The Baby Drank Shampoo: Risks and Treatments

What is shampoo made of?

Modern shampoo was developed in the 1930s and contains detergents (also called surfactants, short for "surface active agents"), a safer replacement for the harsh soaps used in earlier times. Shampoos are designed to primarily clean the hair and scalp of sebum (the oily secretion of the sebaceous glands), perspiration, skin scales, residue of previously used hair care products, and environmental pollutants. In general, shampoos have low toxicity.

The 4 major types of shampoo

Non-medicated shampoos often contain a mixture of surfactants. There are 4 main categories of shampoo detergents: anionic, cationic, non-ionic, and amphoteric. Each has different cleansing and conditioning properties.

1. Anionic surfactants are among the most popular ingredients in shampoos. You might recognize the terms “lauryl sulfate” or “laureth sulfate” from your shampoo label. These are rather harsh detergents that lather and rinse well. Shampoos with lauryl sulfates are commonly used for oily hair. Those with laureth sulfates also have good lathering and rinsing properties for use in cleaning normal to dry hair. Sarcosines are other detergents in the anionic class. These are listed as the second or third ingredient on some shampoo labels. They do not remove sebum well, but function as good conditioners. Lastly, the anionic class of detergents includes sulfosuccinates, such as disodium oleaminesulfosuccinate, which are strong detergents used as secondary surfactants in shampoos designed for oily hair.
2. Shampoos containing cationic detergents, such as cetyltrimethylammonium chloride do not lather well and are poor cleansers, but give softness to the hair and are used in shampoos for permanently colored, bleached, or chemically damaged hair.
3. Non-ionic detergents, such as polyoxyethylene sorbitol esters, are very mild cleansers and provide good anti-static qualities.
4. Amphoteric detergents are used in baby shampoo because they do not cause as much eye stinging, lather well, and leave the hair feeling soft. Examples of amphoteric detergents that you might see in baby shampoos include cocamidopropyl betaine and sodium lauraminopropionate.

How are medicated shampoos different from other shampoos?

Medicated shampoos are used to treat scalp problems such as seborrheic dermatitis, psoriasis, and bacterial or fungal infections. In addition to regular cleansers, they contain active agents such as coal tar, selenium sulfide, or zinc pyrithione.

Coal tar (a byproduct of coal production) shampoo can be used to treat dandruff, psoriasis, and seborrhea (oily, crusting, or scaling skin). It works by slowing bacterial growth and loosening and softening scales and crust. It can cause mild stinging of the scalp or skin irritation.

Selenium sulfide, an anti-infective agent, relieves itching and flaking of the scalp and removes the dry, scaly particles commonly referred to as dandruff. There have been reports of orange scalp discoloration in a few children treated with selenium sulfide shampoo. The coloration was easily removed with rubbing alcohol.

Zinc pyrithione is an antiseborrheic. It works by slowing the production of skin cells, which helps to reduce flakiness. It is used to treat and prevent itching, flaking, and scaling of the scalp caused by dandruff or seborrhea. It can cause skin irritation. One report described a 35-year-old woman who had a 5-year history of stable psoriasis and no other skin disease. She had used many anti-dandruff shampoos. She was then treated with a new shampoo containing zinc pyrithione. Within 1 week, she developed severe pustular psoriasis with many lesions in the area where the shampoo was applied. Skin patch testing showed an allergic contact dermatitis reaction to zinc pyrithione.

The effectiveness of vitamins, most commonly vitamin E, added to shampoos is debatable. They are probably not in high enough concentrations or in contact with the hair or scalp long enough to be of benefit.

What ingredients should I avoid in my shampoo?

It is difficult to predict whether a person will have an adverse reaction to a shampoo product. This is where the product label becomes very important. If you develop a rash or other unwanted effect while using a shampoo product, copy its ingredients from the label, and then make sure that the next shampoo you try has different ingredients. Unless you have a scalp condition, use non-medicated shampoo products, since they are less likely to cause a reaction.

There is a lot of online speculation that detergents and other common shampoo ingredients might cause cancer or negatively affect the immune system. However, except for allergy or hypersensitivity potential, there is little science-based evidence that shampoo ingredients are likely to be carcinogens or otherwise cause health problems.

Is dry shampoo safe to use?

Dry shampoos often contain fragrances, preservatives, and surfactants that can cause allergic reactions, including contact dermatitis. Inhalation of dry shampoo can also cause lung irritation in susceptible people. Read more about dry shampoo.

What to do if shampoo is swallowed or gets in the eyes

When shampoo is swallowed in small quantities, mild nausea, vomiting, and diarrhea can occur. Usually, the only treatment needed is drinking fluids or sucking on ice chips. If gastrointestinal symptoms are severe or persistent, Poison Control could have additional recommendations.

When shampoo gets into the eyes, irritation and redness are common. A serious eye injury is not likely. The eyes should be rinsed immediately. Be sure to remove contact lenses. Use lots of room-temperature water. For children, pour water onto the bridge of the nose and let it gently run into the eyes. Encourage blinking. Then check with Poison Control after rinsing. 

Baby shampoos often contain detergents that numb eye tissues to prevent stinging. However, baby shampoo can still potentially irritate the eyes.

If you suspect someone has swallowed shampoo or got it in their eyes, immediately check the webPOISONCONTROL online tool for guidance or call Poison Control at 1-800-222-1222.

Mary Elizabeth May, RN, BA, MPH
Certified Specialist in Poison Information

Revised William G. Troutman, PharmD
Professor of Pharmacy Emeritus

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