoconazole agent may be a useful therapy for tinea capitis<#> (ringworm), which is another scalp infection caused by fungus.

Studies have proved that the ketoconazole agent is more effective than other drugs and compounds that are used as medication in dandruff prevention.

Zinc pyrithione is also useful but its effect in removing dandruff or seborrheic dermatitis becomes evident only when it is used on hair for a longer time period compared to ketoconazole.

Selenium also plays a major role in these hair care products and a dermatology review panel has confirmed the agent is useful in dandruff removal though the exact mechanism by which it works is yet to be found out.

The fourth important agent that is often blended with medicated shampoo is sulfur (or sulphur in Europe) which is considered to be quite safe for children. Sulfur prevents fungal spores from growing and this can help treat dandruff.

Medicated shampoos in Pediculosis (lice treatment)
Pediculosis, also called lice or nits, are very small bugs that attach to the hair fibers of the head and lay eggs. When the eggs hatch the young lice feed on the scalp skin before maturing into adult lice which then climb into the hair and lay more eggs. Lice can cause severe itching and scratching.

Lice are also fairly easy to transfer between people through head to head contact or by sharing brushes or combs. As such, it is important to treat lice infestations quickly to prevent them spreading to other people.

Previously, a number of medicated shampoos containing pesticides were available for treating lice infestations. Though these agents were effective in preventing the itching and scratching due to lice infestation and removing the lice, most of the agents are not used now in the formulation of the lice-control hair care products due to their adverse side-effects. The safer ingredients that are prevalent and used in medicated shampoos now are:
  • Permethrin
  • Pyrethrin
Studies have proved that Permethrin, an anti-fungal agent present in medicated hair care products is more effective in the treatment of lice than other drugs or agents like Lindane. Another big advantage of the hair care products containing permthirin is that these are devoid of any adverse side effects.

Pyrethrins, an extract from chrysanthemums, are a naturally occurring insecticide which is also an effective blend in medicated shampoos for the treatment of scabies and pediculosis. Scabies are very small bugs that crawl under your skin, lay eggs, and make you itch quite similar to lice.

The action of this anti-fungal agent, Pyrethrin, is enhanced when it is combined with piperonyl butoxide to treat scabies and pediculosis. But with the introduction of the synthetic pyrethroid permethrin, the use of pyrethrin formulated shampoo has become less common.

Prevention of psoriasis
Medicated shampoos that prevent Psoriasis are formulated with some important agents like crude coal tar, salicylic acid, sulfur and selenium. In Psoriasis there is a thick scale and redness around the scalp margins which causes severe itching and a feeling of tightness in the scalp. Some patients also report soreness in the scalp.

The best hair care products that treat psoriasis are tar-containing shampoos which are also frequently used for seborrheic dermatitis. The exact mechanism of coal tar’s action in the psoriasis-affected scalp is unknown, but it seems that it slows down the rate of cell growth and reduces inflammation.

Studies have suggested that medicated shampoos that include a combination of salicylic acid, sulfur and selenium agents are effective in the management of mild to moderate scalp psoriasis. More severe psoriasis can be treated only with prescription drugs that are available only from doctors.

Some modern trends in medicated shampoo formulation
Some of the anti-fungal agents like bifonazole and fluconazole may be more effective than the existing anti-dandruff shampoo agents. It is suggested that these useful agents are devoid of adverse side effects.

There are many medicated shampoos available on the market that include drugs which exhibit specific mechanisms of action and are able to control the underlying scalp complaint. The only thing you need to do is to identify the particular scalp problem and choose the right remedy either with the help of a dermatologist or by yourself after detailed research.

References:
Jerry Shapiro, Stuart Maddin, “Medicated Shampoos“, 1996, Clinics in Dermatology 14:123-128

Talal Aburjai, Feda M. Natsheh “Plants Used in Cosmetics”, 2003, Phytother. Res. 17, 987–1000
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