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Suggest Treatment For Scalp Infection

Posted on Wed, 25 May 2016

Question: My 21 year old son has had a scalp infection for one year. I would ljek to ask a question to a deematologist and possibly an infectious disease specialist. My son has been on antibiotics (minocycline) for most of the past year. He finally stopped taking them and pustules began to form within three days. He uses head and shoulders shampoo and doesnt have oily hair or skin. Im wondering why the doctor doesnt culture the area to find out what is going on. Why cant he take a short course of antibiotics to resolve this? It seems like a bad idea to take antibiotics for so long. Thank you!

Answered by Dr. Dr. Rahul Kumar (1 hour later)

Brief Answer:
Photograph required

Detailed Answer:
Hello
Thanks for the query.
Probably he has developed recurrent folliculitis.
Can you please upload a photograph of the involved area.
This will help me in giving a closer diagnosis and I will be able to answer your questions better.
Waiting for your response.
Thank you.

Above answer was peer-reviewed by : Dr. Sonia Raina

Follow up: Dr. Dr. Rahul Kumar (45 hours later)

Here some pictures. He is currently taking minocycline. (4 months). He ran out and didn't take it for 3 days and it quickly came back. He has thinning hair from orevious outbreaks. It is beginning to clear because he resumed the antibiotic 5 days ago.

Answered by Dr. Dr. Rahul Kumar (11 hours later)

Brief Answer:
Seborrhea

Detailed Answer:
Hello
Thanks for the follow up.
I can see lot of redness on his scalp.
It's probably due to itch.
He is having seborrhea of scalp.
I treat such cases with a mild topical steroid lotion like flucinolone to be applied daily in night and wash scalp with an antifungal shampoo like ketoconazole.
Let me know if you have any other doubts.
Thank you.

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Dr. Rahul Kumar (4 hours later)

He gets white pustules also. They go away when he is on the antibiotics. It isnt itchy but it is very tender to touch. If he stops the entibiotics, this gets worse wuickly. Do you still have the same opinion? Thank you

Answered by Dr. Dr. Rahul Kumar (18 hours later)

Brief Answer:
Folliculitis

Detailed Answer:
Hello
Thanks for the follow up.
Yes, Scalp folliculitis is usually fungal in nature to start with which gets secondarily infected with bacteria.
Give him a course of antibiotics for a week and then follow the advice given by me.
This should be helpful in long term.
Let me know if you have any other doubts.
Thank you.

Above answer was peer-reviewed by : Dr. Deepak

Follow up: Dr. Dr. Rahul Kumar (3 hours later)

Thank you! Can I buy these lotions and shampoos over the counter? What strength and how often and long should he use them? Thank you!

Answered by Dr. Dr. Rahul Kumar (25 hours later)

Brief Answer:
Available over the counter

Detailed Answer:
Hello
Yes these are usually available over the counter.
You can buy flucinolone 0.5 % and ketoconazole 2% shampoo.
The shampoos are to be used on alternate days.
Let me know if you have any other doubts.
Thank you.

Above answer was peer-reviewed by : Dr. Naveen Kumar

Follow up: Dr. Dr. Rahul Kumar (2 days later)

Thank you very much! The scalp is much better already! How long should he use the shampoo and the flucinolone for?

Answered by Dr. Dr. Rahul Kumar (17 hours later)

Brief Answer:
Use for 6 months

Detailed Answer:
Hello
Continue the medication for at least a month.
After this flucinolone is to be used once in 15 days and ketoconazole twice a week for 6 months.
Let me know if you have any other doubts.
Thank you

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. Prasad