Apart from getting injections, what treatments are available for seborrheic dermatitis?

Question

Hello doctor,

Eight years ago, a car wreck shattered the windshield, and my head got injured with pieces of glass. They did not take the glass out, and I have also been dying my hair since I was 16. I developed fibromyalgia from the wreck, which is supposed to be relatively non-progressive, however as the years went by I started experiencing debilitating neck pain paired with even worse migraines. I did stretch, physical therapy, chiropractor, and even medication, but nothing seemed to help. Last year, a pharmacy refused to refill my Tramadol. I scratched my scalp.

After a few months, my scalp is so itchy, flaky, scaly, and pieces of glasses are still making their way out. So, I went to see a dermatologist, who said it is seborrheic dermatitis, but I have used everything you could use for that (Clobetasol, Ketoconazole, apple cider vinegar, Prednisone, some topical cream, Salicylic acid shampoo, tar shampoo, coconut oil). But still, I have to shave my head because my scalp is still very messed up. I think my follicles are damaged, so aside from getting injections at a dermatologist office, what treatments are available for that? Do you have a specific shampoo you recommend for repairing follicles?

Answer 1

Hi,

I am glad you chose icliniq for your medical-related queries.

I understand your concern and will try to help you with it.

The diagnosis from your history would still be seborrheic dermatitis or Sebo psoriasis or scalp psoriasis. This is more of a cyclical problem; it tends to curb down with 2 to 3 months of treatment but recurring back with a change in season or lifestyle. However, it naturally settles down as the age increases, usually around 30 to 35 years of age. The pain, as you describe, could even be neurogenic in view of a past history of trauma to the skin. This could damage the nerve fibers, which have a very slow tendency to regrow and recover, resulting in chronic pain. With regards to your scalp scaling, I would advise you to restart with a Ketoconazole, Zinc pyrithione, and coal tar combination shampoo. Initially, it would be recommended to start using it every alternate day for three weeks, with a gradual tapering in frequency. Thereafter, use it twice a week for the next three weeks, and then weekly once for the next three weeks along with the simultaneous introduction of your regular shampoo. In order to repair the damaged follicles, you could take oral supplements containing Biotin and Pantothenic acid, daily one tablet for a month. Consult your specialist doctor, discuss with him or her, and start taking the medicine after their consent.

Thank you for consulting me.

You can always reach me at icliniq.com.

Answer 2

Hi,

Welcome back to icliniq.com.

I read and understand your concern.

If there has been no improvement despite all the measures, then a strong possibility of scalp psoriasis needs to be considered. I would appreciate if you could upload appropriate images of the present condition so that we can assess it better. You can add a weekly dose of oral Fluconazole 150 mg, once a week for four weeks to the above regimen. Scalp psoriasis would need a different course of treatment.

Looking forward to your response in order to help you.

Thank you.