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Have seborrhea. Using Ionax t shampoo and mometasone cream. Any permanent cure?

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Practicing since : 2006
Answered : 2015 Questions
Hi, I have Seborrhea. i was prescribed Coal tar shampoo- ionax T and ITRA tablets. i have completed one course of 20 ITRA tabs. in 3 pulses. and been using Ionax T shampoo. I was advised to use Mometasone Cream on itchy spots.

My questions are as follows
1) If i dont use Ionax T shampoo for 2 days at succession the itching and bumps on head come back.. the bumps hurt also when touched. Should i start using it every day?How long do i need to use Ionax T. do I need to use it for rest of my life now? i have read coal tar could be carcinogenic
2) Is there any other ointment which is convenient may be a lotion or oil which i can apply overnight before I shampoo?
3) I live in Bangalore and the water quality here is pretty bad. I have been forced to take bath with RO water!! what is the alternative. is there some solution to this. like some thing which can be added to water before shampoo?
4) I heard psoriasis can spread to other parts of body over period of time. I am worried. pls offer advise on all 4 questions. Thanks.
Fri, 19 Apr 2013 in Skin Hair and Nails
Answered by Dr. Kalpana Pathak 7 hours later
Thanks for writing to us.
Firstly I want you to understand three terms
Seborrhoea- increased sebum or oil production
Seborrheic dermatitis- it is a type of eczematous skin condition, characterised by itchy red bumps with greasy scales seen usually over scalp, eyelids, nasal folds, behind ears, chest upper back and flexural sites or skin creases
Psoriasis- seen as red elevated lesions covered by thick silvery scales seen over scalp, chest, lower back, knees, elbows etc

From the treatment prescribed, I do not think you have psoriasis. Your dermatologist prescribed
Itraconazole- antifungal drug
Ionax t shampoo containing salicylic acid and coal tar. Salicylic acid has keratolytic effect. Coal tar has anti itch, keratolytic effects and prevents proliferation of skin cells( keratinocytes) thus preventing cells
Mometasone cream- steroid cream.

It seems you have seborrheic dermatitis.
I would suggest
1) do not use ionax t instead use nizoral shampoo alternating it with sebowash shampoo. It would give better results. Once dandruff , red bumps are controlled use nizoral only two days in a week
2) you can use mometasone lotion once in a day over red bumps
3) I do not think you can add anything to water to improve quality.
4) psoriasis and seborrheic dermatitis can involve whole body but it is not necessary always. You just need to keep a watchful eye.

Hope I have answered your query. Should there be more feel free to write back.
Dr kalpana
Above answer was peer-reviewed by
Follow-up: Have seborrhea. Using Ionax t shampoo and mometasone cream. Any permanent cure? 1 hour later
Thanks for your reply.
I was using ketoconozole shampoo 2% for almost 6 months thinking my condition is dandruff and earlier it used to work. when it stopped working i saw a doctor.
I also consulted another doctor who advised me sebo wash and shampoo 8X after wards ( similar to your advise but instead of ketoconozole he advised 8X shampoo) earlier. However I have not tried Sebowash+ Keto/8x treatment yet.

My 4 follow up questions
1) Would you still advise Sebowash + Ketoconozole given keto had stopped working earlier.i mean the scales didnt go only after washing also.
2) mometosone is a cream and slightly inconvenient to apply. does it come in lotion form also? What is topisol 3%/6% and CT Oil? read these on internet- overnight application was advised there
3) i will watch out for further damage in the mean time can you advise me a routine which maximises my chances of avoiding the dreaded Psoriasis or Sebo-Psoriasis on skin other than scalp?
4) my love bite- hickey XXXXXXX on left cheek is still there. it has become slightly lighter but is visible specially from a looks like one of those birth marks which kids have on their back or bum!! I wanted a second opinion on use of melalite on the area?
Answered by Dr. Kalpana Pathak 17 hours later
Firstly, i would like to comment on your previous query( bruising or love bite)
Bruise undergo a pattern of color change while healing ie initially they are red then bluish purple then green then yellowish then become light brown to disappear. These usually disappear in 2 weeks time. If in case your bruise has not healed even after two weeks time, you may follow the treatment option I had suggested earlier.

Now to answer your follow up questions
The response to antidandruff medicines will only be satisfactory provided you have seborrhoeic dermatitis. Hence a confirmation of diagnosis is necessary. Nevertheless, if you feel that you do not get response with ketoconazole, then use sebowash alternating with salisia KT shampoo. Salisia KT contains ketoconazole with salicylic acid and would give good response. Make it a point to apply these shampoos atleast for five minutes then rinse.

Mometasone is available in lotion form(cutizone lotion, momate lotion) Topisal is a steroid salicylic acid lotion and can be used in severe dandruff or psoriasis. CT oil is coal tar oil. Personally I do not prefer CT oil application.

Sometimes the disease is mild and localised so do not stress your self that it will spread. As such there is no prophylactic therapy for psoriasis or sebopsoriasis prevention. However use of a mild soap like cetaphil soap bar and a good moisturising lotion like venusia lotion is advocated.

Hope that helps.
Above answer was peer-reviewed by
Follow-up: Have seborrhea. Using Ionax t shampoo and mometasone cream. Any permanent cure? 2 days later
Hi thanks for clarification. I am enclosing a picture of some shiny spots on my abdomen and arm. i think i have had them for some time now. they are shiny and silver before applying moisturizer on them. spot no 1 and spot 4.
spot 2 and spot 3 is just dark spot. what are these do i need to worry about them? they dont hurt or anything. i have some more such spots on right side of abdomen also. all of them are like an island of shiny skin with some flat red coloured pimples in them.
Answered by Dr. Kalpana Pathak 21 hours later
Unfortunately the images attached are not of clear resolution. Kindly attach images of all the lesions in clear resolution. Skin lesions of psoriasis can present as small red bumps or plaques covered with silvery scales while seb. Dermatitis presents as red bumps with greasy scales. Clear images would help in ascertaining the diagnosis. Brown lesions if of recent onset could be post inflammatory hyperpigmentation.
All of these lesions would respond to topical steroids.
Take care.
Above answer was peer-reviewed by
Follow-up: Have seborrhea. Using Ionax t shampoo and mometasone cream. Any permanent cure? 2 days later
Answered by Dr. Kalpana Pathak 23 hours later
The lesion over your abdomen and arms probably looks like a psoriasiform lesion. I would like to know if the brown lesions were red earlier that healed with brownish pigmentation.
To treat these lesions apply a steroid cream like mometasone twice in a day. Also if possible get these lesions examined by a dermatologist near by.

Hope that helps. Take care.
Above answer was peer-reviewed by
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