Patient enquiry
I wonder if you can help me, for years I have had an itchy and sore scalp. I have used everything for scales including Head and Shoulders, T-Gel and even Betacap from the GP. Some of these help for a little while, but recently my scalp feels sore after my colour treatment, and I am worried this may be worsening the situation. Please, could I arrange a consultation?
Consultation examination
Following my usual pattern of questions regarding health, I noted that autoimmune conditions run in the patient’s family, although skin conditions do not. I asked thorough questions regarding the patient’s diet, and I noticed a distinct lack of oily fish and dairy products – this is not a good combination for scalps like this.
I observed thickened scales and areas of excoriations where the patient had clearly been picking. (See photo below). I was concerned that unless the scalp improved quickly and the scratching stopped, these affected areas could turn into a secondary infection.
Diagnosis
Psoriasis, an increased skin cell turnover where the scalp doesn’t shed old skin properly. This condition is NOT a dry scalp situation, so the patient should not use any oil.
Further tests: not required, nor steroid creams.
Home treatment
- Diet alterations as advised, to include more oily fish and dairy products
- Lifestyle suggestions: management of stress and allowing quieter reflective time to allow adrenaline levels to lower each day.
- Ointment to use twice weekly and more frequent washing with anti-inflammatory shampoo (both supplied by Shuna Hammocks Trichology).
Photo of the patient
