Smelly Scalp: Which Shampoos Help and When to See a Dermatologist

Noticing an odor from your scalp or a stale smell on your pillowcase can be embarrassing, especially if you wash your hair regularly. Cleveland Clinic¹ calls it smelly scalp, and it’s usually treatable at home. Here is what causes it and how to choose a shampoo.

What causes it

The most common cause is a buildup of skin cells, sweat and the scalp’s natural oils. Bacteria, fungus or too much yeast can add to the smell.¹

Medical causes include dandruff (seborrheic dermatitis), fungal infections, psoriasis, heavy sweating and hormonal changes. Everyday causes include leftover product, including dry shampoo, not washing often enough, sweat and particles from the air.¹

Match the shampoo to the problem

Product buildup: Cleveland Clinic¹ suggests a clarifying shampoo made to remove buildup, and taking a break from styling products so your scalp can recover. It mentions ingredients such as apple cider vinegar or tea tree oil.¹ Our article on dry shampoo mistakes covers one common source.

Flaking, redness or greasy scale: These point to seborrheic dermatitis. The AAD suggests cleansers with pyrithione zinc or a 1% ketoconazole shampoo, or a product your dermatologist recommends.² Tar shampoos can work too, but they can discolor hair.²

Sweat-related odor: If heavy sweating is part of the picture, a dermatologist can discuss treatments.¹ See our guide to hyperhidrosis.

Habits that help

• Find your washing rhythm. Cleveland Clinic¹ suggests looking for a balance, washing often enough to clear oil without stripping the scalp.¹
• Choose fragrance-free and alcohol-free products if your scalp flakes or itches. The AAD notes alcohol in hair products can trigger seborrheic dermatitis flares.²
• Change pillowcases often and wash brushes and combs.
• Watch for patterns with stress and cold, dry weather, which can trigger flares.²

Cleveland Clinic¹ advises against drastic home treatments and suggests talking with a provider instead.¹

When to see a dermatologist

Contact your clinician if home care doesn’t help, or if you have other symptoms such as patches of scale, sores, hair loss or intense itching.¹ Treatment depends on the cause and may include prescription shampoos, antifungal creams or other medicines.¹ Our guide to an itchy, flaky scalp covers related causes.

Try: “My scalp smells even though I wash my hair every other day, and it’s a little flaky. Could this be seborrheic dermatitis, and which shampoo should I try?”

Arms Up includes a Fresh Log and a zone-by-zone match. Use them to track scalp products, washing days and odor changes so you can see what helps. See the book.