Q. A grayish scaly and itchy patch in my scalp has spread to other parts. What is it?

Answered by
Dr. Sneha Mariam Varghese
and medically reviewed by Dr. Sneha Kannan
This is a premium question & answer published on Sep 07, 2020

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.

# 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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