Itchy, flaky (but not your garden variety) scalp

I have a problem with an extremely itchy and flaky scalp...  I went to a doctor a while back and he just off the wall diagnosed me with Seb. Dermatitis (checking his palm pilot rather than my scalp).  He gave me a prescription version of Selsun but it actually made it worse.  I've tried H&S and Pert and T-gel and Aspirin in my shampoo and pretty much anything else you can think of, and all it does is sting like nobody's business in the shower and make it worse.

What happens is that I take a shower, wash my hair, and 7-8 hours later my scalp starts to ooze and itch horribly.  A few hours later the 'ooze' hardens and looks like amber crystals all over my scalp.  Then the next day the flaking begins - huge flakes 1/8"-1/4" that look like cross-sections of something from biology class for the microscope lab.  This also spread to my forehead and my eyebrows, my earlobes, and even inside my ears.

I also suffer from palmoplantar eczema, but I have never heard of there existing a connection between that problem and the scalp.

Any suggestions as to diagnosis and/or treatment would be more than appreciated. (also any treatment discovered for the palmoplantar eczema!)  Thank you all and merry Christmas!

[Bhupinder Kaur, MD]

Hello,
It can be due to dandruff which can be due to internal or external causes. Internal causes include hormonal imbalance, poor health, poor hygiene, allergic hypersensitivity, lack of rest, emotional stress, excessive consumption of sugar, fat or starch and heredity predisposition.
External causes include excessive use of hair sprays and gels, fungal infections, improper use of hair-coloring products, cold weather and dry indoor heating, infrequent shampooing of the hair or inadequate rinsing of the scalp and hair. Eat a healthy diet. You can also take vit B6 and vit A and E which are good for hair and skin. Try medicated shampoos for dandruff. There are a number of over-the-counter shampoos available that can help. The most effective ingredients -- antimicrobials -- to look for are zinc pyridinethione, selenium sulfide, sulfur and ketoconazole (also available by prescription). If your hair is colored, don't use products with selenium sulfide or sulfur.

If the symptoms persist please consult a trichologist for the confirmatory diagnosis and treatment. Seborrheic dermatitis and eczema also need to be ruled out. 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. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.