The 10 Best Zinc Pyrithione Shampoos

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Zinc Pyrithione is probably the most widely used active ingredient to treat dandruff caused by Seborrheic Dermatitis on the market today.

There are hundreds of brands out there that contain the ingredient.  Everything from Head and Shoulders to generic dollar store dandruff shampoos.

But is it the best?

Before we look at the 10 best zinc pyrithione shampoos we’ve reviewed, we’ll look at what zinc pyrithione is, assess how effective it is and outline the risks.  Letting you decide if it’s the ingredient for you.

In this article

What Is Zinc Pyrithione?

Zinc Pyrithione is an antimicrobial added to shampoos to treat dandruff and seborrhoeic dermatitis. The molecule is a pyrithione complex of zinc, and so is also commonly (but confusingly) referred to as ‘pyrithione zinc’. Shampoos containing zinc pyrithione can be typically be bought without a prescription.

In Europe, zinc pyrithione is regulated as a preservative and not a medication. This means that the ingredient is subject to different regulations to other active ingredients found in shampoos (e.g. ketoconazole) – and importantly, the manufacturer decides the dosing schedule. The shampoos are typically left for 5-10 minutes before rinsing, and applied every 2 to 3 days [1]. This can vary by brand, and depends on any other ingredients in the shampoo.

How does Zinc Pyrithione work?

Zinc Pyrithione is relatively unique in that it has been shown to be effective against many species of fungus and bacteria. The ingredient was first identified in the 1930s, but the exact mechanism for its antimicrobial activity was a mystery until 2011 [2]. Researchers working for Procter & Gamble were able to show that zinc pyrithione targets critical iron-sulphur proteins, which causes copper toxicity leading to cell death. A better understanding of this mechanism will be useful in finding new treatments for dermatological conditions.

How Effective Is Zinc Pyrithione?

Zinc pyrithione has a role in certain scalp conditions because it’s effective against Malassezia yeasts – important in the treatment of seborrheic dermatitis [3]. There is relatively little robust evidence for the use of the shampoos, but they have been available for a long time and are generally well tolerated, and so retained as a second-line therapy.

1. Seborrheic Dermatitis

Despite not being a prescription medication in the UK, the National Institute for Health and Care Excellence (NICE) recommend zinc pyrithione as a second-line treatment in seborrheic dermatitis if ketoconazole or selenium sulfide are not effective or tolerated [4]. This recommendation is backed by the British Association of Dermatologists, and based on several key clinical trials [5].

In 2002 an open-label, randomized, 10 week clinical trial of 343 participants evaluated the effects of 1% zinc pyrithione shampoo against 2% ketoconazole and placebo for seborrheic dermatitis [6]. The study found that both shampoos were effective, with ketoconazole significantly superior – 73% to 67% improvement. This was followed by a study of 83 people published in 2010 which showed that zinc pyrithione resulted in less dandruff reduction after four weeks than topical betamethasone or tacrolimus [7].

The lack of high-quality studies looking into the use of zinc pyrithione shampoos for seborrheic dermatitis prevents it from being used as a routine first-line treatment. In studies that have been performed, zinc pyrithione has generally resulted in a statistically significant improvement in symptoms, but to a lesser extent than conventional first-line therapies (e.g. ketoconazole).

2. Scalp Psoriasis

Zinc Pyrithione does not have a formal role in treatment scalp psoriasis, but in 2011 a study found that applying a 0.25% cream twice daily effectively reduced ‘Psoriasis Area Severity Index’ (PASI) scores – used to monitor the severity of symptoms [8]. Corticosteroids are a more conventional therapy for plaque psoriasis, but zinc pyrithione might have a role in retaining disease control during steroid-free periods.

What Are The Risks With Using It?

In 2014 the EU Scientific Committee on Consumer Safety published a 98-page safety report on zinc pyrithione, in response to increased use in anti-dandruff shampoos [1]. The committee concluded that an increase in maximum concentration from 1% to 2% in rinse-off cosmetics (e.g. shampoos) was unlikely to result in harm, due to a range of factors:

  • Shampoos with 1% concentrations were not noted to cause more adverse reactions than those without the ingredient
  • 2% shampoos are used in the US without significantly more adverse reactions
  • The ingredient is a ‘mild irritant’ and so should only be used in rinse-off products
  • Zinc Pyrithione has been shown not be sensitizing to the skin

The comprehensive safety report reviewed all of the available animal and human data and decided that post-marketing surveillance was required after permitting the increase in concentration. This requires cosmetics companies to keep track of all adverse reactions thought to be caused by zinc pyrithione.

It should also be noted that zinc pyrithione is highly toxic if ingested. Studies in animals have shown that doses of 0.05g/kg were sufficient to cause vomiting, with 2.5g/kg leading to death (although for an average adult this would equate to ingesting over 7kg of a 2% shampoo). On the risk of toxicity, the 2014 EU safety report concluded:

‘…it is unlikely that a human accidentally ingesting shampoo could retain a hazardous amount’

The Best Zinc Pyrithione Dandruff Shampoos

Out of the many hundreds of zinc pyrithione shampoos available, there are some utter dross, some absolute gems and everything in between.

Below is a list of the 10 gentlest, most effective, gently formulated zinc pyrithione shampoos we’ve yet reviewed.

Dead Sea Spa MAGIK Mineral Shampoo

Designed to treat Seborrheic Dermatitis, Dry Scalp and Psoriasis

Dead Sea Spa MAGIK Mineral Shampoo is a combination shampoo containing both salicylic acid and zinc pyrithione.  The thinking behind this shampoo is that the salicylic acid will soften and exfoliate existing build up and the zinc pyrithione will help prevent new build up from forming.

I’m generally a big fan of combination shampoos and this is no exception.  The shampoo feels great, has a nice light smell and leaves the hair feeling extremely soft.  It only contains one known contact allergen too - cocamidopropyl betaine.

If you suffer from mild seb derm I can’t recommend this highly enough.

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Pura Dor Argan Oil Scalp & Dandruff Treatment

Designed to treat Seborrheic Dermatitis, Dry Scalp

Pura's D'or Argan Oil shampoo features an interesting formula that combines traditional therapy and herbalism.

It wears a premium price tag, but it is truly a premium product.

The active ingredient in Pura's product is the familiar zinc pyrithione. It also includes aloe vera and grapefruit seed extract, which have antifungal and antioxidant properties, and a number of fragrant essential oils.

Normally, shampoos containing argan oil send up a red flag for people with seborrheic dermatitis. The oleic acid content can exacerbate the condition. However, the amount present determines the sensitivity level, and a little should have no impact.

After using the shampoo, we found that it delivered a great performance without producing adverse reactions.

If you're sensitive to fragrance, cocamidopropyl betaine or phenooxyethanol, you may want to steer clear of this shampoo, but for many dandruff sufferers, it can achieve complete control of symptoms while providing a pleasant and surprisingly sudsy washing experience along with reliable treatment results.

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DHS Zinc Dandruff Shampoo

Designed to treat Seborrheic Dermatitis

DHS Zinc Dandruff Shampoo is yet another top class shampoo from DHS.

Yes there are two ingredients to watch out for; TEA Lauryl Sulfate and Perfume.

But other than the sulfate and the fragrance there are remarkably only another 5 ingredients in this shampoo (discounting the zinc pyrithione). And one of them is coloring!

I wish every manufacturer would subscribe to the more is less philosophy of shampoo formulation.

If you're looking for a shampoo to treat a mild case of seb derm, you can't go wrong with this one.

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Kiehl's Scalp Purifying Dandruff Shampoo

Designed to treat Seborrheic Dermatitis

Kiehl's Scalp Purifying Dandruff Shampoo is a combination shampoo, combining zinc pyrithione and salicylic acid in one excellent but gentle shampoo.

It's the first zinc pyrithione shampoo that has controlled my moderate to occasionally severe dandruff in years - the addition of salicylic acid definitely helps.

Be warned though, long term usage could dry your scalp.

There are one or two unpleasant ingredients in there but if you don't react to perfume or sulfates then this is definitely worth checking out.

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Bioderma Node DS Shampoo

Designed to treat Seborrheic Dermatitis and Psoriasis

Bioderma Nodé DS+ shampoo certainly packs an anti-dandruff punch. Its combination of anti-dandruff actives (Piroctone Olamine and Zinc Pyrithione), with keratolytic Salicylic Acid and anti-inflammatory Sodium Shale Oil Sulfonate are also complimented by several scalp soothing ingredients. A heck of an ingredients list only let down by the use of SLES and one or two other potential irritants.

This shampoo is definitely worth checking out.

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Alpecin Dandruff Killer Shampoo

Designed to treat Seborrheic Dermatitis

While most shampoos contain one or two active ingredients, this bad boy goes the whole hog and contains five; zinc pyrithione, benzalkonium chloride, fumaric acid, piroctone olamine and salicyclic acid.

The shampoo washes with a dense and luxurious foam and leaves the hair feeling soft and clean. There’s no need to use a conditioner as the company have added conditioning agents such as panthenol, allentoin and hydroxypropyl guar hydroxypropyltrimonium chloride.

It may sound like the perfect shampoo but unfortunanately they’ve added some harsh ingredients too including Fragrance, DMDM hydantoin, limonene, sodium laureth sulfate, sodium hydroxide and cocamidopropyl betaine.

If you don’t have a particularly sensitive scalp and suffer from moderate to severe dandruff this is definitely worth a look.

Just make sure you don’t have sensitive skin!

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Ducray Kelual DS Shampoo

Designed to treat Seborrheic Dermatitis

An unique and interesting combination of active ingredients; Zinc Pyrithione and Ciclopirox Olamine, make this a shampoo worthy of anyone's attention. The addition of a formaldehyde releaser, MI, fragrance and SLES dampened my enthusiasm somewhat.

Would I recommend it? With reservations. Removing one or two of the harsher ingredients and those reservations would be gone.

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Clynol Care Anti Dandruff Therapy Shampoo

Designed to treat Seborrheic Dermatitis

Clynol is worth a look if Head and Shoulders has worked for you.

It's gentler, and less likely to irritate

However, if Head and Shoulders didn't work for you, neither will this.

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Aveeno Nourish+ Dandruff Shampoo

Designed to treat Seborrheic Dermatitis

Aveeno have produced some great products for sensitive skin sufferers in the past. That's what makes the harsh contact allergens added to this uninspiring shampoo so hard to fathom.

Don't get me wrong, it's not a terrible shampoo. Just there are better alternatives out there.

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Rene Furterer Melaleuca Anti-Dandruff Shampoo

Designed to treat Seborrheic Dermatitis, Dry Scalp

This shampoo is an enigma. It contains some innovative essential and plant oils but also contains some pretty harsh allergens. The wash is fantastic, it doesn't dry your hair. It smells pleasant too. However, the active ingredient will only help those of you with the mildest forms of Seb Derm and the price is pretty extortionate too.

Picking a score from that is tough but the shampoo, in our opinion, really doesn't justify the price tag.

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We’re adding new reviews all the time, so if you don’t see your favorite shampoo listed here, check out all our Zinc Pyrithione reviews.

References

[1] European Commission: Scientific Committee on Consumer Safety. (2014). Opinion On: Zinc pyrithione. [Accessed: 6/3/17] www.ec.europa.eu

[2] Reeder, N. L., Xu, J., Youngquist, R. S., Schwartz, J. R., Rust, R. C., & Saunders, C. W. (2011). The antifungal mechanism of action of zinc pyrithione. British Journal of Dermatology, 165(s2), 9-12.

[3] Roques, C., Brousse, S., & Panizzutti, C. (2006). In vitro antifungal efficacy of ciclopirox olamine alone and associated with zinc pyrithione compared to ketoconazole against Malassezia globosa and Malassezia restricta reference strains. Mycopathologia, 162(6), 395-400.

[4] NICE CKS. (2013). Seborrhoeic Dermatitis. [Accessed: 6/3/17] www.cks.nice.org.uk

[5] British Association of Dermatologists. (2015). Seborrhoeic Dermatitis. [Accessed: 6/3/17] www.bad.org.uk

[6] Pierard-Franchimont, C., Goffin, V., Decroix, J., & Piérard, G. E. (2002). A multicenter randomized trial of ketoconazole 2% and zinc pyrithione 1% shampoos in severe dandruff and seborrheic dermatitis. Skin Pharmacology and Physiology, 15(6), 434-441.

[7] Shin, H., Kwon, O. S., Won, C. H., Kim, B. J., Lee, Y. W., Choe, Y. B., … & Eun, H. C. (2009). Clinical efficacies of topical agents for the treatment of seborrheic dermatitis of the scalp: a comparative study. The Journal of Dermatology, 36(3), 131-137.

[8] Sadeghian, G., Ziaei, H., & Nilforoushzadeh, M. A. (2011). Treatment of localized psoriasis with a topical formulation of zinc pyrithione. Acta Dermatoven APA, 20(4).

Comments 2

  1. Denis Poitras August 14, 2017
  2. Nakg September 16, 2017

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