Head & Shoulders is perhaps the most well-known brand of shampoos for the treatment of dandruff. But is the brand all that it’s cracked up to be?
In this post, I’ll introduce Head & Shoulders as well as discuss the condition that’s most often ‘treated’ by this product: dandruff. I’ll then dive into the product’s ingredients, and the controversies behind them.
I’ll then discuss how the product may contribute to hair loss, especially in individuals who are already susceptible. And finally, I’ll offer a few alternative recommendations for treating dandruff without Head & Shoulders.
Let’s dive right in!
An Overview of Head & Shoulders Shampoo
The Head & Shoulders brand has long been marketed as the solution to many maladies of the scalp and hair.
The many products carrying the Head & Shoulders brand have a variety of different ingredients, however many of them contain a few similar chemicals and other ingredients, like selenium sulfide which I investigate here.
There has been significant controversy over the effectiveness of Head & Shoulders products, and there have also been public accusations that Head & Shoulders products have caused hair loss and thinning hair for people.
When used in a limited capacity, Head & Shoulders products may have the potential to help address issues of hair loss related to dandruff and irritated scalp.
However, due to the potentially damaging side effects of the ingredients in many Head & Shoulders products, it may be better to address issues of dandruff through other means.
What is Dandruff?
An entire chapter in the book written by Dr. Thomas Dawson and his team is dedicated to the topic of dandruff and the more severe condition known as seborrheic dermatitis (See Fig. 1) (1). The most commonly recognized sign of these conditions is the presence of white-to-yellow, flaky skin particles seen on the scalp or on clothing (2).
The largest difference between dandruff and seborrheic dermatitis is the noticeable and visible irritation of the scalp associated with seborrheic dermatitis (3).
The commonly recognized sign of flakes is actually dead epidermal, or skin cells, which develop due to inflammation of the scalp. These significant alterations to the epidermal layer of the scalp are noticeable even in places that are not actively showing signs of dandruff.
This significant level of irritation to the scalp is commonly associated with the loss of hair and hair thinning due to the effects on the hair follicle (See Fig. 2).
Dandruff symptoms are also commonly associated with the presence of a bacterium species known as Malassezia, a microbial cause of dandruff (4). For this reason, many products such as Head & Shoulders take a multifaceted approach that includes antimicrobial agents as well as those ingredients that address epidermal irritation.
(Learn more about dandruff here.)
Ingredients of Head & Shoulders
While there are numerous ingredients, which vary depending on the exact product with the Head & Shoulders brand, there are two ingredients that are commonly identified as the most significant active ingredients.
These two ingredients are methylisothiazolinone and zinc pyrithione. These two ingredients are commonly identified as the most significant and active ingredients in Head & Shoulders products, and are also commonly the subjects of public discourse and scientific research.
Methylisothiazolinone is an active ingredient in a variety of household products typically advertised as having antimicrobial capabilities (5).
This potentially hazardous chemical can be found in many personal care products, hand soap, dish soap, and even products marketed towards children.
Methylisothiazolinone has been linked to issues of nerve damage (6). There remains limited research on the severity of any side effects related to methylisothiazolinone, and it continues to be utilized as an active ingredient in hundreds of household and personal care products (7).
The other significant active ingredient in many Head & Shoulders products is zinc pyrithione, which is also included in many other personal care products.
According to the National Institutes of Health, zinc pyrithione has properties that may help control skin dryness and scalp dandruff (8). There is also research to suggest zinc pyrithione may serve as an antimicrobial that provides the added benefit of skin hygiene (9).
As there is a correlation between bacterial levels and associated dandruff, the potentially antimicrobrial action of Head & Shoulders may help address that aspect of the condition (10).
These two active ingredients have been the subject of numerous studies and scientific research, with a wide range of conclusions and claims being made.
While individually, or in products that contain only one of them, they may provide beneficial solutions to issues of dandruff and related hair loss, together these ingredients have the potential to counteract any benefit and in fact may lead to negative side effects.
Sodium Laureth Sulfate (SLES) and Sodium Lauryl Sulfate (SLS)
Sodium Laureth Sulfate (SLES) and Sodium Lauryl Sulfate (SLS) are two common ingredients added to shampoos, body washes, and facial cleansers. They are surfactants which means they help the formulation to foam when used.
And, while these ingredients may be common in cosmetic products, that doesn’t necessarily mean they’re good.
SLS is commonly regarded as an irritant (11). It is known to cause contact dermatitis, which includes changes in skin color (erythema) and barrier function.
SLES, while it does produce a milder reaction, has also been shown to irritate the skin. In fact, the reaction was present for up to seven days after use (12).
If you already suffer from sensitivity, these ingredients may only worsen the problem.
How Head & Shoulders May Effect Hair Loss
The Head & Shoulders brand has not been marketed as a treatment for hair loss, but it has been advertised as the ideal solution for scalp dryness and dandruff (13).
There has been significant controversy over the effectiveness of Head & Shoulders products as a treatment for dandruff, and the products have even been identified as potentially causing harm and leading to further issues including hair loss.
While these accusations may have some foundation in truth, there is also research that suggests Head & Shoulders may effectively treat scalp dryness and issues of dandruff (14).
Dry, irritated skin, has long been associated with issues of hair loss and thinning hair. One of the active ingredients in many Head & Shoulders products is zinc pyrithione, which has been the subject of much research for its capacity to treat dandruff and potentially act as an antimicrobial.
In the British Journal of Dermatology, researchers published findings that compared differences in epidermal thickness and dandruff levels between groups of individuals who used a shampoo containing zinc pyrithione and individuals who washed with the same shampoo minus the addition of zinc pyrithione (15).
The results of the study showed that there was statistical significance in the reduction of dandruff in the group that washed with shampoo containing zinc pyrithione, as compared to the group that did not. Participants were instructed to shampoo twice a week, and statistically significant results were evident after only three washes.
A more recent study identified the potential for zinc pyrithione to effect hair density (16).
The study found that individuals that utilized the shampoo containing zinc pyrithione showed significant net increases in hair density and total visible hair counts when compared to the groups that were treated with the placebo shampoo.
The hair count results showed a mediocre and sustained improvement in hair growth for individuals that used zinc pyrithione on a daily basis. Unfortunately, it is not recommended that any Head & Shoulders products be used on a daily basis which may reduce the effectiveness of the zinc pyrithione to increase hair density and maintain sustainable hair growth.
While the results of these studies are promising, the potential effectiveness of Head & Shoulders to help address underlying causes of hair loss only suggests that the brand can help individuals suffering from a specific type of hair loss.
Beyond people who experience hair loss and thinning hair due to various skin conditions of the scalp, Head & Shoulders does not offer a blanket treatment for issues of hair loss. Furthermore, questions remain about the potentially damaging effects of other ingredients commonly found in the brand’s products.
Recommendations If You Have Dandruff
Although Head & Shoulders has been used for many years in the treatment of scalp dandruff, there are other options available that may not have the same potential for harmful effects and increased hair loss.
In severe cases, a prescription-strength product may be necessary to effectively treat numerous scalp conditions that involve scaling. These may help to prevent hair loss related to dandruff or scalp psoriasis.
An article published by the National Institutes of Health criticizes the exploitation of dandruff and scalp dryness by the many commercially available products claiming to address these issues (17). Dandruff is in fact a normally occurring human condition, and typically only requires low level interventions, as long as it has not progressed beyond minor scalp flakes and is not actually seborrheic dermatitis.
The Mayo Clinic also suggests the use of all natural tea tree oil as an additive to shampoo which can help reduce dandruff caused by fungal infections (18). They also recommend taking steps to reduce your daily amount of stress, as stress can be an underlying cause of dandruff as well as hair loss (19, 20).
When to See a Doctor
While dandruff is often a condition that can be treated at home, there may come a point where a professional opinion is needed.
If dandruff is interfering with your daily life, or if you’re experiencing negative side effects as a result of the condition, it may be time to speak with your doctor.
Uncontrollable itching, painful sores, and hair loss are signs of a more serious problem.
And if you’re suffering from red-yellow plaques coated by thick, greasy scales, then it’s more likely that seborrheic dermatitis is the issue.
If you have a compromised immune system, you’ll likely have difficulty combating the issue on your own; and failure to treat it properly at the outset may just lead to further issues down the road (24).
Foods Recommended to Address Dandruff Related Hair Loss
If a nutritional approach is of interest to you, then these foods are the ones that may help to bring your scalp back into balance:
- Chia Seeds
Of course, diet alone is unlikely to treat the underlying cause of your condition. However, it’s a good place to start, especially if you suffer from a minor case.
Although there is no hard evidence that Head and Shoulders shampoo causes hair loss, the combination of side effects as triggered by the brand’s various harsh ingredients may not be best for those with susceptibility.
Fortunately, there are other steps you can take if you’re struggling with dandruff.
These include working with a doctor to find a permanent solution, or even altering your diet to support a healthier scalp.