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Suggest Treatment For Red Boils On The Head

Posted on Wed, 25 Jun 2014

Question: I have been having head scalp follicities past a year.

I visited doctor 3 months back and had given oinment which didn help. Visited another doctor, who gave a different oinment 1 month back and that didn help neither.

I recently met a third doctor last week has prescribed E dox dt (doxycyclne hydrochroide and saccharomycs boulardi )
for 6 weeks. can i take this?

the doctor hasn given any other oinment except a shampoo.

i want a second opionien to make sure this is the right treatment .

i have over 20 small pimple like red boils on the head which has got worse in last 1 month.

Answered by Dr. Dr. Kakkar (21 minutes later)

Brief Answer:
Need more information

Detailed Answer:
hello and welcome to healthcaremagic

I am Dr. Kakkar. I have gone through your query.

I would like to gather some more information from you in order to be able to help you better.

-Do you suffer from dandruff OR Seborrheic Dermatitis?
-Do you use Hair Oil Or Similar products?
-Do the bumps Itch Or Pain? Do they resolve by themselves and new ones keep appearing?
-Do you have Acne on face or back?

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Kakkar (23 hours later)

Hi,

Thanks for your prompt response.

1. Yes I suffer from Dandruff as well for a long time.

2. No, I use hair oil very rarely. About thrice in a year.

3. Initially, they were not itchy. But past 3 months they are itchy and painful. They resolve themselves once n reappeared but i cannot firmly say since i might have taken oinments then.

4. I don't have acne on the face/back.

I had started taking the tablets three days back. Since it contains saccharomycs boulardi, and i read somewhere that it could be fatal to take it if the body immunity is bad, i am a little perplexed.

The itchy/pain seems to be contained after i started taking the tablets though.

Answered by Dr. Dr. Kakkar (58 minutes later)

Brief Answer:
Itchy bumps on the scalp

Detailed Answer:
Hi

Saccharomyces boulardii is a probiotic and the most likely reason it was given along with doxycycline is because doxycycline being a broad spectrum antibiotic will likely interfere with the normal intestinal bacterial flora.

The problem that you mention is commonly seen in those who have an excess of oil secretion or oily scalp. This can manifest as seborrheic dermatitis(itchy greasy adherent scales in the scalp) and also as itchy bumps. A yeast called Malasezzia furfur which is a common commensal (resident flora) is responsible for initiating or perpetuating inflammation as it feeds on the oil that is produced.

The goal is to keep the scalp as clean as possible and not to use any hair oil.

An Oral antifungal rather than oral antibiotics, specially Itraconazole 100mg capsules, 2 capsules once daily(after meal) for a week would help in seborrheic dermatitis and itchy bumps over the scalp by decreasing the resident flora(Malasezzia furfur) which is implicated as one of the factors for causing scalp seborrheic dermatitis and itchy bumps.

I would suggest that you use a 2% ketoconazole shampoo once daily or every alternate day as well. Ketoconazole is antiinflammatory antifungal as well as antiseborrheic. Lather it well into the scalp skin and leave it for 5 min before you rinse.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Kakkar (17 hours later)

Hi,

So do I stop the antiobiotics which i have been taking past 3 days and start the anti fungal thats suggested?

Also please note that i have a dry skin in legs/hands/body. So can scalp alone have oily skin ?

Answered by Dr. Dr. Kakkar (10 minutes later)

Brief Answer:
Antifungals

Detailed Answer:
Hi.

Scalp, face, chest, shoulders and back are areas rich in sebaceous glands. Skin of legs and arms is different from these sites

I would definitely suggest a course of oral antifungals along with an antifungal shampoo for regular use.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Kakkar (3 minutes later)

Sorry for too many doubts but is it safe to stop antibiotics after 3 days?

i am jus worried what if i need to take the same antibiotic later n it doesn respond then ?

also previous two doctors also prescribed anti biotics but for jus 3 days. Could have they missed it being fungal ?

Answered by Dr. Dr. Kakkar (11 minutes later)

Brief Answer:
Scalp infection

Detailed Answer:
Hi.

Yes, i think you should stop the antibiotics. No, it wont cause resistance if required later on.

Well, I can't say why the previous doctors did'nt gave you antifungals. May be they thought that it is plain bacterial folliculitis. Sometimes it is difficult to correctly diagnose in the first visit and sometimes the patient does'nt go back to the same doctor. May be they would have started you on oral antifungals in the next visit, if you had followed up with the same doctor. The recurrence itself suggests that this not simple bacterial folliculitis and fungal origin is definitely a possibility over here.

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. Chakravarthy Mazumdar