Itchy Red Bumps on Scalp

[alexander16]

1.5 years ago I started having itchy and painful bumps on my scalp. Mostly on the back side of my scalp. I received antibiotic treatment and they went away. 6 months later they came back. I received antibiotic treatment again. They went away. This past summer they returned. I waited for them to go away. They did not. The severity varied until December of 2008. I went to the doctor and he gave me antibacterial shampoo treatment. This has not been helping. The bumps become very dry and flaky after I use the antibacterial shampoo but even with the shampoo treatment new bumps always form. They have become extremely itch and flaky. Persistent on scalp behind head. Two larger bumps have formed on both sides of my head behind the ear. Not sure if they are lymph nodes trying to fight the infection or cysts. What should I do? These bumps are stressing me out A LOT!!!

[Bhupinder Kaur, MD]

Hello,

You can get a culture od the discharge from the bumps or if there is no discharge then blood culture can also be done.However the most confirmatory test is biopsy of the skin.Pls discuss about biopsy and get it done from your dermatologist.
Hope it helps.Take care and pls do keep me posted on how you are doing or if you have any additional queries.Kind regards.

[alexander16]

Thank you so much for your response! Greatly appreciated. I'm just so confused because the first dermatologist diagnosed me with folicilitus and gave me an antibiotic treatment that worked only short term. In my second visit i received a strong trial of antibiotics which cured it for a longer period but the problem came back. Then my general doctor diagnosed me with something similar to what you just described. I used an anitbacterial shampoo that didn't really work. My new dermatologist just diagnosed me with dermatitis and gave me treatment of Doxycycline Hyclate 50mg and says she is going to keep me on it for a while. Also that this may become a chronic problem.

How should I interpret the different diagnosis's? Are there any tests I can ask my doctor to run? Thank you again for your time.

[Bhupinder Kaur, MD]

Hello,
I cannot confirm anything without examination,but it can be due to Acne keloidalis nuchae.It occurs when hairs on the back of the head and neck grow into the skin, become inflamed, and cause scar tissue. These ingrown hairs usually occur following a short haircut on the back of the head and nape of the neck.

Treatment of AKN includes suppression of the inflammation with antibiotics and steroid gels or intralesional steroid injections.So apply antibiotic cream like Neosporin or bactroban.If the symptoms persist then oral antibiotics and steroids may be needed.Pls consult a dermatologist in that case.

Larger bumps of AKN present for a while or if not responding to treatments may need surgical removal.

I hope that helps. Please do keep me posted on how you are doing or if you have any additional queries. Kind regards.