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Get painful boils on scalp, use Soapex and Fudic cream. Heals and comes back with pus. Suggest?

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Dermatologist
Practicing since : 2006
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I get these painful boils on my scalp often. I generally use Soapex Soap and Fudic BNF cream and it does reduce or heal and then again they erupt. Sometimes with pus. gets a little annoying even after following a healthy regime.
Posted Tue, 8 Oct 2013 in Acne
 
 
Answered by Dr. Kalpana Pathak 31 minutes later
Brief Answer:
Please read a detailed answer below

Detailed Answer:
Hi,
Thanks for writing to us.
you seem to be having recurrent scalp folliculitis.
The same can be treated by
using cetrilac scalp wash daily. Apply it over scalp and keep it for 10 minutes, then wash off
apply mupirocin or nadifolxacin cream over affected area twice in a day

I prefer cetrilac and mupirocin over soapex and fusidic acid cream.
once lesions heal, just continue with cetrilac scalp wash and avoid oiling hair


If not much response is seen with above measures, an oral antibiotic can be added after doing pus culture and sensitivity from the lesion. This helps in determining the most effective antibiotic against pathogenic causative organism. Sometimes in recurrent chronic conditions other drugs like rifampicin or isotretinoin needs to be added.


I would like to know
since how long are you having this
if lesions are persistent or appear occasionally
if lesions are few or multiple
type of lesions- pustules or big boils or nodules etc
if there is hair loss and redness in affected area
If there is presence of greasy scales or thick scales over affected area.


Answering these queries would help me in assisting you further.
Hope to hear from you soon.
Take care
Above answer was peer-reviewed by
 
Follow-up: Get painful boils on scalp, use Soapex and Fudic cream. Heals and comes back with pus. Suggest? 23 minutes later
Hi Doc,

Cetrilac scalp wash daily. > Is this a shampoo ?

Here are my answers to your questions:

since how long are you having this - A year and half or more I guess.

if lesions are persistent or appear occasionally - I between persistent and occasional. They come and go.

if lesions are few or multiple - Multiple , back of my scalp , just above my neck line , on the sides here and there and on top. ( Right now I think have around 10 - 12 )

type of lesions- pustules or big boils or nodules etc - they are not big.. appear as red boils and then form pus. they are annoying and quite painful.

if there is hair loss and redness in affected area -
Good question Doc. There is redness and it hurts that is a major worry.
Also I have Male Pattern Baldness. Have tried many options to Home and also got conned with hair restoration centers like HairLine and Dr.Batras where they use derma rollers and acupuncture etc yada. I have not opted for Monoxidil , Finax as they dont agree with me. Have even tried PRP and Grape Seed extract tablets ( Prescribed by Doc in Hairline , but no great result ) with no results. Recently I visited a Skin Doc in Bangalore and he had asked me to start with Tugain Foam , but again that caused irritation on my scalp and had to stop it. He then prescribed Gropixia Gel, Adgain Capsule and Anaphase Shampoo.

If there is presence of greasy scales or thick scales over affected area. None so far but I do get dandruff winter season.
 
 
Answered by Dr. Kalpana Pathak 18 hours later
Brief Answer:
Cetrilac scalp wash is a shampoo

Detailed Answer:
Hi,
Thanks for answering the queries in detail.
Sometimes greasy dandruff can lead to development of boils.
As you said you mainly get it in winters, So I would advise you to follow the treatment protocol suggested by me as initially I would like to treat it as a case of recurrent folliculitis. But still as your scalp is prone to have dandruff please use cetrilac( its a shampoo) and ketoconazole shampoo like nizoral on alternate days and apply an antibiotic cream over affected areas.
If no results are achieved, you may start an oral antibiotic.

Now there is one more possibility considering your lesions to be localised to nape of neck. It is known as acne keloidalis nuchae. Initially the lesions are painful red bumps which later on persist as hard painless raised bumps. I would definitely like to rule this possibility in your case, so please send a clear resolution image showing your scalp lesions. Please upload a close shot as well as distant shot showing the lesions.

as far as androgenetic alopecia is concerned, you may start with prescription of grocapix, adgain and anaphase as it seems fine and would nt irritate your scalp. Minoxidil has a potential to irritate scalp.
Hoping to hear from you soon.
Take care
Above answer was peer-reviewed by
 
Follow-up: Get painful boils on scalp, use Soapex and Fudic cream. Heals and comes back with pus. Suggest? 1 hour later
Hello Doc,

So I will start cetrilac Shampoo and and mupirocin Cream for this issue. Attaching pics for your reference. this site does not allow huge file size hence sending compressed size. hope they are clear . Really appreciate your consult. Hope you had a fab weekend.
 
 
Answered by Dr. Kalpana Pathak 39 hours later
Brief Answer:
Please start with cetrilac and mupirocin.

Detailed Answer:
Hi,
Thanks for writing back.
I have seen the images attached, these are furuncles only.
Please use cetrilac shampoo daily and apply mupirocin cream. Also please start with tablet amoxyclav 625 mg thrice in a day for a week.
this would definitely give you good response. once the lesions resolve please continue with cetrilac and avoid oiling
But if the lesions recur again, as I said earlier a pus culture sensitivity will be required for complete resolution of lesion.
Hope that helped.
Take care
Above answer was peer-reviewed by
 
Follow-up: Get painful boils on scalp, use Soapex and Fudic cream. Heals and comes back with pus. Suggest? 28 hours later
Hi Doc,

None of the medicals are aware of CETRILAC Shampoo. I used Nizral for these days and TBACT cream . The boils did subside and the pain reduced. I am still apprehensive to antiboitics tablets. Not a great fan of medicines. I try to avoid it . I had Dengue last year same time so am even more cautious to take any medicines as I still have some after effects of it. Let me know if its a must to take these tabs and if its safe take with my BP tablets ( Amlokind AT - Half daily ).

Also please advise if Grocapix will regrow my hair. I would not expect miracles. May be 20 tp 25 % hair restored :) . Let me know. I am not keen on taking Finax or other tablets as mentioned before. I do agree the gel does not irritate scalp. Its strange to see in this advanced medical era there isnt a medicine to reverse hair fall :). How we wish it was there.
 
 
Answered by Dr. Kalpana Pathak 20 hours later
Brief Answer:
Please read a detailed answer below

Detailed Answer:
Hi,
Thanks for writing back.
Cetrilac 5% scalp wash or betadine AD shampoo are quite easily available. If not then continue using nizoral( as its giving you result, could be due ZPTO it contains which has bacteriostatic action) even when lesions subside and avoid oiling scalp

If the lesions have completely resolved, then do not take an antibiotic. But if lesions reappear, get a pus culture and sensitivity done to start with an antibiotic. Also consult your doctr prior to starting it. You had dengue last year, so now I do not think taking any medicine would harm you.


Grocapix is a newly launched drug and is said to be effective to induce hair growth. The response to any medicine depends upon the severity and grade of hair fall. If you do not want to take finax, take tablet androanagen daily. It might help you out.

Hope this helped.
Take care
Above answer was peer-reviewed by
 
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