Best dandruff shampoos for kids

Dandruff, while not typically medically harmful, can be a source of embarrassment for kids and teens, and over-the-counter dandruff shampoos are inexpensive but can be a big help. Keep in mind that you might need to try a few options before finding a shampoo that works for your kid's scalp, since different shampoos are made with different active ingredients, says the Mayo Clinic. You may get the best results by switching between two shampoos too. 

In some instances it may be worth getting help from your child's pediatrician. "If there is severe associated itch, swelling, or open sores it's best to see a physician," Dr. Craiglow says. You should also contact your child's doctor if over-the-counter dandruff shampoos haven't solved the problem within a couple of months.

Toddlers and babies with cradle cap (an infant form of dandruff that can also cause redness or scaliness around the neck, armpits, or ears) don't need dandruff shampoo. Frequent washing with a mild baby shampoo plus soft brushing is usually enough to remove the flakes and scales, according to the American Academy of Pediatrics. 

If you opt to use a medicated shampoo, you should avoid products containing salicylic acid. "For cradle cap, it's best to stick with shampoos containing zinc pyrithione and/or selenium sulfide," Dr. Craiglow recommends.

Dandruff shampoos can get their flake-fighting power from a few different active ingredients. All can be effective, though some may work better on certain scalps than others, and it's not uncommon to need to try a few different options before finding a good fit. 

"I usually recommend patients alternate zinc/sulfur shampoos with salicylic acid shampoos for a better outcome if they are over 2 years of age," says Dr. Lal. 

Commonly used active ingredients include:

• Pyrithione zinc: An antibacterial and antifungal agent.
• Salicylic acid: Can help slough off flake-causing scales.  
• Selenium sulfide: An antifungal agent. Selenium sulfide has the potential to discolor the hair or scalp, so should be rinsed thoroughly after use. 
• Ketoconazole: Another type of antifungal agent. 
• Coal tar: Slows the rate at which flake-causing scales form on the scalp. It can also discolor hair and make the scalp more sensitive to sunlight. 
• Fluocinolone: A corticosteroid that helps control itching and irritation. 

Most over-the-counter dandruff shampoos are considered safe to use in adolescents and children over 2, say Dr. Lal and Dr. Craiglow. But you should avoid shampoos made with salicylic acid for babies and toddlers under 2. 

"There is a small risk for salicylic acid to be absorbed in the skin and cause toxicity," Dr. Craiglow says.

Steer clear of using shampoos with coal tar on kids as well, recommends the American Academy of Dermatology. It hasn't been studied extensively in children, plus it can make the scalp more sensitive if exposed to sunlight. 

Once flakes enter into the equation, plan for dandruff shampoo to become a part of your child's bath or shower routine for a while. 

"Seborrheic dermatitis is a chronic condition, so routine use of anti-dandruff shampoos is usually necessary," Dr. Craiglow says. "Most people will do well using a shampoo two to three times weekly." 

Alternating shampoos with different active ingredients often yields the best results. "For instance, a salicylic acid shampoo can help reduce the scaling while one with zinc pyrithione or selenium sulfide will target the yeast that is causing the dandruff," says Dr. Craiglow.

Read the instructions carefully before washing your child's hair, or go over them together if your child is old enough to suds up on her own. Some dandruff shampoos need to be left on the scalp for a certain length of time before rinsing, for instance, while others should be rinsed immediately. 

Finally, pay attention to what kind of progress is being made. You should let your child's pediatrician know if your child's scalp isn't improving or gets worse after several weeks of using a dandruff shampoo. In that case, a prescription-strength shampoo or steroid lotion might be needed.

There's no need to supervise bath or shower sessions if your child typically washes her own hair. But you should read over the directions together to make sure she understands how to use the shampoo. 

"It's important that these shampoos be thought of as scalp treatments, so kids should be instructed on appropriate use," Dr. Craiglow says. 

Over-the-counter dandruff shampoos are generally safe for teens and kids aged 2 and up, and they can help kids feel less self-conscious. "Dandruff can cause a lot of anxiety for kids and is a common cause of bullying according to some of my patients," Dr. Lal says.

It's normal to need to use medicated shampoos on a regular basis to keep the flakes under control, since dandruff tends to be a chronic problem. But if a product isn't helping your child's dandruff after a few weeks, or her scalp is very itchy, irritated, or has open sores, stop using the shampoo and contact the pediatrician. Together you can discuss other options for managing your child's dandruff.