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Can you recommend an effective shampoo other than Nizoral which was ineffective in ending a twice occurring outbreak on my scalp?

by Linda
(Canada)

I’ve had an itchy scalp for years, even after washing my hair. In the last 1-2 yrs I’ve experienced a generalized itchiness across my face also. I’ve been fighting off what I think is a Malassezia outbreak on my scalp since the Spring and have used Nizoral and a prescription fluid Betaderm type of medication but it only subsided for a while and flared up again recently.

The second flare up spread to my ears. It can be scraped off with my nails but I’ve read that it makes it worse. The sticky flakes leave a mess of my hair and has caused some hair loss from scratching.

I also have an excessively sweaty scalp during activity and warmer months. Because of the excessive sweating on my scalp, even wearing a hat in winter can make my scalp somewhat sweaty, would I benefit from treatment to shut down some of the sweat glands on my scalp?

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Jan 03, 2026
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by: Dan

The best thing to do would be to have your doctor do a culture of the infected areas and send it to a lab. The lab can identify the species and test to see which prescription anti-fungals work the best; your doctor could then prescribe that medication or shampoo.

If you are not able to do that, then I would try propylene glycol, zinc pyrithione shampoo, ciclopirox, and selenium sulfide.

Natural treatment methods would include liquid grapefruit seed extract, oregano oil and possibly cinnamon oil. These can all be hot on the skin and are typically diluted with olive oil, but Malassezia does feed on fats excreted from the pores so either straight or with water would be best.

Diet wise, I would minimize my consumption of Omega 6 fats.

As far as disabling some sweat glands, it would be best to discus that with your doctor.

Any other questions let me know.

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