The Better Scalp Company Sensitive Scalp Treatment Sequencing Checklist

How do I add shampoos, actives, and prescriptions without triggering flares?

Medical disclaimer: This guide is for educational purposes only and is not medical advice. It does not replace diagnosis, treatment, or personalized recommendations from your own clinician. If you have worsening symptoms or red flags, seek in person care promptly.

Start here: a calm, evidence guided plan

Sensitive scalps get overwhelmed when too many variables change at once. We will build a clean baseline, add one change at a time, and watch the skin for clear signals. You will see where fragrance free basics fit, when to rotate medicated shampoos, when to trial leave on actives, and when to ask your dermatologist for prescriptions.

What should I stop and swap in week 0?

Clear the deck. Remove obvious irritants so your scalp can speak clearly. Choose products labeled fragrance free, not unscented. Unscented products can still contain masking fragrances that irritate sensitive skin.¹ ²

Make three swaps today.

1. Cleanser: Use a gentle, fragrance free shampoo for daily or every other day washing. The Better Scalp Company Sensitive Scalp Shampoo is formulated for this exact role. Pair with The Better Scalp Company Sensitive Scalp Conditioner on mid lengths and ends if you need slip.

2. Styling: Hold off on dry shampoo, hairspray, and high hold gels while you reset.

3. Water contact: Rinse with lukewarm water and limit scrubbing. Fingertip pads beat nails.

Why this order works. Scalp skin often improves with simple, fragrance free routines that avoid harsh surfactants and perfumes, which are common triggers.¹ ²

How do I set a safe baseline before treatments?

Give your baseline seven days. Wash with your fragrance free shampoo and avoid all medicated or leave on actives during this window. Keep a simple diary: itch, flake, burn, and visible redness scored 0 to 10 each evening. If the baseline alone resolves symptoms, you may not need medicated steps. If symptoms persist, move to week 1.

Daily micro checks help. Look for these quick cues after washing:
• Itch settles within 30 minutes.
• No burning at hairline or behind ears.
• Flakes reduce from sheet visible to collar only.

What is my likely pattern, and how does that guide step 1?

Name the pattern you see.

• Waxy flakes with itch that eases after shampooing suggests seborrheic dermatitis, sometimes called dandruff. Antifungal shampoos are first line and often enough on the scalp.³ ⁴

• Thick, sharply bordered plaques with silvery scale suggests psoriasis. Topical corticosteroids and vitamin D analogs are common first line therapies under medical guidance.⁵ ⁶

• Burning or stinging after products or hair dye suggests contact dermatitis. Patch testing identifies triggers like fragrance mixes or preservatives.⁷ ⁸

You do not need to self diagnose perfectly. These patterns simply steer the safest next experiment.

Week 1: how do I add a medicated shampoo without flaring?

Add one medicated shampoo on alternate days. Keep your fragrance free shampoo on non medicated days to protect the barrier. If dandruff signs are present, start with a ketoconazole shampoo two to three times weekly. Ketoconazole is an antifungal that reduces Malassezia yeast and inflammation and has good safety data in seborrheic dermatitis.³ ⁴

Use the medicated shampoo correctly.

1. Wet hair and scalp thoroughly.

2. Apply a small amount, then massage into the scalp, not the hair.

3. Leave on 3 to 5 minutes before rinsing to allow the active to work.

4. Condition lengths with The Better Scalp Company Sensitive Scalp Conditioner, keeping it off the scalp if you are very reactive.

Assess after two weeks. Many patients notice less scale and itch within 14 days with antifungal shampoos.³ ⁴ If improvement is partial, continue. If you worsen, stop and return to baseline.

Should I rotate shampoos or stick to one?

Use rotation only if needed. For chronic dandruff, rotating antifungal and keratolytic shampoos can help when a single product plateaus. Stick to one change every two weeks so you can read the scalp.³ ⁴

A simple rotation plan.
• Monday and Thursday: Ketoconazole shampoo.
• Other wash days: The Better Scalp Company Sensitive Scalp Shampoo.
If heavy scale persists, your clinician may add a short course of a topical steroid solution or foam for the scalp.⁵ ⁶

When is a leave on active safe to try?

Wait until shampoo changes are stable. Once your scalp is calmer for 14 days, you can trial a single leave on active, such as a calming serum. Perform a home usage test before full use: apply a pea sized amount behind one ear nightly for three nights, then pause two nights. If no reaction occurs, start every other night.

Special caution with hair regrowth actives. Minoxidil can irritate skin or rarely trigger allergic contact dermatitis, sometimes to the propylene glycol vehicle. Case reports exist even with foam formats.⁹ ¹⁰ Introduce minoxidil last, at low frequency, and patch test behind the ear first.

How should I use topical corticosteroids on the scalp safely?

Use the right potency for the right time. Scalp skin is thicker and often requires a medium to high potency steroid solution, foam, or lotion to calm inflammation. General safety guidance limits super high potency use to up to three weeks and high to medium potency to up to twelve weeks, with intermittent schedules for longer control.⁵ Work with your clinician to set the exact schedule.

Apply with precision.
• Part hair to expose plaques.
• Place a small amount on fingertip.
• Tap onto the patch, then spread thinly.
• Wash hands after application.
• Avoid eyes and face.

Taper, do not vanish. When plaques calm, taper by lowering frequency or switching to a milder agent to avoid rebound.⁶

Do I need patch testing, and what will it show?

Consider patch testing if burning persists or products sting. Patch testing places small amounts of common allergens on the back for 48 hours, then reads reactions over several days. The American Contact Dermatitis Society provides a core allergen series that helps clinicians evaluate suspected allergic contact dermatitis thoroughly.⁸

Fragrance allergy remains common in patch tested patients. Recent North American Contact Dermatitis Group data note that fragrance allergy is still frequent among those tested, although the pattern of specific fragrance markers is evolving.⁷ This is one reason we emphasize fragrance free basics, including The Better Scalp Company Sensitive Scalp Shampoo and Sensitive Scalp Conditioner.¹ ²

What are the red flags that mean I should see a dermatologist now?

Do not wait if you notice any of the following.

• Painful swelling, pus, honey colored crust, or fever.

• Sudden clumps of hair shedding or visible scarring.

• Thick plaques that crack and bleed, especially if covering large areas.

• Worsening after every new product despite a careful plan.

These signs point to infections, scarring alopecias, or inflammatory diseases that need prescription care and possibly lab tests.

How do I build a two week sequencing plan I can actually follow?

Use this simple calendar. You can copy it into your notes app.

Week 0: Reset
• Daily or every other day: The Better Scalp Company Sensitive Scalp Shampoo.
• Styling pause: no sprays, dyes, or dry shampoo.
• Evening: 30 second symptom log.

Week 1: Add one medicated shampoo
• Monday and Thursday: Ketoconazole shampoo, 3 to 5 minute contact.³ ⁴
• Other wash days: The Better Scalp Company Sensitive Scalp Shampoo.
• Evening: symptom log plus note of wash or non wash day.

Week 2: Adjust
• If better: continue.
• If partial: consider clinician guided steroid foam short course with clear end date and taper plan.⁵ ⁶
• If worse: return to baseline for seven days and discuss patch testing.⁸

How do I minimize risk with every new product?

Run the three step new product protocol.

1. Label check: Confirm fragrance free and look for short ingredient lists. Be cautious with unscented, which can still include masking fragrance.¹ ²

2. Use test: Behind ear, pea size, three nights in a row, then two nights off.

3. Launch low and slow: Start twice weekly on the scalp for the first two weeks. Increase only if symptom logs stay quiet.

Tip: Introduce new products on evenings before non wash mornings. If you react, you can rinse it away quickly.

Which at home habits protect a sensitive scalp?

Keep the barrier happy while you treat.

• Wash cadence: Match to oil level. Many sensitive scalps tolerate every other day washing with a gentle, fragrance free base and short contact time.¹

• Contact time control: Medicated shampoos need minutes on scalp. Basics should be rinsed promptly.³ ⁴

• Heat rules: Use the lowest heat that dries hair and keep tools moving.

• Brush choice: Soft, widely spaced bristles reduce micro tears.

• Sun sense: Wear a hat for long outdoor days. Sunburn worsens itch and delays healing.

How do I prepare for a dermatologist visit?

Bring data, not just products. Pack clear photos of flares, your two week symptom log, and a list of every product used in the last three months, including dyes and styling. Ask three questions:
• What is my working diagnosis today?
• What is the first line plan for that diagnosis?
• What are my steroid potency and taper rules for the scalp?⁵

Expect a stepped plan. For seborrheic dermatitis, that often means antifungal shampoo plus short steroid bursts for flares.³ ⁴ ⁵ For psoriasis, expect a topical steroid solution or foam, sometimes combined with a vitamin D analog, with a taper once plaques resolve.⁵ ⁶ For suspected allergy, expect a discussion of patch testing.⁸

Quick reference: safe sequencing flow

1. Reset to fragrance free basics for seven days. Use The Better Scalp Company Sensitive Scalp Shampoo and, if needed, Sensitive Scalp Conditioner.¹ ²

2. Add one medicated shampoo for two weeks if dandruff signs persist. Favor ketoconazole with proper contact time.³ ⁴

3. Layer prescriptions only when needed. Use topical corticosteroids with a defined potency, duration, and taper.⁵ ⁶

4. **Consider patch testing if stinging persists or dyes trigger flares.**⁷ ⁸

5. Introduce leave ons last, with a use test. Be extra cautious with minoxidil and its vehicles.⁹ ¹⁰

6. Escalate care for red flags. Seek a clinician promptly.

You are not expected to guess perfectly. You are expected to listen to your skin, change one thing at a time, and get help early. That is excellent care.

Glossary

• Fragrance free: A product made without fragrance chemicals or masking scents. Unscented can include masking fragrance.¹ ²
• Seborrheic dermatitis: An inflammatory scalp condition linked to Malassezia yeast, seen as greasy flakes and itch, often responsive to antifungal shampoos.³ ⁴
• Ketoconazole shampoo: An antifungal shampoo used two to three times weekly to reduce yeast and inflammation in dandruff.³ ⁴
• Topical corticosteroid: Anti inflammatory medication applied to skin. Potency and duration rules reduce side effects.⁵
• Vitamin D analog: Prescription topical that helps normalize skin cell growth in psoriasis, often combined with steroids.⁶
• Patch testing: Diagnostic method that identifies allergic contact dermatitis by applying standard allergens to the skin and observing reactions.⁸
• Propylene glycol: A solvent in some topical solutions. It can cause contact dermatitis in a minority of users.¹⁰
• Leave on active: Any product designed to stay on skin or scalp, such as minoxidil or calming serums.
• Contact time: Minutes a medicated shampoo remains on scalp before rinsing. Longer contact improves effect.³ ⁴
• Taper: Gradual reduction in dose or frequency to prevent rebound after improvement.⁵ ⁶

Claims Registry

Citation #	Claim(s) supported	Source title + authors + year + venue	Accessed date (America Toronto)	Anchor extract	Notes
1	Dermatologists recommend fragrance free over unscented for sensitive skin; unscented may contain masking fragrance	Dermatologists’ top tips for relieving dry skin. American Academy of Dermatology, 2024, AAD.org	2025 11 20	“Use products labeled ‘fragrance free’… If you see the word ‘unscented,’ the product can contain chemicals that… can irritate dry, sensitive skin.”	Authoritative patient guidance from AAD
2	FDA explains that even products labeled unscented may contain fragrance to mask odor	Fragrances in Cosmetics. U.S. FDA, 2022, FDA.gov	2025 11 20	“Even some products labeled ‘unscented’ may contain fragrance ingredients… to mask the unpleasant smell…”	U.S. regulatory agency guidance
3	Dandruff and scalp seborrheic dermatitis often respond to dandruff shampoos alone	Seborrheic dermatitis: Diagnosis and treatment. AAD, 2024, AAD.org	2025 11 20	“A dandruff shampoo can treat mild to moderate seborrheic dermatitis on your scalp.”	Current AAD patient guidance
4	Ketoconazole shampoo improves irritation and scaling in seborrheic dermatitis with good safety	Ketoconazole Shampoo for Seborrheic Dermatitis of the Scalp. Tynes BE et al., 2024, Dermatology and Therapy (PMC)	2025 11 20	“Numerous trials display significant improvement… with ketoconazole shampoo… low relapse rates… little to no side effects.”	Peer reviewed review, open access
5	General safety limits for topical corticosteroid potency and duration; intermittent strategies	Topical Corticosteroids: Choice and Application. Stacey SK et al., 2021, American Family Physician	2025 11 20	“Super high potency… no more than three weeks… High and medium potency… no more than 12 weeks…”	Widely cited clinical review
6	Corticosteroids are common first line therapy for psoriasis in many strengths	Psoriasis: Diagnosis and treatment. AAD, 2024, AAD.org	2025 11 20	“A corticosteroid works quickly and is available in many strengths… treating all types of psoriasis.”	AAD patient guidance
7	Fragrance allergy remains common among patch tested patients in North America	North American Contact Dermatitis Group Patch Test Results. Houle MC et al., 2024, PubMed record	2025 11 20	“Fragrance allergy is still very common…”	Multicenter patch test surveillance
8	ACDS core allergen series supports comprehensive patch testing for suspected allergic contact dermatitis	American Contact Dermatitis Society Core Allergen Series: 2020 Update. Schalock PC et al., 2020, ACDS PDF	2025 11 20	“Recommend useful and appropriate patch testing series to allow complete evaluation of our suspected ACD patients.”	Professional society guidance
9	Allergic contact dermatitis can occur with topical minoxidil products	A Case of Contact Allergic Dermatitis to Topical Minoxidil. BinJadeed H et al., 2021, Case report, Cureus (PMC)	2025 11 20	“A 27 year old woman… allergic contact dermatitis to minoxidil 5 percent foam.”	Peer reviewed case report
10	Reactions may involve the vehicle, such as propylene glycol, in minoxidil products	Contact Dermatitis Caused by Topical Minoxidil: Allergy or Vehicle? Junge A et al., 2025, Acta Dermato Venereologica	2025 11 20	“Cases of systemic contact dermatitis have been reported to propylene glycol… not to minoxidil.”	Recent peer reviewed review