Why do the itchy scalp, pimples, and hair fall not improve in an individual despite taking medications?

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I went through your query and understood your concern.

I have gone through the history provided by you, and I have also viewed the image (attachment removed to protect the patient's identity). Scalp itching, along with pimples, may occur due to multiple reasons, out of which the most important reason is because of stagnation of sweat and moisture on the scalp. Other reasons include frequent use of helmets or caps, sharing other people's belongings, stress or hormonal fluctuation, which causes excess release of sebum which results in the formation of pimples and dandruff on the scalp. Also, using various hair care products, low immunity, dietary changes, and climate changes can also contribute to hair fall. So, I suggest you to follow a few instructions mentioned below,

1. Use Scalpe plus (Ketoconazole, Zinc Pyrithione topical, and Piroctone Olamine) shampoo. Apply on the scalp every three days. Take 3 to 4 drops of the shampoo and mix it with one-third cup of water. Apply the mixture on your scalp and massage for one minute to release the flakes. Keep it for 5 minutes and wash it off. Repeat this for 3 to 4 months.

2. Use Muciprocin (topical antibiotic) 2 % cream. Apply three times daily on the pimple area, which is present on the scalp. It is important to apply the antibiotic cream to reduce the formation of pimples on the scalp. Make sure to use them for at least four to six weeks or till the pimples disappear. Pimples can appear due to sweating and, therefore, can appear later on as well. This cream may be used in case of the presence of any pimples in the future on the scalp.

3. Take the tablet AF (Fluconazole) 150 mg. This tablet can be taken once per week for four weeks. Therefore a total of four tablets for four weeks has to be taken with water after dinner.

4. Take the tablet Follihair (multivitamin supplement). This tablet has to be consumed daily after dinner for two months. This helps in increasing hair growth and reducing hair fall.

5. Take the tablet Limcee (vitamin C supplement) 500 mg. It is a chewable tablet. This tablet must be chewed and consumed in the morning after breakfast for two months. This helps in healing the pimples faster and prevents further pimple formation. Make sure to avoid taking extremely hot food and drinks, and milk during the consumption of this medication.

6. Above all, it is important to ensure that your scalp remains dry and that any excess sweat that forms throughout the day is wiped off completely. Make sure there is no stagnation of sweat or moisture. Make sure that the inner part of the helmets and caps are cleaned and kept under sunlight in order to prevent fungal as well as bacterial infections.

7. Avoid oily, fried food, milk and dairy products, red meat, and sweets. And make sure to include more fruits, vegetables, fiber, and at least 12 glasses of water per day in a 250 ml glass size. Consult a specialist, take to them and take the medications with their consent.

Dandruff and pimples may occur on the scalp on and off, depending on external and internal factors. It is important to avoid sweat and moisture stagnation along with lifestyle modifications in order to reduce and prevent the recurrence.

I hope the details provided above were informative and provided clarity.

Kindly follow up if you have more doubts.