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Scalp Itching and Search for Remedies
from Donna M.

Hi Ed: I stumbled on to your site today looking for some kind of relief and I noticed a lot of other people have too. It is such a nice site! Thank you for having it.

I've been reading letters after letters and decided to write one to you, too. I am 39 and have psoriasis of the scalp. It was diagnosed about 2 years ago. It wasn't too bad: just on the nape of my neck. My Doctor prescribed a cortisone cream that worked alright but not the best. The problem would come and go. This summer has been the worse. I live in Maine and I'm not sure but I think the hot weather we've been having here has had a lot to do with it. It now has flared up all over the back of my scalp and onto my neck. I also have long hair and I refuse to give in to this awful disease and cut it. I just went to my Doctor 3 days ago and she prescribed Dovonex for me for my neck plus another medication with steroids in it for my scalp. I don't have the name of that one right now because the pharmacist did not have any. Figures!! Anyway he's supposed to have it in today and I'm anxious to try it.

While I was waiting for my doctor's appointment I found some relief from the itching with Campho Phenique. The itch is unbearable sometimes. I don't know if it's alright to use on the scalp or not but the first day I used it, it felt quite a bit better. After trying my new prescription I'm getting today I'll let you know what the name is and how it works. The doctor did say that I would have to stop using it later cause it does have steroids. But she is hoping that after it gets calmed down I will be able to control it with Neutrogena extra strength T-gel shampoo. I hope so. Also, I read in your response to a letter about "scalp cocktail." I haven't tried any of the recipes yet because when I went to see about getting the one my pharmacist said I needed a prescription from a doctor. But here's a site where I found a bunch of recipe's for psoriasis.

http://home.newmedia.no/flaker/recipe.html [This link did not work for me on 7/30/99. -Ed]

Lots of different recipes for ointments and also baths with wheat germ for the itch. Some of these you shouldn't need a prescription for. I'll tell you, I'm going to see how the new medication works out for me and if I'm not happy with it I'm going to bring all these recipes to my Doctor and have her prescribe one for the pharmacist to make. Thanks again for taking time to read my long letter! I love your site and think it is GREAT!! -Donna M.

*****

Ed's Response: Sounds like de ja vu, Donna. My scalp was the first thing to flake and, like you, I have always suspected it was a sudden climate change that triggered it. I moved from an eastern humid climate (Washington, D.C.) to a dry high desert climate (western Colorado) in the fall of ‘88. The following summer I experienced humidity-less high heat for the first time in a decade and that's when the scalp P started. My P has evolved over the past decade, but the scalp P has remained a constant. I hope our de ja vu ends with the scalp P!

More than one derm at the NPF's 30th Anniversary Conference in New York City last October said in their presentations that scalp P is one of the hardest forms to treat. A part of the problem is that, from our perspective, scalp P is very difficult to leave alone—it does itch and irritate something awful! As a result, our scratching hurts what the medicines help and we often end up without improvement. [See link at end.]

I'm surprised your derm hasn't mentioned anything about occluding your scalp overnight. For me this is the ONLY therapy that typically improves my situation: the rest just help me tread water (so to speak). Occlusion can be used with almost any medicine you might be using on your scalp; however, few derms will prescribe it for scalp P using a group 1 (strong) corticosteroid. I occlude using "scalp cocktail," which is a prescribed combination of salicylic acid and coal tar derivative compounded by my pharmacist. I use a tight shower cap to cover this goo over night, sometimes supplementing the shower cap's elastic with medical tape if I suspect it may move or come off over night. (You do NOT want a coal tar derivative getting into your linen if you can help it!)

There is a "geology" to treating bad scalp P that can't be ignored. Flakes build up on the scalp because of the dense hair. They form mountainous piles of dead skin that you can easily feel with your fingers. Much of the scratching we do is concentrated on breaking loose and prying off these gobs of dead skin—and because we can't do it very carefully by touch and fingernails alone, we inevitably damage some living skin in the process. Scratching, clawing, prying, raking with combs and brushes ... all these exacerbate the condition. Conversely, so long as there are these huge build-ups of dead skin, it is difficult-to-impossible for medicines to penetrate to the living tissue where they must go to be of any use. Hence we must employ some reasonable fashion of "scalp strip-mining." A number of products and techniques are used, but basically the trick is to loosen the dead skin and soften it so it can be gently combed off the scalp (no digging! no raking!). Occluding over night can accomplish this. Letting some shampoos sit on the scalp for several minutes before they are rinsed away, then combing before the hair dries can also work.

Keep us apprized of how your treatment goes, and welcome aboard! -Ed

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