T/Sal shampoo by Neutrogena contains salicylic acid and is an effective treatment for controlling dandruff as well as seborrheic dermatitis. Salicylic acid topical products are classified "keratolytics". Keratolytics have many different effects on our skin including:

  • Hydration of the stratum corneum (outer skin layer)
  • Facilitates skin peeling of excess keratin
  • Relief of itching
  • Reduction of redness and inflammation


Recent news has suggested that T/Sal may be discontinued and at the very least, has been in extremely short supply making it difficult to find. Fortunately, there are many effective alternatives to T/Sal. These include:

  • Generic versions of T/Sal (i.e. Salicylic acid shampoos)
  • Coal Tar shampoos
  • Ketoconazole Shampoos
  • Traditional anti-dandruff shampoos (e.g. Head & Shoulders, Selsun Blue)


T/Sal Alternatives

Generic Salicylic acid products

If you have used salicylic acid products in the past with good effects, it makes sense to stick with those products. Although brand name T/Sal may no longer be available, there are a multitude of generic versions that contain the exact same active ingredient (salicylic acid). Most drugs stores have their own "store" brand. Below, are a few links to a few "generic" salicylic acid shampoo products:


The above products should provide similar results to the brand name Neutrogena T/Sal as they all contain 2% salicylic acid.


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 keratolytics. Technically, coal tar shampoos inhibit 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. 


For some, coal tar is a more effective option for controlling dandruff. Unfortunately, they are 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 ovaleleading 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 tp 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.


Summary

If T/Sal is no longer available to you, there are many alternatives that should provide similar relief of excess dandruff and seborrheic dermatitis. These include:

  • T/Sal generics
  • Coal tar
  • Ketoconazole
  • Head & Shoulders/Selsun Blue


If salicylic acid shampoo have 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 may be effective for your situation.