Encyclopedia · anti dandruff
Ciclopirox
An antifungal shampoo ingredient with randomized-trial support for scalp seborrheic dermatitis and a particular edge on itch, with no good evidence that it grows hair.
What it is
Ciclopirox olamine is a broad-spectrum hydroxypyridone antifungal with anti-inflammatory properties. It is available as a 1% shampoo and as creams. Whether it needs a prescription depends on the country and the strength, so check locally.
How it works
It binds iron and other metal ions that fungal enzymes need, and it is active against Malassezia in the lab and in people (Gupta 2006).
What the studies show
- In a randomized, vehicle-controlled 4-week trial in scalp seborrheic dermatitis, the 1% shampoo gave the best effect: the sum score fell from 8.3 to 4.4 (p = 0.037 versus vehicle). Efficacy rose with concentration and the shampoo was well tolerated (Altmeyer 2004).
- In 154 people washing three times a week for 4 weeks, ciclopirox 1.5% plus salicylic acid 3% and ketoconazole 2% both helped. Only the ciclopirox combination significantly cut itch (Squire 2002).
- A review concluded that varying concentrations and frequencies were safe and effective in scalp seborrheic dermatitis (Gupta 2006).
Our search for ciclopirox with hair growth or alopecia returned only fungal-infection papers, so the idea that ciclopirox grows hair has no human outcome data.
How it's used in studies
Trials used 1-1.5% shampoo two to three times a week for four weeks.
Side effects and safety
Mild irritation or burning was the main reported effect, and trials report good tolerability.
Bottom line
A good second-line choice when ketoconazole or zinc pyrithione do not clear the itch, where it is available. Hair-growth marketing is unsupported, and direct comparisons with selenium sulfide or piroctone olamine are lacking. Discuss with a doctor.
Studies 3
Altmeyer P et al. Efficacy of different concentrations of ciclopirox shampoo for the treatment of seborrheic dermatitis of the scalp: results of a randomized, double-blind, vehicle-controlled trial. 2004
Tested: ciclopirox shampoo at several concentrations versus vehicle
Result: The 1% shampoo gave the best effect: sum score fell from 8.3 to 4.4 (p = 0.037 versus vehicle); efficacy rose with concentration and tolerance was good.
Read the study ↗Squire RA, Goode K. A randomised, single-blind, single-centre clinical trial to evaluate comparative clinical efficacy of shampoos containing ciclopirox olamine (1.5%) and salicylic acid (3%), or ketoconazole (2%, Nizoral) for the treatment of dandruff/seborrhoeic dermatitis. J Dermatolog Treat. 2002
Tested: ciclopirox 1.5% plus salicylic acid 3% shampoo versus ketoconazole 2% shampoo
Result: Both improved dandruff and seborrheic dermatitis; only the ciclopirox combination significantly reduced itch.
Read the study ↗Gupta AK et al. Ciclopirox 1% shampoo for the treatment of seborrheic dermatitis. 2006
Result: Ciclopirox shampoo at varying concentrations and frequencies was safe and effective in scalp seborrheic dermatitis; it is active against Malassezia.
Read the study ↗Related
- KetoconazoleAn antifungal shampoo ingredient that is among the best-proven treatments for dandruff and, with much weaker evidence, a possible add-on for pattern hair loss.
- Piroctone olamineA gentle anti-dandruff ingredient common in European shampoos, with trial results roughly equal to zinc pyrithione but mostly from manufacturers.
- Zinc pyrithioneThe most widely used anti-dandruff shampoo ingredient, proven in large trials to cut flaking, though most of those trials were run by the companies that sell it.
- Seborrheic dermatitisSeborrheic dermatitis is dandruff with redness and inflammation, and it is controlled rather than cured with antifungal shampoos and, for flares, short-term anti-inflammatory treatment.
- DandruffDandruff is a common, chronic flaking of the scalp driven by yeast, skin oil and your skin's sensitivity, and an antifungal shampoo controls it well as long as you keep using it.