Alternatives to T/Sal Shampoo

T/Sal shampoo, by Neutrogena, contains salicylic acid 3% and is an effective treatment for controlling dandruff, as well as seborrheic dermatitis.

Recently, there has been news that T/Sal may be discontinued, or at the very least, will be in extremely short supply for the foreseeable future, making it difficult to find.

Fortunately, there are many effective alternatives to T/Sal if you can't find it online or at your local store.

How Does T/Sal Shampoo Work?

Salicylic acid topical products, like T/Sal, are therapeutically classified as 'keratolytics'.

Keratolytics have a variety of effects on the skin, including:

All of the above help with the symptoms you stated you are experiencing in your question (e.g., flaky and itchy skin on the scalp). Over time, with continued use, it generally helps reduce flaking, which you mentioned is your primary concern.

T/Sal Alternatives

As mentioned, T/Sal has been somewhat challenging to find on the market.

If you have used salicylic acid products in the past with good effects, it makes sense to try and find a similar product.

The good news is that although the brand name T/Sal may no longer be available, there is a multitude of generic versions that contain the exact same active ingredient (salicylic acid 3%). Most drugs stores have their own "store" brand. Below, are a few links to some "generic" salicylic acid shampoo products:

• Walgreens T+ Plus Shampoo
• Denorex Extra Strength Dandruff Shampoo and Conditioner

The above products should provide similar results to the brand name Neutrogena T/Sal as they all contain 3% salicylic acid.

Now, shampoos that contain salicylic acid aren't your only option. Several other therapeutic shampoos you may find helpful include:

• Coal Tar shampoo
• Ketoconazole Shampoo
• Traditional anti-dandruff shampoos (e.g. Head & Shoulders, Selsun Blue)

Coal Tar Shampoo

Coal tar shampoos, which include Neutrogena T/Gel and Zetar, work in a similar way as salicylic acid shampoos in that they are keratolytic.

In addition to softening scaly skin, coal tar shampoos also inhibit the excessive production of epidermal cells, reducing their size and overall numbers.

While perhaps not as hydrating as salicylic acid products, coal tar generally works exceptionally well in preventing excess flaking of the skin (it does more than just reduce itching, something you stated you were concerned about).

For some, coal tar is a more effective option for controlling dandruff. Unfortunately, it is associated with an unpleasant odor and can stain clothing and less commonly, skin. Nevertheless, if you are unable to find or are not getting good effects from salicylic acid products, coal tar shampoos may be a good alternative.

Ketoconazole Shampoo

Ketoconazole is a topical anti-fungal. While many people associate dandruff and flaking skin simply to dry skin, yeast, and fungus are actually very commonly the culprits. Specifically, overgrowth of a common yeast, Pityrosporum ovale, causes itching of the scalp and flaking.

Ketoconazole shampoos are available in a variety of generic products as well as the brand-name product Nizoral. 

Antifungal shampoos such as Nizoral control the overgrowth Pityrosporum ovale, leading to less dandruff and relief of itch. These shampoos have the advantage of not needing to be applied often. Ketoconazole binds to hair in-between uses and generally only needs to be used 2 to 3 times a week.

Traditional Anti-Dandruff Shampoos

Traditional anti-dandruff shampoos include:

• Head & Shoulders (Pyrithione zinc)
• Selsun Blue (Selenium sulfide)

These are classified as cytostatic agents and work in a similar way to the other products mentioned in this article, working by regulating cell growth and preventing excess flaking of the skin. While they can be mildly irritating to the skin, they are generally considered gentle options and are can be used daily.

Final Words

If the salicylic acid shampoo has worked well for you before, be sure to look at local pharmacies for a generic product. If those aren't available, one of the other options I discussed may be effective for your situation.