Introduction: Scalp seborrheic dermatitis is a common, relapsing chronic inflammatory skin disorder with a substantial impact on quality of life, and medicated shampoos play an important role in its management. This study compared the efficacy and safety of a shampoo containing piroctone olamine plus salicylic acid versus a 1% selenium sulfide shampoo.
Methods: An open-label, randomized, controlled clinical trial was conducted at Ho Chi Minh City Hospital of Dermato-Venereology from July 2024 to March 2025 in 82 adults with scalp seborrheic dermatitis. Participants were randomly assigned to a shampoo containing piroctone olamine plus salicylic acid or a 1% selenium sulfide shampoo, three times weekly for 8 weeks. Because the products differed in colour and fragrance, blinding of participants and assessors was not feasible. Outcomes were assessed at baseline, week 4 and week 8 using the clinical severity score, the Adherent Scalp Flaking Score (ASFS), and patient- and physician-reported evaluations. Data were analysed using SPSS 22.0.
Results: The median age was 24 years and 54.9% were female. After 8 weeks, the combination shampoo showed better outcomes than 1% selenium sulfide in patient-reported dandruff improvement, itch reduction and hair cleanliness, and in physician-reported dandruff improvement, satisfaction and safety (p<0.05). Adverse events were uncommon in both groups (2 versus 3 cases) and did not differ significantly (p>0.05).
Conclusions: Over 8 weeks, the shampoo containing piroctone olamine combined with salicylic acid produced greater symptomatic improvement than 1% selenium sulfide and was well tolerated. Given the small sample size, short follow-up and open-label design, the safety findings should be interpreted with caution; larger multicentre studies incorporating scalp microbiome analysis are warranted.