Brief Answer:
Debridement and topical emollients

Detailed Answer:
Hello,

I understand your concern. Erosive pustulosis of the scalp is a chronic skin disease that is mainly due to prolonged sun exposure. I am assuming that a skin biopsy has already been done to rule out other conditions, before deciding on this diagnosis. If not, I highly recommend it.

The main line of treatment is with topical high potency steroids, such as Clobetasol Propionate that you refer to have already been using. While there are other medications that are used to treat this condition, such as topical Tacrolimus and topical Dapsone, also oral zinc and oral retinoids, these have shown varying results.

Given the medications you have been using, I recommend debridement (scraping) of the crusts and electrocautery, every 2 to 3 weeks, while applying daily a topical antibiotic or a petrolatum emollient. This method has shown considerable results and should, of course, be done under the supervision of your Dermatologist or PCP.

I hope this answers your question. Feel free to ask any further questions you may have.

Take care.

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