Brief Answer:
Kindly provide certain important points.

Detailed Answer:
Hello,

Welcome and thanks for posting your query to the forum.

I can understand your concern for scalp psoriasis and am quite empathetic for the same.

In view to help you best I request you to kindly provide certain important points :

- Is the scalp psoriasis diagnosed by a proper dermatologist.

- Do you see any red patches on scalp.

- How much is the flaking or scaling on the scalp. Is it mild or moderate or profuse.

- Do you feel itching on the scalp. Is it mild or moderate or severe.

- It would be best if you can elaborate the treatment taken.

Hope to hear soon from your side.

With regards,

Dr Sanjay Kanodia
MD-DERMATOLOGY

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Brief Answer:
Scalp psoriasis : sugggestions and guidance.

Detailed Answer:
Hello,

Welcome again to the forum and thanks for your follow up with important information.

After analyzing your condition best diligence I can make out that you have taken different modes of treatment for the scalp psoriasis and nothing seems to be working well.

Before I guide you the management of the condition let me guide you certain important points regarding your condition: Scientifically and medically our skin is a multiple layered structure. Our skin gets renewed every day.

The layer which is present on the top today will be fallen off tomorrow. It will not be present tomorrow and would be dead skin in form of scales. This process is not actually visible on normally. So we can say we are just one day old from our skin most superficially.

Now, in some persons it is renewed at a faster pace. Our superficial skin is renewed in every 28 days which is known as keratinization. If the process of renewal occurs at fast pace in 4-5 days rather than 28 days it leads to this chronic relapsing condition of psoriasis.

So, it is a keratinization disorder where cell cycle is disturbed and immature skin appears in the form of scales. It has a tendency of recurrence and till now there is no permanent solution for it. It tends to exacerbate in winters every year.

Psoriasis of scalp is a long running condition and needs proper best management in form of maintenance of scalp hygiene to reduce the accumulation of excessive deposition of flakes and scales.

We can not change our own tendency to renew the skin but the personal measures of hygiene of scalp as well as the environmental factors can be modified to reduce the accumulation.

For the remedy part, follow the things below:

1.Wash your scalp daily. I guide my patients to wash twice in a single bath. It means when you are washing your scalp apply first time shampoo for washing the hair part only, then rinse it off immediately with water. Reapply the shampoo again immediately, leave it for around 5 minutes, do a good gentle massage by your fingers for around 2 minutes and then wash it off. You will get good benefit by doing so for around 7 days.

2. Stick to one good shampoo which is suiting your hair, don’t change the shampoos frequently. If the scaling or flaking is too high then you can use any medicated shampoo like fungitar,Ionax-T or Keratol. Once the flaking is reduced tehn you can again shift to simple regular use shampoos.

3. Despite using shampoos if the flaking is not reduced then I prescribe a lotion containing topical steroid and salicylic acid (like Topisal or HH salic) for few days (not beyond 15 days) and then try to maintain with shampoos only.

4. Do not use any kind of hair oil or any oily or creamy stuff any time on your scalp.

5.Comb your hair at least 3-4 times a day and most importantly at night time so that the dust particle and other of dead skin is taken off.

If despite doing above therapy if the condition is not getting better then I prefer to start Methotrexate. It is the mainstay of the therapy but has its own blood and liver related side effects. It is always to be taken under dermatological advise other wise can cause side effects.

Other than this in the latest of the therapy I also suggest my patients for certain specialized combs which emits ultra violet radiations. It is home based treatment and patient can use it by his/her own. These combs have shown to give very good improvement in scalp psoriasis. You can discuss all these options with your dermatologist.

Psoriasis of scalp is though long running condition but is quite simple of the condition also provided if managed properly and regularly so do not worry about the same.

I hope this information will help you. I will be glad to answer any further of your queries.

Wish you good health and happy new year.

Regards,
Dr Sanjay Kumar Kanodia
MD (Dermatology)

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Brief Answer:
Scalp psoriasis & Seborrheic dermatitis: various differences and guidance.

Detailed Answer:
Hello young fellow,

Welcome again to the forum and thanks for your further follow up.
Scalp psoriasis & Seborrheic dermatitis: various differences and guidance.
It si quite common to find a close proximity between the two conditions of psoriasis & Seborrheic dermatitis of scalp and the two conditions are very much confused with one another.

Regarding Seborrheic dermatitis of the scalp: It is also a condition where there occurs accumulation of dead skin on the surface and causes mild to moderate flaking. But it is less severe than psoriasis of scalp.

Let me give you a brief idea between the two:

In Scalp psoriasis we find red skin covered with flakes and silvery scales and the patchy silvery scales or thick crust on the scalp may bleed when removed. Also the patches many a times extend beyond hairline or appear on other parts of the body.

In Seborrheic dermatitis of the scalp there is less red skin covered with greasy-looking white or yellowish scales and the patchy scales or crust on the scalp are easily removed.

Scalp psoriasis is often persistent and more difficult to treat than is seborrheic dermatitis of the scalp. There is also winter exacerbation of scalp psoriasis more than that so in Seborrheic dermatitis.

So it is basically the clinicians experience and way of proper examination which can actually differentiate the two entities. Even then I request you to click few good resolution pictures of the scalp area, parting away the hair so that the skin should be visible in the pictures so that I can make an idea regarding the probable condition.

For that you have a feature on the right side of the page. Or else you can send your pictures at

YYYY@YYYY

With attention " Dr. Sanjay XXXXXXX Kanodia "
Anyhow, the way of treatment is almost the same in the two conditions except for the part of difference between some oral treatments.

Regarding your treatment part given: I tried my best to find out he contents of the three tablets but was able to find only of skomyce-500. It is azithromycin antibiotic and is given if you have any infection on any area. So do let me know if you have any pus filled thing or any infection.

Regarding rest of the part of Isina-20, mobino-10, I was not able to find the contents because of regional variation of the name of the tablets. I would be highly obliged if you can go through the contents of the two tablets and revert back to me.

Eating non-vegetarian food does not cause any exacerbation of the two conditions. But sometimes if is more spicy then can cause more pronounced itching in some individuals.

I hope this information will help you. I will be glad to answer any further of your queries.

Wish you good health and happy new year.

Regards,
Dr Sanjay XXXXXXX Kanodia
MD (Dermatology)

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Brief Answer:
Have not been able to find the pictures. Kindly resend the same.

Detailed Answer:
Hello young fellow,

Welcome again to the forum and thanks for your further follow up.

As per your description it appears to be seborrheic dermatitis rather than scalp psoriasis. But not able to deduce anything without pictures.

I was waiting a long to get the pictures uploaded but have not been able to find the same. I request you to either resend the pictures or can talk to the customer care to upload the pictures. For that you have a feature on the right side of the page. Or else you can send your pictures at

YYYY@YYYY

With attention " Dr. Sanjay XXXXXXX Kanodia "

Hope to hear soon from your side.

Regards,
Dr Sanjay XXXXXXX Kanodia
MD (Dermatology)

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