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Suggest Treatment For Dry, Flaky And Itchy Scalp

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Posted on Mon, 19 Oct 2015
Question: Hello Doctor, I have a serious scalp problem that started 15 years ago with a red ring at my temple. Half of the ring was exposed and the other half was hidden under my hair line. The rings are a little smaller than a wedding ring. There is hard crusty flaking, itching and when I scratch the thick hard flakes, there is red bloody painful scalp. The blood covers my finger tips after scratching and the blood saturates my hair. Over the next 15 years it slowly spread over my entire head, eyebrows and center of my chest (where the chest hair is the thickest). At times I can see red rings on my chest (perfect red circles). My family doctor gave me DurmaSmooth which helped at first but became less effective over time. I used stronger doses and different prescription steroid scalp oils over the years (tried 3 or 4 different ones - including DurmaSmooth and Ketaconazole in different strengths). I am presently using Fluocinolone Acetonide .01% oil. All of these help for a time, but then are less effective. The scalp oils are messy, hard to use, burn my eyes and interrupt my sleep. I went to a Dermatologist and she did no testing and said I just had a flaky scalp problem and gave me some samples of Elidel for eyebrows and Taclonex. Honestly I didn't' try the samples because the samples were so small they would not have done much on my problem that covered such a large area and I was warned that they were very expensive. I told her about the perfect red rings that are visible at times and she did not seem to know what they were and gave no explanation for them. Do you have any ideas on what my condition is and is there anything that will cure it, or be more helpful and less messy than steroid hair oils ? Thanks very much, XXXX
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Answered by Dr. Dr. Kakkar (54 minutes later)
Brief Answer:
Kindly upload a few images so that I can guide you better

Detailed Answer:
Heo. Thsnk you for writing to us

I have gone through your query and I have noted down your concern.

From what I can judge from your description it seems like you may be suffering from either scalp psoriasis or seborrheic dermatitis. Scalp and hair line is a common site of involvement. These conditions commonly present as itchy, scaly, round or oval, red patches on scalp and hair line. The condition is chronic and can last for years. Chest is also a common site of involvement with seborrheic dermatitis and sebopsoriasis.
Both these conditions are responsive to topical steroids as you must have noticed that your condition gets better with these i.e fluocinolone acetonide oil which you have been using. Topical immunomodulators like pimecrolimus (elidel) and tacrolimus are also effective in both these conditions as is ketoconazole shampoo, however the condition may relapse.
I request you to kindly upload a few images so that I am able to guide you better. You may upload an image either at "Reports Section" Or You may mail me at YYYY@YYYY with the subject line as Attention: Dr.Kakkar.

Regards
Note: Hope the answers resolves your concerns, however for further guidance of skin related queries consult our Dermatologist.Click here to book a consultation

Above answer was peer-reviewed by : Dr. Vaishalee Punj
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Answered by
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Dr. Dr. Kakkar

Dermatologist

Practicing since :2002

Answered : 9612 Questions

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Suggest Treatment For Dry, Flaky And Itchy Scalp

Brief Answer: Kindly upload a few images so that I can guide you better Detailed Answer: Heo. Thsnk you for writing to us I have gone through your query and I have noted down your concern. From what I can judge from your description it seems like you may be suffering from either scalp psoriasis or seborrheic dermatitis. Scalp and hair line is a common site of involvement. These conditions commonly present as itchy, scaly, round or oval, red patches on scalp and hair line. The condition is chronic and can last for years. Chest is also a common site of involvement with seborrheic dermatitis and sebopsoriasis. Both these conditions are responsive to topical steroids as you must have noticed that your condition gets better with these i.e fluocinolone acetonide oil which you have been using. Topical immunomodulators like pimecrolimus (elidel) and tacrolimus are also effective in both these conditions as is ketoconazole shampoo, however the condition may relapse. I request you to kindly upload a few images so that I am able to guide you better. You may upload an image either at "Reports Section" Or You may mail me at YYYY@YYYY with the subject line as Attention: Dr.Kakkar. Regards