Are Excessive Scalp Secretions A Sign Of Seborrhea?
Regarding your scalp complaints
Hello. Thank you for writing to us
I am dr.kakkar (dermatologist).
I have gone through your query and i have noted your concern.
Besides seborrheic dermatitis, scalp psoriasis is the other more common condition that leads to build up of scalp scaling.
Other less common condition include lichen XXXXXXX pilaris, scalp DLE and head lice infestation with secondary bacterial infection.
Your treatment seems to suggest that you have either seborrheic dermatitis or scalp psoriasis.
I would like to modify your treatment a bit. Instead of antifungal shampoo you may use a coal tar and salicylic acid based shampoo every alternate days or preferably daily if you have short hair. Secondly, instead of plain clobetasol propionate lotion you would be better served by a lotion containing a combination of clobetasol propionate and salicylic acid.
Regarding possible causes of your scalp condition
If you also have itching and therefore scratch and massage your scalp then secondary bacterial infection, oozing and crusting could be another possible cause of your scalp secretions. I would advice an oral antihistamine e.g cetrizine 10mg tablet twice daily for symptomatic relied from itching and scratching. Also if there is oozing or fluid coming out and crusting then a course of an oral antibiotic e.g either amoxicillin Or cephalexin would be of great help.
Most likely you have either seborrheic dermatitis or scalp psoriasis. Both these conditions itch and that can commonly induce scratching, leading to oozing and crusting. DLE, Lichen XXXXXXX pilaris and scalp psoriasis can be diagnosed by their clinical appearance, however they may require a skin biopsy for confirmatory diagnosis.
Regarding scalp dermatitis
Yes, Clarinex is desloratadine which is an antihistamine. You may take it during day and if this is sufficient its fine. However if you still itch on scalp you may add cetrizine 10mg at night.
I think you would do better with a coal tar and salicylic acid based shampoo. Shampoo every alternate days. Allow it to act for 3-5 minutes and rinse it off thoroughly. Use clobetasol and salicylic acid lotion once daily at night.
Let me know how it goes.