Ask an Expert: Scalp is very spongy

Skin Care and Diseases

Scalp is very spongy
10/09/2006

Question:

I have been using dandruff shampoos and even a special shampoo from my dermatologist, but my scalp is still very itchy and instead of flaky dandruff my scalp has a spongy layer of skin flakes.

Any suggestions about how I should treat it.

Answer:

Scaling scalps can come from many things. The most common is from “dandruff”. This is usually controllable (although not curable) by trying different shampoos (selenium sulfide vs. salicylic acid vs. zinc pyrithione vs. tar) on a frequent basis (depending on the dryness of your hair, type of hair, etc., at least several times a week to everyday). Newer shampoos include antifungal preparation such as ketoconazole (Nizoral shampoo) and other antifungal shampoos (Loprox or stronger strength Nizoral) can be prescribed by your doctor.
If the scaling is thick, or there is redness or notable itching of the scalp associated, the possibility of conditions such as seborrheic dermatitis and psoriasis need to be considered. These may be controlled with over the counter shampoos used on a regular basis (similar to the ones mentioned above) and scalp oils (coconut oil, etc). If the itching is occurring at the margins, over the counter hydrocortisone creams may help. However if this doesn’t help, a consultation with your physician or board certified dermatologist is recommended. Other things such as ringworm of the scalp, eczema, and less common conditions can also occur which requires your dermatologists diagnosis. I recommend you see your dermatologist if the above suggestions don’t help.

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Response by:

Pranav Sheth, MD
Formerly:
College of Medicine
University of Cincinnati