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What Causes Itching On Scalp?
Question: My 1 year old son is suffering from severe itches on his scalp. He scratches and digs his nails in so hard that his scalp bleeds. He has some head lice from his day care center. But lice is not the only problem, I have checked his scalp well, only some dead nits are left but no live lice can be seen. Even then he goes on scratching his head. One dermatologist advised Cetrilac scalp wash but it is not available at my local chemists'. He has got t=some brown spots on the front part of his head, which seem to be cradle cap, but that is not the part that he scratches. He usually scratches the back and top of his head, which are perfectly clean areas. Please advise, I am scared the bleeding wounds will get infected and damage my son's hair follicles.He has very long hair since it is against the religious sentiments of my in laws' to cut hair before 18 months. It is very hot and humid here in Kolkata.
Brief Answer:
Pemethrin1%, Ketoconazole shampoo
Detailed Answer:
Hello and welcome to healthcaremagic.
I am Dr. Kakkar. I have gone through your concern and I have understood it.
Definitely the itching is both due to Lice as well as Seborrheic dermatitis(greasy adherent scales on the scalp).
You need to manage both of them:
-For head lice you could use a 1% permethrin creme rinse (perlice 1%), which has to be applied after shampooing and air drying the scalp hair. It should be applied to the whole of scalp and the entire length of the hair. It should be kept for 30min - 45 min and then washed off with a shampoo. Usually a single treatment is enough.
-For seborrheic dermatitis, if it is difficult to procure cetrilak, you could use a 2% ketoconazole shampoo (Nizral 2% shampoo) every alternate days, which is equally effective. For severe involvement, even daily shampoo may be required. A topical moderately potent steroid lotion/cream e.g fluticasone cream/lotion(Flutivate-e cream) would help in faster relief from seborrheic dermatitis, which can subsequently be stopped and the improvement maintained by an antidandruff shampoo.
-Of course you could give Atarax for symptomatic relief from itching.
regards
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Can Aceptik LA be given in place of Cetrilac?
Brief Answer:
Seborrheic dermatitis
Detailed Answer:
Hi.
Aceptik LA contains Cetrimide 0.6% w/v whereas cetrilak (cetrimide) which is commonly use for seborrheic dermatitis of the scalp contains 5% cetrimide w/v, therefore the concentration of cetrimide in Aceptik-LA is very less.
You could either use Aceptik-HC which contains cetrimide 15%, dilute it 1:3 with water to get the desired 5% concentration.
Even ketoconazole 2% shampoo will work as good as cetrimide. Ketoconazole is available easily as NIZRAL which is marketed by Johnsons & Johnsons in India.
A topical moderately potent steroid lotion/cream e.g fluticasone cream/lotion (Flutivate-e cream) for 2 weeks, would help in faster relief from seborrheic dermatitis.
Regards
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you doctor, just one more question. How many times a day should Flutivate-e be applied?
Brief Answer:
Flutivate-e cream twice daily
Detailed Answer:
Hi.
Flutivate-e cream/lotion should be applied after you had done lice treatment on the baby and it should be applied twice daily, at the scalp skin for 2 weeks. Wash the scalp with an antidandruff shampoo (2% ketoconazole). Flutivate-e brings about remarkable improvement in 2 weeks time, when it can be discontinued.
Later on just continue with an Antidandruff shampoo for maintenance of improvement.
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
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