Brief Answer: Folliculitis; wash scalp properly; no hair oil Detailed Answer: Hi XXXXXXX Thanks for posting your query to Healthcare Magic. I can understand your concern for skin problem in scalp area. After reading your query with diligence and analyzing the complete condition at its best I can make out that you are suffering from the problem of "Folliculitis" or simply saying boils. To tell you simply - This is a condition of inflammation and infection of the hair root and oil gland attached to it. To explain it medically, we have hair all over our body which have opening of the oil glands attached to it. By many a factors these hair root and oil gland can become inflamed and infected leading to folliculitis. The reason for the inflammation and infection of the area is due to the fact that our body harbor multiple types of bacteria on the skin which are known as “Normal flora” of the skin. A bacteria “Staphylococcus aureus” is also a part of that flora, but as soon as there is some break in the skin or trivially also due to bit ups and downs in immunity, the bacteria gets access into the skin and causes the aforesaid process of inflammation and infection. When it is superficial it heals without any problem, but when it is deep it causes lot of pain and swelling around the area. In general these persist for few days to weeks and heals without any problem. After a period of time our immunity prevents the further formation and inflammation. The main concern is when it is occurring frequently and regularly. There are certain important tips regarding your problem: 1. Do not pinch, pop or even try to touch any of the area of boils. 2. Kindly avoid scratching any area of normal skin also, as it leads to minor entry points for the entry of bacteria. 3. Maintain proper hygiene and take two times daily bath. 4. Avoid any kind of stress, even for this condition also as stress is one of the very important factor playing role in our immunity (making it low) so prone for infections. Yoga, meditations and simple walk do help a lot in improving immunity. 5. For the boils present now, you can do warm saline compresses (1 glass of water and pinch of salt in it) for 2-3 times a day. 6. Wash your scalp daily. You will say you are already doing it. But my way of application is- it is to be done 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. By doing so for around 7 days you will get good benefit. 7.The other way if you can not do two time wash is apply your shampoo ( diluted with water) for around half an hour before bath like an hair oil. And then rest of the second application and bath as told above. 8.Stick to one good shampoo which is suiting your hair, don’t change the shampoos frequently. If you are using any conditioner also then to be used over the strands of hair only and not over the scalp skin. Do not use any kind of hair oil or any oily or creamy stuff any time on your scalp. It actually attract more of dirt and grease over the scalp leading to more proliferation of germs and therefore more boils. 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. Eat a lot of good healthy diet, do mild exercises, reduce your work stress as all these have bit impact on skin so also on scalp skin. If I were your treating dermatologist then would have suggested you to apply plain antibacterial cream such as fusidic acid or mupirocin (latest is retapamulin) and to take pain killer tablet by mouth for reducing the intensity of pain and redness. If these are enlarging and painful, then along with above mentioned measures you would require a course of oral antibiotics (best after culture and sensitivity of pus) under medical advice. If at all you take oral antibiotic, then do take proper dose and full course of antibiotics (as improper dosing and schedule leads to antibiotic resistance and then recurrent nature of the situation). Hope I have answered your query. If you have any further questions, I will be happy to help. Wish you good health. Regards, Dr Sanjay Kumar Kanodia (MD- Dermatology & STD)

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