Avatar universal

Inflamed, itchy, red skin on scalp

Looking for some advice on this nagging condition, please. I am a male and 29 years old. For the last 7-8 months I've noticed several areas of my scalp to be noticeably red and inflamed. This is affecting my crown, some parts of my sides, and also some areas above my nape. I do get random bouts of itchiness from these areas. The red areas are not flaky or raised, just noticeably red and itchy. This does not affect my entire scalp, but only specific areas mentioned above. I do notice my hair is thinner in these red patches which is very disconcerting.

I've consulted with a dermatologist and I was told it's likely seborrheic dematitis. I was given a topical solution, Clobetasol, and also capsules of Mimocycline. I've consistently used both and have had no improvement to my scalps health.

I have also tried dozens of shampoos: Tgel coal tar, tsal, Nizarol, etc. None of these have helped me any. I've also attempted herbal remedies such as apple cider vinegar washes. I've tried washing more and less as well as using and not using conditioners. No change ups seem to alter the condition.

I have never had this scalp condition in the past, and it only came about after a very stressful time in my life.

Please let me know if you have any other suggestions to try or what I can do to get this resolved.
2 Responses
Avatar universal
Ask for a biopsy. Seb dermatitis should respond to clobetasol. You may have scalp psoriasis instead.
Avatar universal
*link to photos provided below

Jake, thank you for the response. My condition seemed to have calmed down some and I stopped treating...But things have gotten much worse now.

I've now been to two dermatologists. The first one had me pegged for Seborrheic Dermatitis. I was put on Mimocycline antibacterial pills and given the Clobetasol steroid liquid. Neither really did anything for me. The second dermatologist thought it was more of a fungal case rather than bacterial and considered folliculitis to be the diagnosis. He had me start up a 30 day supply of Fluconazole. I'm 20 days in and not seeing any improvement.

I'm my opinion, I still don't think it's SD because I have no scaling or flaking/dandruff. Just the irritated, red, blotchy skin in the crown, frontal 1/3 and 2/3s of my scalp.

The folliculitis diagnosis makes more sense to me based on my symptoms, and the fact that treatment as SD has done nothing but exacerbate the problem. I see that antibacterial cream like Mupirocin has been used by others. Can anyone comment on its effectiveness for treatment of scalp folliculitis? Any other medical treatment (oral and topical) that would be recommended here?

I have a third opinion at the end of this week. If nothing obvious is suggested or said differently to me, I'm going to request an immediate biopsy to hopefully get a concrete diagnosis. How accurate are biopsies? Will I be certain in knowing once and for all if it's fungal or bacterial?

My scalp and hair quality has continued to degrade due to this condition. It is extremely debilitating and I'm very worried about permanent damage.

Links to pictures of my current scalp are below. Thank you to anyone who can offer further suggestions.

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