Desperately need help with my scalp

[INeedNewShoes]

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!

I also wondered about psoriasis.

Can anyone recommend a dermatologist who practices on the NHS?

Oh yes, definitely dry your hair quickly after washing on a not too hot setting. My scalp doesn't like being left damp at all .

Can anyone recommend a dermatologist who practices on the NHS?

You need to see your GP, and they will refer you to the dematology department of your closest hospital.

Unrivalled - I have already seen my GP more than once about this, who eventually referred me to the dermatology department of my closest hospital. I saw this dermatologist recently and I feel as though I could do with seeing someone different. If anyone here has had a positive experience of a dermatologist helping them specifically with a scalp problem, I would appreciate the recommendation.

I'm in the North West and have seen a dermatologist on NHS and privately. I can recommend depending on where you are?

I've seen a dermatologist about my scalp and face I mean.

OP, fellow scalp psoriasis sufferer here - the easiest/quickest thing to try on your list is T-gel, so I’d go out and get some straight away. Alphosyl is ok, but T-gel better imho.

I’ve been living with it for about 35 years so have tried most prescribed and non-prescribed shampoos and all the stuff suggested here.

You’ll find the T-gel will stop working after a few months, so move onto something else like Alphosyl or Polytar liquid. The same will happen with them, they’ll stop working. The Body Shop ginger stuff doesn’t work at all for me unfortunately.

I’ve been on Phillip Kingsley itchy flaky scalp shampoo for two or three years now and touch wood it’s still working for me. Bloody expensive though.

Get T-gel on it pronto - that’s my verdict.

Sorry OP I have no suggestions but am placemarking because there are lots of good suggestions on here.

I have seborrhoeic dermatitis, it’s such an unpredictable condition and there’s no long term treatment for it. Antifungals don’t always work for me and sometimes my scalp will build a resistance anyway. Also, steroids are not a sustainable option.
The malassezia which supposedly triggers our SD is part of healthy skin flora too and doesn’t cause issues in people with healthy scalps

Usually I would recommend seeing a dermatologist for chronic skin conditions, but the ones I’ve seen privately haven’t been able to help me much. I’ve tried different antifungals, urea, salicylic acid, steroids, and tacrolimus. Selenium sulphide helped me the most but it’s hard to get hold of shampoos which contain it now grr

The condition just hasn’t been widely researched enough in my opinion. I have atopic dermatitis too but at least with that there has been plenty of new and groundbreaking evidence over the past decade

I’m very sorry I couldn’t provide any advice OP but I understand your frustration

I recommended Polytar as well on page 1 and I don't think that you included it in your list that you went through, just mentioning again like PP in case you missed it, as that's my go-to heavy duty shampoo when my scalp eczema is at its worst. Tbh I'm wondering whether weather and stress are playing a particularly significant part for the both of us atm because mine is worse atm than it has been for a few years and just seems to be getting worse, haven't used Polytar for years but may have to ask GP for some soon if it doesn't calm down, the itchy feeling is starting to really bother me at work even and I'm getting self-concscious that people can probably notice me itching it. I do try and tell people I have eczema on my scalp so they don't think I have headlice or something!

There's a variant of T-Gel with salicylic acid which I found good when I was younger and my scalp was really crusty.

Try alohasyl 2 in 1 we had the exact same in our house and worked wonders. Prescription only shampoo

You can buy that on Boots or on line,it looks really good actually,might give it a go.

@INeedNewShoes you poor thing. That looks & sounds horrific

I went through a bad period for a couple of years a long time ago where I had a terrible eczema flare-up, extending into my scalp too & also diagnosed as seborrheic dermatitis.

I had a long road of being recommended coal tar shampoos & the line by my GP at the time. All pointless & with the severity of what you have I'd absolutely avoid at the moment if I were you.

I was under the care of a dermatologist who like yours, prescribed steroid creams of different sorts, some antibiotics, oral & topical when it got infected. It didn't resolve it.

In my case, a locum GP - who I feel forever grateful to - prescribed a strong antibiotic plus anti-fungal tablets. It was amazing. It cleared the initial problem up very significantly & then I could manage with some OTC treatments such as some of those PP have recommended.

In my view, you absolutely need a referral to an engaged & proactive dermatologist. Please revisit your GP to discuss. The current referral obviously hasn't worked at all.

For the moment, I'd avoid all the suggestions for coal-tar & similar, or other OTC treatments. Yours needs more than that. Nitty Gritty comb is an awful idea! You will absolutely destroy your poor sore scalp & yes, as it's so enmeshed in your hair, you'll take lumps out.

It's the underling cause, not the flakes (it's more than flakes I know 😥) that you need to address.

So:

1. Return to GP for referral. List out as you have here, all you have tried. Be clear about severity, including hair loss & thinning.

1. Secure dermatologist referral, hopefully someone with expertise in this & do the same re: previous treatments. You need medicalised treatment to try & clear it up to some extent.

1. Once some progress has been identified you could look at underlying factors eg stress, diet, products used. (For me, the problem persisted for some years but never as bad & I could alleviate by being very pro-active when I saw the start of flare ups)

Although stress, diet, certain products are factors in eczema / skin conditions, they aren't the whole story as some PPs suggested.

I was so low when I had this condition & it wasn't as bad as yours (pretty terrible around my face tho, used to have flakes of skin falling off eg at meetings 🤢) so please be as forceful as you can getting a response.

Best of luck 💐

I tried more or less everything suggested here but the only thing that worked for me was Selsun shampoo.

I suffered for 10 years or more, tried everything you could imagine, but now I use Selsun maybe once every two weeks and ANY shampoo in between and it's fine.

It may not work for you but I didn't notice it on the list.

The Philip Kingsley worked a bit too, not perfectly but somewhat.

I feel your pain, OP, it's awful to live with but there are lots with the same problem.

I also have dry curly hair and was diagnosed with yeast infection on my scalp. My Dermotologist proscribed 'Stieprox' shampoo and Fluconazole
(Same as you can get for thrush)
It really helped- my main symptom was a burning scalp, lots of spots on the scalp and hair thinning

I'd stop using any other products on your hair for now op. They could be inflaming things.

My dd is 14. She has scalp psoriasis and it has at times been as bad as this. Psoriasis is a massively huge complex condition. They still don't know the exact causes. I've had it for 40 years. It annoys me when people say "oh it's stress".

Firstly, as you know you need to try and get different dermatologist.

A pp is right - there is no one cure-all for psoriasis. Especially scalp psoriasis.

Things that have helped dd - out of desperation (and bleeding!) I went on YouTube out of desperation.

Things is, the flakes have built up so much that no matter what you put on it, it will not penetrate to beneath the flakes. Don't just pick off the flakes without loosening them. It will just make it all worse.
On YouTube I came across a method that used Hemp oil (in a similar way to coconut oil). The difference was they heated up the oil before liberally applying it. You need to let it soak in overnight. Wash out with a coal tar shampoo like Capasal or similar. Put the shampoo on your head without wetting to cut through the oil. It may need a few go's. Wait for it to begin to flake off. For flakes as caked as this if will look horrendous (sorry!). Repeat as often as you can.

Currently, my dd does this twice and week. It hasn't cleared the problem but it has helped massively. We're planning on doing it every other day over the summer holidays in order to make more of a change.

These days she doesn't flake as much afterwards and it allows us to use a medication like Betacap on the scalp while it's supple and easy to get to.

Lastly, when she was 6 my dd has a massive flare up of psoriasis. Massive. It covered about 90% of her body. She was sent for UV light treatment at the hospital. This worked wonders for her and the side effect was it cleared her scalp although the uv rays wouldn't have really penetrated. She had a smaller breakout on her body recently. Her dermatologist was prepared to send her again for uv treatment but she decided to hold off (you're safely allowed 480 sessions in a lifetime).

You can't suffer like this OP. There WILL be something that helps you.

You say you have eczema and food allergies. Have you tried cutting out gluten. Prior to being diagnosed as coeliac, I would get flare ups. Since I was diagnosed and stopped eating gluten, it very very rarely happens now. Only when I am Uber stressed and it is very mild when it happens. It was a pleasant side effect of cutting out gluten.

I wondered about diet too. Our skin is the largest organ in our body and if there’s something not right inside the body it will do what it can to get rid of it anywhere it can.

I had a Skype session with a therapist last night and he explained a lot to me about gluten and dairy intolerances long term effect on the body.
We’d already been strictly g and d free for two weeks and he reckoned another three weeks I should feel a lot better.
I’d consulted him about my ibs which was out of control and I felt really ill.

Me and dh both need to take vitabsorb B because gluten intolerance affects your B6 production which is the precursor to making
Our happiness substance..and can be a cause of depression. Oh yes I’ve definitely felt depressed..despite the lovely sunny weather.
Also we need to take Zinc ascorbate together with it. He recommends a company called biocare

We also need to take the herb goldenseal from nature’s answer.
6 drops in water twice a day, building up to twelve drops twice a day to help with the inflammation caused by a build up of bacteria

I know mnetters don’t like homeopathy, so I will leave out those treatments he recommended.

We are also looking at other remedies for the trauma stuff in my life.
It looks very uncomfortable OP. While putting things on it may help I sometimes think we need to look at the whole body and see why it’s not dealing with it.

Precursor to making seratonin
( don’t know why that was removed)

We also need to take the herb goldenseal from nature’s answer

That's a blast from the past,when Ds was 18 months he had a what looked like a fungal infection on his toenail. Doctor said leave it as he was too young for treatment but my homeopath suggested painting on Goldenseal function and it was gone within 2 weeks, it was a miracle worker. I didn't know you could take it internally.

Well I just happened to have a bottle so dh and I started last night and this morning on it.
As things die off if we have a healing crisis we can have a break for a couple of days, take an alternate remedy and then start again
We take this for three weeks.
I would also look into doing a parasite cleanse op
That’s black hulled walnut, wormwood and cloves
Build up with so many drops a day etc
There should be a protocol for it somewhere on the net
My doctor was dead against putting stuff on top of skin irritations. She reckoned it drove it deeper for it to reappear somewhere else or as something else

@Milicentbystander72, your poor dd! How awful for her.

OP, d you have psoriasis anywhere else? I had UV light therapy for mine last yeara dn ti cleared up my scalp as well, which was not expected, but I am so thankful for it.

When you go back to your GP, tell them about your bad experience with the last dermatologist and ask if you can see another one.