Hello Madam,

Welcome and thanks for posting your query to XXXXXXX

As per your query you have crust on the scalp which is very itchy and red appearing like sunburn. In your query you have not mentioned the exact time period since the crust is present.

As per the nature of the crust and the site, the best possibility appears to be "Seborrhea capitis" or a case of moderate to high "Pityriasis capitis".

Medically speaking our skin is a multiple layered structure. Our skin gets renewed every day. The layer which is present on the top today will be fallen off tomorrow in the form of dead skin known as scales. This process is not actually visible on normally. So we can say we are just one day old from our skin most superficially.

Now in some persons when it is renewed at a faster pace there is a heap of scales which we call as dandruff. Because of hygiene and scalp hair this dead skin in form of scales gets entangled and trapped. It varies from person to person and also on other of factors which makes the difference inter-individually.

The scalp skin also secrets oil continuously and the secretions of oil glands are deposited on the local area. These secretions itself leads to subsequent blockage of the glands and so leads to mild inflammation of the area. There after the continuous secretion and the mild inflammation leads to yellowish dry crusting of the area. So it leads to the kind of appearance which is like cradle cap.

The irritation at local part causes intense desire to itch and due to itching the area is denuded of skin leading to exposure of red raw areas of skin with excoriation and redness of the skin.

This is totally normal condition and is generally found more commonly in post middle aged persons. It is also not a sign of any systemic illness.

Now for the betterment kindly follow the suggestions below:

- The most important thing you should not touch, pinch, pop or squeeze the area by any means. So again I write in capital letters" NO SCRATCHING & NO TOUCHING". This is the most important part in your condition because there are raw areas of skin which can get infected and irritated because of mere unnecessary touching.

- Do saline water compression meaning 1 glass of water with pinch of salt in it and then cotton soaked in the water and compressing for 5 minutes. You can take warm or cold water according to your comfort. Do it for at-least 2-3 times in day. It will loosen the dry flake, which will fall off easily.

- Wash your scalp daily if you do not have long hair or if long hair are present then can do alternate days.

- Maintain scalp hygiene. DO not apply any hair oil or any home remedies as can irritate the skin.

- You can take any antihistamine tablet by mouth such as desloratadine or levocetrizine for itching and irritation under medical guidance. It can be taken for one time if itching is less or for two to three time if the irritation is more. desloratadine can be taken in day time while levocetrizine can be taken in evening or night time.

- As you have bit of pain also so you can take pain killer tablets in the initial part for few days.

- Apply a cream containing Fluticasone with mupirocin on it for two times a day. You can apply two times a day in such a thin layer that it should be visible by naked eye. Do not apply beyond 7 days of period.

So the above measures can be done for atleast 7 days to reduce the acute effect. Once you get relief from all these measures done judiciously and prudently then can apply and take certain antifungals and keratolytics (medicines reduce and removing excess scaling) under dermatological advice.

Despite above measures if the things are not clearing then you can XXXXXXX a dermatologist who can prescribe you certain higher medications and treat it accordingly. But I am quite hopeful and confident that by above measures you would be quite alright in next few days.

I hope these information's will help you. If you have further queries I will be happy to help.

"Wish you good health"

Regards,
Dr Sanjay Kumar Kanodia
MD (Dermatology and Sexually Transmitted Diseases)

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Hello Madam

Welcome again to the forum and thanks for replying.

As per your recent query you have mentioned little blisters with clear liquid with pain and itching.

I think you must have started the suggestions provided by me. As I said earlier it may take few days to get better and medicines also do take bit of the time to take their effect to reduce the pain and itching. The age factor is also an important factor in general healing process and also down with the progress of age.
So considering all these above factors we should wait for some time and judiciously do all the measures to present further aggravation of the problem.
As you said there are little blisters now which is generally not a feature of seborrhea or P. capitis but can be present if we try to scratch the area or due to mild irritation itself. Nevertheless the measures told before are very much applicable to any kind of scalp problem, so you need not to be worried for the small blisters.

As these are containing clear fluid that means are not infected, so do not touch or pop the blisters. Do take antihistamines and painkillers to reduce the intensity of itching and pain. If you feel the blisters are increasing or if there is development of pus then you may need medical attention and antibiotics added to the treatment.

But I hope you will follow my simplest of the suggestions and will be completely alright in few days.

I hope these information's will help you. If you have further queries I will be happy to help.

"Wish you good health"

Regards,
Dr Sanjay Kumar Kanodia
MD (Dermatology and Sexually Transmitted Diseases)

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