Scalp Scale

Scalp scales can be a problem for individuals with ichthyosis. The skin on the scalp thickens and scales just like the skin on the rest of the body. Removing the scales without removing the hair around them can be a challenge.

The recommended way to treat scalp scales is to coat the scalp with your favorite lotion or oil to soften the scale, cover with a shower cap or plastic wrap and go to sleep; shampoo in the morning and brush or comb scales out after shampooing.

Some of our members have found other strategies and products that work for them. They include:

  • Nizoral Shampoo with 2% ketonazole. Available by prescription
  • T-Sal Extra Strength Shampoo, by Neutrogena
  • Healthy Scalp, by Neutrogena
  • P&S Liquid, available through your pharmacy
  • Biojoba Shampoo, by Joyco, available through beauty salons
  • NeoStrata Problem Dry Skin Cream, by NeoStrata, 888.437.9598. FIRST Members receive a direct purchase discount.
  • Mineral oil
  • Scalpicin, formulated with 1% hydrocortisone to relieve itching. Or 3% salicylic acid to stop itching and flaking
  • For children – wrap head in a bandana instead of a shower cap, or cover shower cap with a soft fleece hat that ties or velcros under the chin to keep it from sliding around.
  • Children and teens can put P&S Liquid on after school while they do their homework and then shampoo it out before bed, to save on shower time in the morning.
  • Use a fine-toothed comb to pull up scales. A dog’s flea and tick comb is very fine, or use one made to remove head lice nits.

** If the scalp is sensitive, or has some areas of open skin, some of these products will sting. Consult with your doctor before using any of these products on an infant or child.


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This information is provided as a service to patients and parents of patients who have ichthyosis.  It is not intended to supplement appropriate medical care, but instead to complement that care with guidance in practical issues facing patients and parents.  Neither FIRST, its Board of Directors, Medical & Scientific Advisory Board, Board of Medical Editors, nor Foundation staff and officials endorse any treatments or products reported here.  All issues pertaining to the care of patients with ichthyosis should be discussed with a dermatologist experienced in the treatment of their skin disorder.



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