Drug dependence is a disorder in which stopping a drug results in unpleasant symptoms, which makes people return to using the drug. For example, many people get unpleasant itching or “brain-zap” sensations when they go off certain antidepressants. Another type of withdrawal symptom is the rebound effect, in which the symptoms that a medication was taken to control return and become even worse when the medication is stopped. Decongestants like xylometazoline are a common example of rebound-causing medication: you take them to relieve a stuffed-up nose, but if you take them for too long and then stop, then your nose gets stuffed up even worse for a while.
I’m wondering whether Head & Shoulders shampoo also falls into this category. I ask because I’ve noticed this effect in my own use of the product. I don’t usually have dandruff, but when I do, I can get it to clear up by using Head & Shoulders for a week. But then, after switching back to my regular shampoo for a few days, my scalp starts to itch uncontrollably, and there’s nothing I can do to relieve it except to wait it out for several more days or use Head & Shoulders again.
I haven’t noticed this problem with other types of anti-dandruff shampoos, such as ones based on the antifungal medication ketoconazole (Nizoral). Those also clear up my dandruff, but I don’t get any itching when I stop using them.
I’ve spoken to one other person who claims to suffer from the same problem with Head & Shoulders, but that’s just one further lonely data point. Has medical science recognized the active ingredients in Head & Shoulders as causing dependence, or as having some sort of a rebound effect?
I use Head and Shoulders Clinical Strength for seborrhea. It works well for me and is fairly inexpensive. I just looked for reports of rebound sx when discontinuing similar products. I didn’t see anything beyond anecdotes. I personally haven’t noted this despite using head and shoulders for over twenty years.
Not sure. Then again I have used a combination of anti-dandruff shampoos (salicylic acid + coal tar) exclusively for over a decade now with no apparent ill effects (I have psoriasis). If I’m “dependent” on it, I’m okay with that.
I’m no expert on the subject, but I think the OP is misusing the term drug dependence in order to describe situations in which taking a medication builds up tolerance and may produce unpleasant symptoms when it is stopped, especially suddenly.
ICD-10 Diagnostic guidelines
A definite diagnosis of dependence should usually be made only if three or more of the following have been present together at some time during the previous year:
A strong desire or sense of compulsion to take the substance;
Difficulties in controlling substance-taking behaviour in terms of its onset, termination, or levels of use;
A physiological withdrawal state when substance use has ceased or have been reduced, as evidenced by: the characteristic withdrawal syndrome for the substance; or use of the same (or closely related) substance with the intention of relieving or avoiding withdrawal symptoms;
Evidence of tolerance, such that increased doses of the psychoactive substance are required in order to achieve effects originally produced by lower doses (clear examples of this are found in alcohol- and opiate-dependent individuals who may take daily doses sufficient to incapacitate or kill nontolerant users);
Progressive neglect of alternative pleasures or interests because of psychoactive substance use, increased amount of time necessary to obtain or take the substance or to recover from its effects;
Persisting with substance use despite clear evidence of overtly harmful consequences, such as harm to the liver through excessive drinking, depressive mood states consequent to periods of heavy substance use, or drug-related impairment of cognitive functioning; efforts should be made to determine that the user was actually, or could be expected to be, aware of the nature and extent of the harm.*
I’m going to take a wild-assed guess here that even if it is common to develop Head and Shoulders Shampoo withdrawal symptoms, it’s not “drug dependence”.
Based on brief online “research” I understand that the latest DSM classification has subsumed dependence under the phenomenon of addiction.* now imagining Head and Shoulders addicts with uncontrollably itchy scalps lurking outside dermatology clinics, Walgreen’s and supermarkets to get their fixes.*
***“Hey man, got any 16-ounce bottles you wanna sell?”
Many years ago when I was in my teens/twenties I used to use Head & Shoulders regularly because I had dandruff !!!
One day someone said I was wasting my money as H/S was formulated to actually create dandruff so you would keep using it.
I did’t actually believe that a famous company would do such a thing (still young and naive then) but as it was costing me money each week thought I’d give it a try and stop using H/S.
In those days I used to wash my hair while taking a bath every evening so started to use a different shampoo. Forget now which, could have been Johnson’s baby shampoo, it was cheap.
Anyway never used H/S ever again and never had any problem with dandruff since.
I think it worked on me, but I’m a special case. I’m a bald guy, and use the refreshing minty variety of Head and Shoulders. It doesn’t make much difference in my case what shampoo I use, but its a funky feeling on the bare scalp.
I’m not an expert either, but the definition of dependence I found differs a great deal from the one you found. Wikipedia (which is sourced to, and quotes several paragraphs from, a neuropharmacology reference book) defines it as “an adaptive state that develops from repeated drug administration, and which results in withdrawal upon cessation of drug use.” It is distinct from addiction, which refers to an psychological compulsion to continue using a drug which overrides the negative consequences. So I think that under my definition, what I’m describing fits my OP. I may not be psychologically compelled to continue using it, though my scalp is somehow adapting to repeated administration in a way that makes it unpleasant to stop using it (which thus gives me a strong physical incentive not to).
I stop every time I’m in rehab or jail. They lock up my H&S with my dryer sheets.
I’ve run out or been on extended camping or biking trips and not used H&S for periods of around two weeks I would guess. The sx return at approximately the same level as before using the product. My sx are red scaly patches around my nose and upper lip. Their appearance or severity is directly related to stress, primarily lack of sleep. H&S has in no way cured the seborrhea but it keeps it from affecting my life.
As Jackmannii noted, the lack of a cure is Big Oil / Big Pharm’s fault.
I’ve never been actually diagnosed as having seborrhea, but the description symptoms fit. If I use soap on my face, I will get scaly bits around my eyes, nose and mouth, so I switched to a non-soap cleanser which I can’t get at the normal grocery store.
I usually use H&S one a week, which seems to be sufficient. If I don’t, I basically get a sort of buildup of skin flakes, which don’t actually flake off. I’ve always thought of it as the adult’s version of cradle cap.
I think of it the same as the medication that I take regularly to control my depression. The causes of dandruff are ubiquitous, and if you get it normally without using anything to control it, of course it’ll come back when you stop using it. I actually don’t have much problem with dandruff from my hair per se, but from the area around my ears which doesn’t have hair. Sometimes just applying H&S daily isn’t enough and I get the stronger stuff that I can really feel working, which helps bring it back down to manageable levels. But it never fully goes away - just like the depression.
I have used H&S for a solid twenty years. While I am a guy that maybe shampoos his hair once a week, I have always thought of it as just a shampoo (albeit specialized). Why the concern?
I think what the OP is suggesting is most comparable to “Chapstick addiction.” Does the product purposefully create a circular need/use requirement? Probably not. Is there a mild irritation/alleviation pattern for some people? Probably.
