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Having itchy scalp, hair loss. Have meningioma. Suggestions

Dec 2013
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Practicing since : 2002
Answered : 4120 Questions
Hello I hope you can offer some suggestins. For four and a half years I have had a very itchy scalp, it began with simple itching and has progressed now to the point it itches incessantly and the scalp is very sore. The hair breaks off very easily and I have lost quite a lot of hair. There are small bald patches all over my head. I have seen numerious dermatologists no one has been able to diagnose anything or give me something to stop the itching. I do not respond to steriods of any sort. My thyroid gland is now being treated with 75 mcgs daily I have a meningioma right next to the pituitary gland and this last endocrinologist feell my pituitary has never worked porperly, he called it an immature gland. I needed clomophen to conceive my 3 daughters. My blood tests are all over the place my liver function tests have risen. Rge growth hormone and aldosterone are slowing dropping. I have also had a huge weight gain over the past 5 years. I can cope with all the things going on but the itchy head is causing so much trouble and distress. I am so tired all the time and have fallen asleep while driving the car on a coule of ocasions. I am unable to sleep at night as my head itches day and night. The hair and scalp are so dry and of course that increasis the itching. The strange thing is my actual hair is fine, its shiny and looks healthy its the broken hair underneath that is sharp and digs in when I lie down. I use Black Sesamee oli to nourish the scalp and a special shampoo and conditioner. I have had 5 biopsies with nohting showing. Small lesions like tiny red worms come up and these itch until they dry up. I even went to a seminar of dermatologists not one could offer any diagnosis. I was sent off to a neurologist to see if it was a neurological problem. I was passed back to the dermatologists. Can you suggest anything to stop the itch. Thank you XXXXXXX
Posted Fri, 7 Jun 2013 in Skin Hair and Nails
Answered by Dr. Sanjay Kumar Kanodia 2 hours later
Hello Mam,

Welcome and thanks for posting your query to XXXXXXX

Myself Dr S K Kanodia and will try to provide you the best of information regarding your query.

I can very well understand the stress regarding the kind of severe itch you are having in your scalp.

There are so many reasons of scalp itching ranging from simple dandruff to head lice and even contact with certain chemicals or certain skin diseases. As you have had multiple visits to dermatologists as well as biopsies done, so I consider that the skin conditions such as "psoriasis" or "lichen planus" and other of skin conditions had been be ruled out.

From the above point I want to first reassure you that at least there is nothing serious going on scalp.

Now if we have ruled out the serious causes- so whats left then.
To answer above, we have seen many times that despite of so many investigations and examinations some times we are not able to find out the exact cause of itching in the scalp. In these case we presume that the itching is due to simple dandruff only. In your case it appears to be due to a second important cause of nutritional as you quoted broken hair.

In your case kindly follow the regimen below:
1. Stop application of all the hair products on scalp for few weeks of period.

2. Do anti-lice treatment. Apply "ivermectin" lotion for 1 hour once per 7 days repeated after 7 days. You can alternatively apply permetherin 1 % lotion for 24 hours and repeated after 7days.

3. Do hair wash everyday for 7 days of period and then do alternatively. We have seen that simple hair wash daily provides the best relief in itchy scalp.

4. Take round the clock antihistamine (antipruritic/ anti-itching) medicines under medical guidance. In my practice I prefer loratadine by mouth for 2-3 times in day time( even 4 times can be taken if itching is not controlled) and hydroxyzine at night time according to your kind of problem. this will reduce the itching as well as reduce your anxiety. These will not be having any adverse effect on rest of your problems. You can take further guidance from your doctor before stating the medicines.

5. Eat the best of nutritious food in your daily diet.

6. Do not try to scratch even for a single time. Ask your family members and surrounding people to check you if you are even touching your scalp.

Lastly I would again reassure you for the most important thing that there is nothing serious in the scalp and the only problem of itching can be controlled by simple measures advised above.

Hope I have answered your query. If you have any further questions, I will be happy to help.

With good health wishes.


Dr Sanjay Kumar Kanodia
(MD- Dermatology & STD)
Above answer was peer-reviewed by
Follow-up: Having itchy scalp, hair loss. Have meningioma. Suggestions 1 hour later
Thank you Dr XXXXXXX I would just like to check that the drugs you have suggested wont clash with the medications I already take. Effexor 375 mgs, Zanax 1mg BD.
Gabapentin 300mgs daily, Fexofenadine 180mgs daily( I could drop this in favour of another antihistamine.) Celebrex 200mgs daily, crestor 10 mgs daily, oestilin 10mgs daily plus some fish oil. My GP has pointd out some of these drugs are not liver friendly hence the raise in my liver functions.
You are correct all the normal skin diseases have been ruled out, the dermatitis type, lice, fungal diseases cranial acne ect. The treatment of lice created havoc the skin on my head was red raw, the chemicals where just too strong.
The skin on the scalp has thickened considerably I try very hard not to scratch, I find using very cold water or ice numbs the itching. When trying to apply the sesamee oil the short broken hairs rub against the scalp this causes more breakage and makes it even itchier. I now heat the oil wrap my head up in plastic and leave it on for about 3/4 of an hour then wash it out. This is very soothing but leave too much oil and conditioner on for too long has the effect of making it itchy as well. Its a really difficult situation.
I dont know whether the drugs you have suggested will effect any of the medication I already take. I will discuss them with my GP. I also wonder whether the fact I dont have any estrogen progesterone or testerone, have some influence on the total lack of production of natural sebum. I have just been started on a Estreogen 50mcg patch as I am having terrible hot flushs. Its like a second menapause. The thyroxin has just been started and the specalist wants to review the tumour in September to see whether it has grown. In the meantime some new suggestions are most welcome. Thank you for taking the time to try and help me. Kind Regards XXXXXX.
Answered by Dr. Sanjay Kumar Kanodia 4 hours later
Hello & Welcome again to the forum Madam.

I am really empathetic to know how many of medicines you are already taking for different of the problems. It’s really so great of you to have the zeal of staying fit.

Now further guiding you for your problems, as I can see there are multiple of the medicines you are taking for different of the problems. At this juncture I suggest you to kindly request your general practitioner to prescribe you most essential of medicines with lowest of the dose possible. As there are too many of medicines and this feeling itself makes us ill.

Specifically to mention is the drug- Effexor (Venlafaxine). It has some or other of side effects as you must be told. The one to mention is kind of feeling of tiredness you feel. It is better to consult your general practitioner to see for any other of side effects in occurring in yourself.

Regarding the problem of itchy scalp to guide you further it appears from your query that the thickening of the skin which you are stating, might actually be “Lichen Simplex chronicus” in our medical language. This is one of the condition where there is intense itching followed by scratching and then it further leads to more itching. So simply saying there is itch –scratch and itch cycle.

The most important part in your treatment for the itchy scalp is to break the cycle of itching. This can be done by complete round the clock antihistamine coverage. One more addition to it is by applying halobetasol lotion under proper medical guidance. This is a high potency steroid have best results in thickened skin. This can be worth used for around 2-3 weeks and then can be reduced.

The kind of oil application method you are doing is not the right way in my opinion. As it gives relief for a very short time and later can aggravate the situation. So I request you to give some rest to your scalp skin. A proper scalp wash is the need of the time. There is further elaboration of the same:

1. Wash your scalp daily. Wash it twice in a single bath. It means when you are washing your scalp apply first time shampoo for washing the hair part only, then rinse it off immediately with water. Reapply the shampoo again immediately, leave it for around 5 minutes, do a good gentle massage by your fingers for around 2 minutes and then wash it off. By doing so for around 7 days you will get good benefit.

2. The other way if you can not do two times wash is to apply your shampoo (diluted with water) for around half an hour before bath like an hair oil. And then rest of the second application and bath as told above. You can reduce the frequency of twice application after 2 weeks and then can optimize it according to your own need.

3. If you are not getting any better then can also do it two times in day for time being- yes you read it properly two times per day. It is same like how many times you generally brush your teeth- you say one time, but those who have some problem with teeth do brushing twice also. In the same manner to reduce the flaking - the latest dermatological view is you can gently wash your hair two times (the same thing I can not say to a female with long hair and I suppose you also don’t have long hair).

4. Stick to one good shampoo which is suiting your hair, don’t change the shampoos frequently. If you are using any conditioner also then to be used over the strands of hair only and not over the scalp skin.
Above and all the most important measure is to be done fro your side by “NO SCRATCHING” and “No touching” scalp skin.

Lastly to say, if you can bear so many of the big problems then you can definitely overcome this simple itchy scalp condition by your positive attitude and will power.

Hope I have answered your query. If you have any further questions, I will be happy to help.
"Wish you good health".

Dr Sanjay Kumar Kanodia
(MD- Dermatology & STD)
Above answer was peer-reviewed by
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