Itchy Skin, Dandruff And Acne On Face. Blood Test Came Normal. Suggest Treatment
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Detailed Answer:
Hi,
thanks for writing to us.
From the description provided, I understand that your son is suffering from chronic urticaria and seborrheic dermatitis. SD is characterised by severe dandruff scalp, red itchy scaly skin over chest, eyebrows, eye lashes, nasal folds and behind ears. These pimple like lesions could be due to SD or sometimes acne can occur with SD also.
Chronic urticaria can be managed by oral antiallergics like cetirizine, hydroxyzine along with histoglob injections or oral steroids. SD can be managed with topical or oral steroids.
I would appreciate if you could attach images of the concerned areas as it would help me in diagnosing the condition and suggesting appropriate management. Also I would like to know treatment that has been taken so far for urticaria.
Hoping to hear from you soon.
Regards
Please read a detailed answer below
Detailed Answer:
Hi,
Thanks for writing back.
I have seen the images attached. I believe Deepanshu is facing three skin problems simultaneously
Acne
Seborrheic dermatitis
Urticaria.
Now to treat these skin problems, I would advise that you may begin with below mentioned treatment
Urticaria- continue Histoglob injections. Ask him to take levocetirizine (like HH levo/ levosiz/ lcz )two times in a day and hydroxyzine( atarax) 25 mg in night. At places of severe itching he may apply antiitch lotions like sarna lotion or venusia soft lotion or calosoft lotion etc
Seborrheic dermatitis/ severe dandruff scalp- ask him to use ketoconazole shampoo every alternate day. Should keep the shampoo for five minutes over scalp and wash off( scalp/ nizoral/ keraglo ad etc). Use steroid lotion like diprovate or zydip lotion over scalp in night. This would control dandruff. Once its gone, just continue with shampoo twice in a week and stop steroid lotion
Acne- Ask him to take doxycycline 100 mg two times in a day. He can use clindamycin gel( clindac a/ faceclin) over acne lesions in morning and tretinoin gel in night(nexret). If required oral isotretinoin can be started to control his acne
Personally I feel he should begin with urticaria and dandruff treatment first. Once dandruff is controlled, he may start acne treatment. Treatment for urticaria will continue for long. Ask him to take oral antiallergics for 3 weeks. If good control is there with these medicines, then later on we may taper the dose.
If his skin feels dry then he may use cetaphil dam moisturiser to hydrate dry areas.
As such whatever skin concern he is having are common ones though chronic in nature. You do not need to go anywhere far away from city to get these treated. You may visit any qualified dermatologist in your city. If at all you are not satisfied with doctors in your city, you may take consultation from a XXXXXXX professor of dermatology department iany government medical college nearby your city. I believe you may go to Bhopal medical college for the same.
For any further doubts or clarification ,I shall be availble. So feel free to send in your queries.
Regards