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Suggest treatment for flaky scalp non responding to antifungals

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Posted on Fri, 18 Jul 2014
Question: i have flaky scalp, ear and eyebrows. itching causes redness and sometimes blood. do i have seborrheic dermatitis ? i tried nizoral shampoo but didnt work. Should i prefer oral medicines than tropical solutions ? please tell me which tablet to take. I am fed up with this. always itching and embarrassment. All doctors have diagnosed an infection but none said a proper name. Some one even told psoriasis but its not as bad as that. But itching and flaked are a lot. even in ears and eyebrows.
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Answered by Dr. R.G. Joshi (45 minutes later)
Brief Answer:
steroid lotion will help.

Detailed Answer:
Hello,Thanks for writing to health care magic.I can understand your concern.

Scaly lesions not responding to antifungals can point towards psoriasis.However there is one more condition known as sebopsorais which have features of both seborroheic dermatitis and scalp psorasis.Many cases of scalp psoriasis can convert in to psoraisis.

Topical steroids are always required in such cases.Clobetasol lotions such as clonate lotions applied twice daily will reduce itching and scaliness. It will always be better to use steroid lotions as and when required and for short period only.This will prevent side effects with steroids.

A combination of ketconazole and salycylic acid will work better.This is available as a brand name of salisia kt.Use it regularly twice in a week.Once scaling is reduced then you can shift over plane ketoconazole shampoo.

In my opinion no oral medication is required in these cases.

Hope this will help you.In case of any concern I will be happy to help you.Take care.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. R.G. Joshi (20 minutes later)
Thank you doctor. please let me know Salisia-KT is available under which names ? just saying ketoconazole 2% and salicylic acid will do ?

Also the condition of my scalp is bad. There are Flakes all around and its always itching. Same is the case with eyebrows and inner lining of ears. Should i apply the solution to all the places ? Please also suggest how to apply this solution. ie with warm or normal water, and should it be used as a shampoo or just lotion and the duration for which it has to be applied. Also should i get my head shaved to let it absorb properly or apply in the roots of the hair will do ?

Also i need only Salisia-KT or clobetasol solution also ? if yes please suggest me the exact names by which two drugs are identified by the bengaluru Pharmacy guys.


Thanks
doctor
Answered by Dr. R.G. Joshi (21 hours later)
Brief Answer:
clonate lotion,keraglo ad shmpoo.

Detailed Answer:
Hello,

As you are suffering from severe itching and scales first you need to apply only steroid lotion.Clonate lotion (from h&h pharma) has excellent results.Apply it two to three times daily.

Antifungal shampoos are used to prevent relapse.Instead of salisia kt ,I will try you to go for keraglo ad shampoo.Use it as a regular shampoo.Use this twice in a week.

It will be better if you avoid harsh soaps and hot water.You can also take oral cetrizine tablets in case there is severe itching.

All these medications are available in medical stores by these names only.

Hope this will help you.Take care.
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
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Answered by
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Dr. R.G. Joshi

Dermatologist

Practicing since :2003

Answered : 733 Questions

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Suggest treatment for flaky scalp non responding to antifungals

Brief Answer: steroid lotion will help. Detailed Answer: Hello,Thanks for writing to health care magic.I can understand your concern. Scaly lesions not responding to antifungals can point towards psoriasis.However there is one more condition known as sebopsorais which have features of both seborroheic dermatitis and scalp psorasis.Many cases of scalp psoriasis can convert in to psoraisis. Topical steroids are always required in such cases.Clobetasol lotions such as clonate lotions applied twice daily will reduce itching and scaliness. It will always be better to use steroid lotions as and when required and for short period only.This will prevent side effects with steroids. A combination of ketconazole and salycylic acid will work better.This is available as a brand name of salisia kt.Use it regularly twice in a week.Once scaling is reduced then you can shift over plane ketoconazole shampoo. In my opinion no oral medication is required in these cases. Hope this will help you.In case of any concern I will be happy to help you.Take care.