Scalp irritation on Accutane.

Hi.

I started 20mg, daily, of Accutane 18 days ago, and 9 days in to the treatment I started developing a tender to touch scalp which is also rather itchy. There's no flaking for some reason, which appears to rule out severe dandruff (unless the early stages don't present flakes). I tried using Head And Shoulders shampoo, which only seemed to escalate the burning.

I am VERY concerned about the possibility of hair loss on this medication and I was wondering if this was a precursor to it? Could my follicles be being damaged as we speak? I've noticed no extra hair loss during the inflammation, but is it a risk for the future?

I've read your responses to many re: hair loss and Accutane and you seem to be very sceptical about the link. However, the wealth of information on the internet from those who've experienced devastating side effects is scary.

I have body acne only, nothing on my face, and although it makes me unhappy, hair loss would be even worse as it's viewable to the outside world. Should I discontinue the treatment based on my current side effects?

Many thanks for a very anxious guy.
Alex.

[Alan Rockoff, MD]

I don't think that the inflammation is caused by Accutane, since I rarely if ever see it in my Accutane patients, and scalp inflammation is common on its own.  Second, even people with severe scalp psoriasis and similar conditions don't lose their hair permanently from it.  Third, I remain skeptical of the Accutane-hair loss connection; it must be awfully uncommon if I've never seen a case in 23 years.  Remember that people who post on the internet like to highlight what's alarming....

Ask your doctor for a treatment shampoo or solution for your scalp.  And try not to scratch.

Best.

Dr. Rockoff