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Dr. Andrew Rynne

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How can scaly plaques over the scalp be treated?

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Dr. Vasudha Jayant Athavale

General & Family Physician

Practicing since :1970

Answered : 7093 Questions

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Posted on Wed, 21 Jun 2017 in General Health
Question: Dr. XXXXXXX XXXXXXX Athavale ,
yes and i have followed your instructions and i think you are right. I have used a coal tar shampoo, used the vinegar, and got a clarifying shampoo. i still haven't got through all the plaque on my head. There are lots of time i stand in the shower and wash it 3 times in a row with the clarifying shampoo. I letit sit on my head 5-10 minutes at a time. I know its working cause my hair will feel super sticky. The 3rd time i wash it I just do the bottom of my hair to get rid of all the sticky stuff. When i comb out my hair all kinds of crap falls out. Sometimes its a white pasty substance, sometimes orange, red, even black. It's not always soft and plyable sometimes hard as a rock.Any other suggestions? O and when i continually run my hands through my hair in one spot i can feel and see the white stuff come off and it is moist to yhe point of making the strands of hair wet and sticky.
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Answered by Dr. Vasudha Jayant Athavale 9 hours later
Brief Answer:
suggesting few more options- to be approved by treating dermatologist.

Detailed Answer:
Hi XXXX,
Thanks for the query. I understand your concern.
As I had mentioned before.. the symptoms you have are of Seborrhic dermatitis.It's a chronic inflammatory condition of skin .. with flareups of symptoms in between. So it's a long running condition & needs to be managed well during flareups & also in between.
Mostly local treatment with medical shampoos, cremes & lotions are sufficient to manage the condition .. as described in detail earlier. But when it is not controlled with it, following additions need to be considered & added to the treatment plan as per need.
-Anti histaminic drugs- Given with local anti fungal shampoos/ cremes, these help in controlling itching
- Keratolytic drugs like urea can be added.. specially when the scabs get hard like rock ( as you describe it )
-Anti androgenic agents-Excessive secretions of sebaceous glands is characteristic of predominance of male hormones ( as is seen in case of poly cystic ovarian disease in women)Based on this fact after hormonal assessment - anti androgenic agents( like Spirinolactone ) are given to improve the condition in few months.
- Immuno suppressant tropical creme can help to resolve the condition
- Photo therapy- With specific ultra violate rays helps in inhibiting fungal growth.
* Please understand the suggested treatment additions need to be approved by the treating dermatologist so as to suit your personal needs . So I would suggest to discuss them with your doctor .. before using .
Though management of the problem needs lot of patience & persistence.. a determined & positive approach & expert dermatologist's guidance would definitely help.
I hope you find the query helpful & informative. Any more information you need , please feel free to ask. I would like to help.
Thanks.
Above answer was peer-reviewed by : Dr. Prasad
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