Question: Dear Dr,
Over the last month or so I have developed an itchy rash on the temples, hairline and general scalp areas. I have never had such a rash before, and have not changed any hair products, shampoos, lifestyle or eating habits for many years.
The rash itself varies according to the area. It is lumpy and red on the temples and has created an oddly textured area where the skin is slightly darker. On the hairline (more central) and creeping down onto the forehead it isn’t red, but just lumpy, resembling more of an allergic welts look (there may also be a little hair loss at/near the temples). Then on the general scalp within my hair, it tends to be just pink, itchy-patches, without lumps (the main area of concern and irritation is from the temples and hairline). My head generally feels hot although the weather is very cold. Other mild symptoms are a very slight itching around the general upper-face (but nothing visible), and a feeling of tightness in the skin in my foreheat and around my eyes/cheekbone. I should also mention that it seems to fit a pattern throughout the day, being quite calm and not lumpy when getting up in the morning. The irritation and lumps start to increase around 10-11 am and progressively get worse throughout the afternoon, then calming again in the evening. Although this coincides with when I’m at work 9-5 (like a reaction to something at work), I just work in a normal office without air-con, and nothing has changed about the offices or their contents in several years and I’m not stressed. However, the symptoms don’t completely disappear during evening and weekends. My whole face also feels like it’s sunburnt (I haven’t been outside) although there is nothing to see externally.
My doctor first prescribed both a topical steroid for the scalp and an anti-fungal shampoo. I had to stop using the steroid because not only did it seem to inflame the area and make it much more itchy, I also suffered unrelated side-affects which I always have with steroids of any kind. The shampoo hasn’t made any difference.
My doctor then prescribed a strong antihistamine, but this also doesn’t seem to have made any difference to anything.
Other facts about me: I’ve taken Amitriptyline daily for the last 5 years. I have very thick hair and don’t have any balding history in my family. Although probably unrelated, my gums have receded ridiculously quickly over the last 4/5 months.
Here are a few photos, but as with all photos they don’t show the severity of the colour and bumpyness of the skin in reality…
Photos at: https://www.dropbox.com/sh/lj2ylggkous48uw/AAAwsgZYOvygqyrijg6eeGNha
Any help or suggestions much are appreciated!
Many thanks, XXXXXXX

Thank you for your reply. I was already taking a vitamin supplement which covered Vit B complex, but I have also added an antioxidant supplement to my intake now.
However, since I originally wrote to you new symptoms have arisen. I've been feeling very hot most of the time even in cool conditions (so much so it's making me feel a bit nauseous) and I can't seem to stay hydrated and have been having to use rehydration drinks to help. Every time I drink anything, I urinate considerably only about 10-20mins later.
I also have several liver/age spots appearing on my face these last few weeks (I don't know if this is anything to do with the rest, but just thought I'd mention it).
Many thanks, XXXXXXX

In answer to your questions:
1. No
2. No
3. No

Sorry, that's not much help. Do you have any idea why my skin on my cheeks and around my eyes are suddenly producing permanent marks which look like sun damage? I've never sunbathed and always tried to stay out of the sun and work indoors. It would be nice to try and stop more appearing at such a rate, as it seems a bit early in life to have skin this damaged when I've stayed out of the sun.
Many thanks XXXXXXX