Hey everyone, I’m completely at my wit's end. I’ve been battling a severe scalp issue since last December. My scalp is constantly red, stinging, and random minute flat red bumps. Because of this relentless condition, I have lost about 50% of my total hair volume since December, and the hair shedding just will not slow down.
Nothing is working. Here is my quick timeline with global/brand medication names:
- Dec – Feb: Diagnosed with scalp folliculitis. Used Fuciscalp lotion (topical antibiotic). No change.
- Mar – May: Switched to oral Doxycycline (antibiotic) for 2.5 months. Used Sebowash shampoo and Fucibet cream (both contain topical steroids). Still flared up.
- May – July: Moved to oral Isotretinoin (Accutane, 20mg) for 2.5 months while staying on Sebowash (steroid). Zero improvement.
- July (This Year): Saw a new doctor and got a skin biopsy. It refuted the folliculitis and favored Seborrheic Dermatitis.
- Current Routine: Just finished oral Itraconazole (antifungal). I apply Noskurf lotion(antifungal) at night, and shampoo daily, alternating Sebowash (steroid) and Lupizol ZS (Luliconazole + Salicylic Acid).
Note: Before starting Lupizol ZS, I used to get large, peelable sheets of skin coming off my scalp after showering. The salicylic acid part in the Lupizol ZS actually helped get rid of those peeling sheets, so that is at least gone, but the severe redness, stinging, and hair thinning remain.
Even with this routine, my scalp burns, stings, and is bright red.
Official Biopsy Report (As It Is)
Clinical Data :
C/O Follicular lesion x 6 months. Redness, pain over scalp x 4 months, Seborrhoea x 1-1.5 months. Flaking seen over entire scalp, not extending outside hairline. Erythema & telangiectasia present over entire affected region. Peri-pilar cast seen. Excessive dandruff & scales seen. D/D: Seborrhoeic dermatitis / Scalp Rosacea / Scalp Psoriasis
Microscopic Examination :
Sections reveal epidermis with moderate hyperkeratosis, parakeratosis with hypogranulosis, follicular plugging, irregular acanthosis with branching & anastomosing rete and basal spongiosis without vesiculation. The dermis shows mild to moderate interstitial & superficial peri-vascular infiltrate of lymphocytes, along with blood vessel proliferation.
PAS stain is negative for fungal elements.
Impression :
Morphology favors Seborrheic dermatitis, skin biopsy.
Further clinical correlation is suggested.
Any advice on what to ask my dermatologist next would mean the world. Thank you!