How to get rid of grayish scaly and itchy scalp?

Patient's Query

I am looking for some answers to my scalp issues. My scalp developed this one grayish scaly patch that felt like a bump and would itch. I had no idea it would eventually spread to other parts of my scalp. I have to wash with medication shampoos and conditioners at least everything 3 days because at day 4 it would become extremely itchy. I have only had this problem since the beginning of this year and I’ve developed discoid eczema all down my back and chest (this was diagnosed by a dermatologist). Please help with my scalp. If I try to loosening these patches they become open wounds so they are not dandruff. I don’t know what this is. I’ve tried topical fluocinonide .05% and I’ve noticed that he hurts after application and develops scabs. Not sure if that’s a good thing. I’ve tried ketoconazole shampoo and another application....mometasone. I take Zyrtec and hydroxyzine 10 mg which were prescribed by derm. I use clobetasol application for discoid eczema on skin. I was told that scalp issues were sebo dermatitis.

Answered by Dr. Sneha Mariam Varghese

# Hello
Welcome to icliniq.com
Hope you are keeping safe

1) I understand your concern and have seen the attached photos. The following possibilities to be ruled out are
- Seborrhea Scalp ( Pityriasis Capitis)
- Scalp Psoriasis / Seboporiasis
- Fungal infection ( Tinea Capitis)

It can be concluded only by a biopsy from the lesion and the lesions tend to look the same or should be examined under a woods lamp / dermatoscope

2) You can use
- Tarsalic solution ( coal tar + salicylic acid ) to apply for 5 min on scalp before washing, twice weekly for 2 weeks
- Liquid paraffin for the scalp morning and afternoon
- T. Cetrizine 10mg once in the night ( if itching present)
- Omega-3 capsules once daily for 1 month

Topical steroids to be added after biopsy results.

Review after 2 weeks .

3) Follow these measures
- Wash hair with Luke warm water
- Do not share personal items
- Do not scratch the area as it can lead to secondary bacterial infection

Hope your query is cleared

Thank you and take care.

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