Please help me, what is wrong with my head (pictures attached)?!

[Helpmyheadplease]

Posted before a while ago but it’s back unfortunately so trying again for help.

I’ve got some kind of eczema flare up/dry skin on my scalp. It’s open, weepy and looks like big patches of raw skin. Sort of like when you would fall and skin your knee when you were a kid and it looked all wet and gunky. Sometimes it goes all scabby but the skin falls off and leaves the big open wound, then the skin scabs over again and falls off and leaves a big open wound again. It’s in this vicious cycle and started 2 years ago.

It was all over my head and on my face and inside my ears at one point, but now that’s all cleared up apart from a big stubborn patch at the back of my head.

I’ve been to the GP and they’ve been really helpful about it and referred me to dermatology at the start of 2021 but in the meantime we’ve tried everything- lots of different steroid creams, antibiotics (it was infected with staph at one point), antifungal creams/washes/shampoos. The most effective thing so far was antifungal tablets, I took them for 2 weeks and it completely disappeared for a good while. Then I woke up one day and it was back again on the same place in my head. I was going to phone back for more fungal tablets but I didn’t want to be annoying and be thaaaat person that keeps calling the doctor and being annoying so I just left it until the dermatology referral came through, which thankfully it has and I’m going in a few weeks.

It’s very itchy and painful But I m not picking it, and I wore white gloves during the night to see if I was scratching it accidentally when I sleep and I’m definitely not.

Does anyone know what will happen at the appointment? I’ve never seen a dermatologist before, I don’t even know what this is (I’m guessing eczema?) and my skin was fine before all this started. Does anyone know what they’ll do to fix it? The antifungal tablets have been the most effective thing so far, but even then it just came back. I’m starting to get worried that nothing will make it go away for good.

I’m so sick of the back of my head being a big wet and crusty mess😩 brushing nevermind washing my hair is agony, I can’t ponytail it without it being really obvious, I can’t even lie on my pillow at night because it hurts so much and when I do my head sticks to it with all the gunk.

I have psoriasis and it doesn't look like that - it's dry and flaky, not wet. Though there are different kinds of psoriasis.

Mine gets very weepy, oozes and bleeds if I pick at the scales, but I am not sure it's psoriasis either.

Looks like a kerion (abscess caused by fungal infection). Needs a 6-8 week course of oral antifungals

I've had psoriasis all my life and it definitely doesn't look like it , nor has mine ever responded to anti fungal cream. Has the gp tried you on a course of oral steroids along side the anti fungal cream?

Oooof that looks painful:/ my partner has psoriasis that ebbs and flows with the season/stress/diet and his scalp gets weepy and raw like this. I hate to say that because it’s an autoimmune disease there is no “cure” but lifestyle changes and treatments from the GP (I’ve explored so many for him, avoid steroids!!) can make a difference. Good luck!

I also have scalp psoriasis which extends to the back of my ears and inside too. Although my scalp doesn’t get quite this bad, my ears do, and it took years to get it diagnosed (I more or less self diagnosed in the end but derm doc agreed). I have beta methasone scalp lotion which works miracles. I suspect the antifungals cleared it coincidentally, mine is much worse when I’m stressed. I have to be strict to not scratch and pick at it.

OP I suffer from something very similar where my scalp constantly scabs up and oozes(will be scabby but start to ooze if there's any pressure on it such as lying on a pillow)as a secondary symptom of my eczema. I also frequently have staph infections.

Have you tried any steroidal treatments? I find that steroids ointments are most effective for me but my new GP is so reluctant in prescribing them for me so I just kind of trudge on with it now even though it makes me so self conscious and means I have to wash my hair every single night. I use Alphosyl shampoo which I found to be more effective than normal coal tar like Capasal as it's 5%.

Just a guess but perhaps you caught the same thing back from your pillow after it cleared up the first time? Could be worth buying a new pillow when it's cleared up again.

@tulips27 it's something i've been dealing with on and off for years now, it's not always associated with a staph infection. i wash my pillows nightly as well. it just happens as part of a secondary symptom of eczema.

Yeah I’m definitely not picking it, I have really really short nails anyway so physically can’t (even though I wish I could, it’s become so itchy recently and I’d loooove to give it a proper scratch). I’m definitely not though. I wasn’t sure if maybe I was rubbing it when I was sleeping so I wore white gloves during the night and in the morning they were completely clear so I don’t think I’m even touching it when I’m sleeping.

it’s either really crusty and scabby or it’s like a big wet patch, almost like a burn. I’m glad it’s not on my face or in my ears anymore but I don’t know why it won’t budge from my scalp 😩

I have nothing to add except sympathy. It looks really sore. Hope you get it sorted ASAP 💐

You poor thing! It looks so very painful. Can I ask if your hair has been greasier or drier than normal? (Even before this started…) I would be suspicious of seborrheic dermatitis. Do you have painful, pimply (almost) bumps? Even in your eyebrows? It’s closely linked to rosacea too. You may require treatment with Nizoral 2.5% shampoo and maybe even something like prescription spironolactone to balance your hormone levels and reduce oil.

People have mentioned a kerion. Might it have been caused by ringworm?

I'm not a medical professional but I think anti fungal medication, as pps have said.

It does look a little like a kerion, and the hair is sparse in that area. It may not be of course!

Has it got worse since the weather warmed up? You may well have a constant low level fungal infection present and ot has just gone crazy in the damp sweaty environment caused by the hot wrather.
Get your gp to put you back on antifungals. Ask about a topical antifungal lotion or shampoo too. In the meantime put on some canasten several times a day, you can also buy an antifungal shampoo from the pharmacy called nizoral (its for seborrhoeic dermatitis) which might help. Do see your gp sooner rather than later to avoid nasty infections.
Do you have any pets? It could possibly be ringworm, again a fungal infection, from them with the same treatment but if it is you might beed to confirm to see if they ned treating too (dr takes a scrape of dry skin to send away-totaly painless ).

I have had a antifungals help when allergic reactions got red and weepy. Basically the underlying reaction allowed the fungal infection to take hold and so the whole thing just snowballed. Treating the secondary infection was essential, but it just kept coming back until we figured out the real problem.

I have no idea what your particular reaction is, but of the anti-fungals helped, CALL YOUR DOCTOR. Skin infections can cause real problems if left untreated.

Yeah I’ve been using antifungal shampoos in the meantime but they aren’t really helping it anymore.

betacap sort of helped it at the start but then that stopped working too😩

When I had covid and was staying in the house I tried just not putting anything on it and tieing my hair up and not washing my hair or getting it wet at all, just to let it breath and see if it heals on its own but it just got worse.

in the photos, both patches look like a weird C shape but they’re not, they’re actually just big round/oval patches, they just look a bit like a C because of how I’ve pulled my hair out the way. It’s definitely spreading and getting bigger, obviously I can’t draw round it because it’s in my head but I got my mum to measure it and it’s getting bigger again over time.

urghhh i just want it to stop! 😩

Can you afford to go private? It will cost approx 150 for a consultation. I've just had to go privately for a skin lesion.

Yeah I have a dermatology appt in a few weeks thankfully, I’m so desperate for whatever this is to be gone and never come back 😩

Hopeful bump just in case anyone else sees this and has any advice x

I think a lot of the advice has been to go back to your doctor, or call them for more anti fungal tablets, while you're waiting for your dermatologist appointment.

Are you stressed?

I’ve suffered very bad stress (ie trauma) and I used to get sores all over my scalp. Horrible.

since I’ve been less stressed I haven’t had them - I do still get occasion flare up’s of psoriasis on elbows but not on my scalp anymore!

Poor you, that looks very inflamed. I would stop using any steroid treatments because if there is a fungal infection things like beta cap can make them worse. You really should go back to the GP but if you really want to avoid that you could try Daktacourt on it. Make sure you're changing your pillow cases very regularly and washing at a high temperature and when you're washing with your (hopefully anti fungal) shampoo leave it on a good 15 minutes or as long as you can before rinsing.

The advice is to go back to your GP. Say the anti fungal tablets were effective but it came back. Ask if it could be a Kerion and that you understand if it is you'll need a 6-8 week course of anti-fungals. I wouldn't wait for the derm appt that looks awful and must be very sore.