Is it psoriasis if coal tar shampoo doesn't work?

For a couple years now I've had fairly bad flakes--as in they never let up all day long. They are particularly numerous whenever my hair is dry after I washed it. I cut my own hair with clippers and keep it very short year-round, 1/8" -1/4", so the flakes were never a problem, it seemed. No itching, no excessive amounts of it, etc.. I would try moisturizing shampoos, which wouldn't work; so I'd try dandruff shampoos, which also didn't work. But I wasn't too interested in figuring out a solution.

But in the last 6-9 mos., it's gotten worse. It never stops now, as I mentioned above. In addition, I have to rashes on my forehead now, and it seems their appearance coincided with the dry skin becoming a problem. Still, nothing is terribly itchy, certainly not routinely so. The rashes aren't crusty, they don't ooze, and they're not raised or anything. Just a mild red rash, oddly shaped, coming out from the border of scalp. So unnoticeable are they that my very nosey relatives haven't even mentioned it.

The rashes and the increasingly annoying dry scalp led me to try coal tar shampoo, thinking that I might have psoriasis or something that warranted a more special treatment. Well, not even coal tar shampoo has done anything. I still have a lot of flakes everyday I use it.

So, any ideas on what I could do to figure out what the problem is, and how to treat it? I used to think maybe I wasn't rinsing my hair thoroughly enough, so I started rinsing longer. I thought maybe I washed too much, so I washed less frequently; then I thought not washing enough, so more frequently. A lot of layman work I've done, but I haven't gone to the doctor.

I'd welcome the guesses, suggestions, etc. of anyone.

Best,
AM

PS. I just realized that my username is somewhat misleading. My head is not really that itchy, or at all.

[Bhupinder Kaur, MD]

Hello,
One such possibility that presents with such symptoms is seborrheic dermatitis or adult cradle cap. It is usually caused by overgrowth of Malassezia furfur. This skin disease commonly affects adolescents and young adults, especially in warm and humid climates and is aggravated by sweating and humidity.

You can treat flaking and dryness with over-the-counter dandruff or medicated shampoos. Shampoo the hair vigorously and frequently (preferably daily). Active ingredients in these shampoos include salicylic acid, coal tar, zinc, resorcin, ketoconazole, or selenium.

If the symptoms persist, then it would be best to get it confirmed from a dermatologist. It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided. For exact diagnosis, you are requested to consult your dermatologist. Treatment can be started only when the diagnosis is confirmed. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.

[kumars26]

This is a psoriasis.There in definite treatment and cure of this problem.you must continue with coaltar shampoo and some lotion like Elomet etc are available which may use in scalp two times in a day with consultation of yr doctor.This will help in control the problem.take care

[kimber69]

I've had this problem for about 6 months now, the dandraff the tight tingly feeling around my head, almost hurt's.  I went to a dermatologist in Dec, she said it was psoriasis & she gave me a perscription for calcipotriol and betamethasone gel.  I use it every other night & wash it out in the morning it works well for me the itching, dandraff & tight tingle feeling stays away if i use it ever other day.  I just started using it days before christmas & within a few days of starting I notice a great different in the way my head felt.  Hope this helps.