Desperately need help with my scalp

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I have a long-term problem with my scalp. GP and Dermatologist referral has led to me trying treatments for seborrheic dermatitis as well as fungal things. Nothing has ever noticeably worked. It seems to have a mind of its own and just run in a cycle of flare ups then be better again with no apparent reason.

I've come to accept it's here to stay. However, I'm horrified to realise today that it's now so bad that it's very visible through my hair.

Picture attached.

Big, very stubborn flakes that seem to wrap around hairs so if I ease a flake out a clump of hair comes with it.

I've asked on Mumsnet before but I'm going to ask again in case anyone can suggest anything new.

Please help!

Increasing your intake of omega 3 is shown to be beneficial for reducing eczema. I’d recommend a high dose supplement such as nature’s best

You can buy Dermax on line,I've just googled 😊

Another vote for the PK scalp tonic and itchy flaky scalp shampoo. I’ve been using the shampoo for 8 years. It’s the only thing that helps my poor head

Dd has similar issues, but it's stress related so flares up. She's adult but I find combing with a nit comb is the only answer, she uses a mild paraben free shampoo every other day which keeps it to a minimum but 3-4 times a year the comb comes out eg exams

I think you should consult a trichologist. What were you prescribed by your dermatologist and GP ? And how long did you use the treatment ? I feel for you and hope it clears soon

La Roche-Posay Kerium DS Anti-Dandruff Intensive
Moogoo Shampoo
Green People for Men Itch Away Shampoo

On a rotating basis - using strong products every day only seems to anger mine.
Plus a good quality multivitamin.

Neutragena T Gel shampoo

My son had something very similar-looking to this. All the doctors we saw were baffled by it. It started as a red ring underneath his hair, that slowly turned into a scab. He was only three at the time, so everytime he knocked it, it bled. Eventually we saw a consultant who said it was a severe case of pustular dermatitis. He prescribed Clarelux Mousse for it. This helped almost immediately, but as it treated the dermatitis, it took the scab and hair with it. I hope you find something to help soon.

Are you sure it isn’t scalp psoriasis? I have this (also affects the back of my ears) and the only thing that has helped has been steroid lotion for the scalp. I apply it nightly -when I remember- and it has transformed it. I still get a bit of scale, but much less, and not nearly so irritated either.

I now use a bar shampoo too, it seems better than bottled.

Wow! Tons of responses. Thank you for all the replies.

I want to go through this properly and answer the questions and put a list together of what of these suggestions I've already tried and those I haven't which I can't do tonight but will do tomorrow.

Thanks again everyone. This is stressing me out but I'm feeling more positive now having such a useful response to my post.

Mine was nowhere near as bad as yours but has been so much calmer for ditching silicones.

@Whywonttheyletmeusemyusername - why do you say this? If you have psoriasis, you will know that one solution does not work for everyone.

Coal tar shampoo does NOT get rid of the issue for everyone,

Op, have you seen a gp? That’s the first step. They will refe you to a dermatologist, who will be able to diagnose your problem and suggest some things to help.

I mix the Aldi anti dandruff shampoo with the Body shop Ginger product.

Only have a problem if I don't use them. Hope it works out for you OP.

I use Capasal (coal tar, coconut oil and salicylic acid shampoo) and Betacap too. You can get the GP to prescribe them both if you get free prescriptions, otherwise Capasal shampoo is £7.85 in Superdrug (and cheaper on Ebay). Betacap is a POM.

OP, may I ask how your general health is, particularly your joints?

I absolutely dread the day the Body shop stop selling the Ginger shampoo. I tried everything, absolutely everything and they all either did nothing it made it worse. I've been dandruff free for years now.

However, the minute I wash my hair twice in a row with something else, I get a nasty reminder of how bad my dandruff can be. I also only wash my hair every 3-4 days unless it's particularly greasy/smelly.

Hope it's not too uncomfortable for you OP.

I'll urge you to get your vitamin D checked first of all. Then start using Nizoral shampoo you have to leave it for 15 minutes after you wash with normal shampoo. Wash every couple of days.
Also you can try in between coconut oil and massage your scalp leave it overnight.
You most be so uncomfortable and itchy.

Leave it to work for 15 minutes then rinse.

Thank you all for the suggestions of products to try. Here's a list of the things suggested and whether I've tried them or not:

Haven't tried
body shop ginger shampoo
Philip Kingley’s scalp tonic
Neutrogena TGel with tar ingredient
L'Oréal elvive Phytoclear shampoo- normal and sensitive
Head and shoulders clinical solutions with selenium
Head and shoulders argan range (I have a severe nut allergy, so I'm reluctant to try anything Argan nut derived)
Boots sensitive shampoo
L'Oréal Lo Shampoo
Allergenics
Aspirin (this is an interesting one!)
Miconazole (I have tried other antifungal medicated shampoos)
La Roche-Posay Kerium DS Anti-Dandruff Intensive
Green People for Men Itch Away Shampoo

Tried and didn't seem to work
Cocolis
Oilatum
Nizoral (but I did use this successfully for years for less severe 'dandruff')
Betnovate scalp
Moogoo Shampoo
Dandrazol Shampoo

Tried and seemed to help a bit but not clear it
Capasal
Dermax
Soaking in olive oil then easing the flakes out (but I did this about 6 weeks ago and the regrowth has been so vicious this time)

Things not mentioned above that I've previously tried that haven't worked
Yes to Carrots
Jason shampoo
Neem shampoo
Avalon Organics Tea Tree Scalp shampoo
Bodyshop Rainforest shampoo
Eucerin Shampoo

To answer some of the questions here:

For each medicated shampoo prescribed by the GP I have used it as per the instructions for around 4–6 weeks before stopping if I've noticed no improvement.

I saw a dermatologist in February, when unfortunately I only had a small patch showing, so it wasn't the best use of the appointment. She diagnosed it as Sebhorreic Dermatitis and prescribed Dandrazol (Ketoconazole) shampoo plus a Steroid treatment which I can't remember the name of (it's at home and I'm away this week so I can't check). Neither seemed to work at all. It's the Dandrazol that I've been using these past couple of weeks while its gone from moderately bad to awful.

I've just been to the pharmacy where I'm staying and the strongest thing they could sell me OTC is Alphosyl which is 5% Coal Tar (5 times the amount in Capasal). I'll give that a go. I feel the need to try something heavily medicated as it's so bad, then I will try some of the things suggested here.

I have curly, dry hair. I've been using gentle shampoos and non-silicone conditioners since 2012 (this scalp problem pre-dates that so I don't think the gentle shampoos are the cause). I tend to wash my hair every other day with shampoo (medicated when scalp is bad, a gentle shampoo otherwise), then conditioner. I rinse my hair very very thoroughly as I suspect conditioner won't help my scalp. Then I use boots curl cream but I'm careful not to get this on my scalp.

Info about my health: I am atopic (asthma, eczema, food allergies). My eczema on my body is well controlled by Eucerin 10% Urea lotion and by avoiding wearing synthetic fabrics, avoiding fabric softeners and avoiding certain soaps/shower gels. My asthma is well controlled using Symbicort. I have Ulcerative Colitis but it is currently in remission without medication. I have previously needed immunosuppressants for this but last took them in 2015.

The only time in the past 20 years that my scalp has completely cleared was during pregnancy.

Sorry if I've missed any questions. I've tried to go through everyone's posts and answer questions methodically.

Just realised I forgot to comment on one suggestion which is easing them out with a Nitty Gritty comb. I think this sounds like a good idea when its not quite so bad, probably putting coconut oil on it first as suggested by another poster. At the moment I'm terrified that easing flakes out is going to leave me with a very prominent bald patch.

This might sound silly but how often do you get your hair trimmed? I've had seborrhoeic dermatitis on face and scalp for ages. Dermax gives me some relief, but I've now found that getting my hair trimmed regularly helps as my scalp is worse when I have longer hair making my scalp feel hot.

None of the tar based shampoos worked for me, as they stripped the top surface and made it sore, then it built up again.

I try not to leave my hair wet for too long after washing, as my scalp is again worse if I've left it wet (I think the warm damp conditions cause the scalp to build up).

I have a silicone massager that I use when my scalp feels prickly, rather than touching it with oily fingertips. I also wear a stretchy head scarf at home to stop me from touching it.

I'm really sorry for you as it must be so sore.

I keep my hair fairly short (it's basically the length it appears in the photo - at its longest, just to below my ears).

It has thinned over the years as well.

I do wonder whether I should have a phase of blow-drying it to ensure it's not damp - at least as long as this particularly nasty flare continues.

I rinse my hair very very thoroughly as I suspect conditioner won't help my scalp. Then I use boots curl cream but I'm careful not to get this on my scalp personally,I wouldn't even use that, lots of products irritate my scalp even if I'm careful about just using it on the ends.

Avoid the Head and Shoulders Argan unless you email them and actually check if there's anything nut based in the shampoo- there might not be . I emailed Method about their almond floor cleaner as we have nut allergies in the family and apparently there isn't anything nutty at all!

My husband had awful psoriasis and outside of strong prescriptions he finds this makes a big difference...
uk.lush.com/products/superbalm

You have a few indicators there for psoriasis, OP. I think a re-referral to a dermatologist would be in order.

Psoriasis is an auto-immune condition and notoriously tricky as what suits one patient will not suit another. I have a good dermatologist who helped me navigate a topical lotion regime that worked for me. (I didn't fancy the Vit A or systematic alternatives.)

Anyway, I really think you need to go back to the dermatologist, to get a better diagnosis and treatment plan.

Best of luck.

OP Have you tried Polytar? That’s the only one of those listed that works on me. I put it on and leave it for 15 minutes, then rinse and another go for a few minutes, then rinse and no conditioner.

I’d second using a hairdryer when it’s really bad - damp seems to make it worse.

And finally, for me it’s both diet and stress related (I’m also atopic). Any dietary triggers you can think of and minimise?