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What Do Painful Lumps On Scalp Indicate?

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Posted on Tue, 6 May 2014
Question: Hi Dr Kakkar! I hope you're ok. With regard to my previous problem, the steroid cream really worked and I am absolutely fine down below... you can imagine my relief. As I rate you very highly, I am hoping you can help me fix another problem that has been nagging me for a long time: I have some painful lumps on my scalp. I think it may be follicolitis. They are hard and only sometime get filled with pus, especially if I itch them and they do itch quite often. I have tried medicated shampoo and tea tree oil, which seems to mildly help. This has been going on for years now and my doctor doesn't seem to know what to do. He's suggested antibiotic and a very strong antimicrobial wash... but they don't really help as the cycle of the bumps reappering continues. Any idea?
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Answered by Dr. Dr. Kakkar (27 minutes later)
Brief Answer: Antidandruff shampoo+oral Itraconazole Detailed Answer: Hi. Thanks for the kind words and appreciation. The problem that you mention is commonly seen in those who have an excess of oil secretion or oily scalp. This can manifest as seborrheic dermatitis(itchy greasy adherent scales in the scalp) and also as itchy bumps. A yeast called Malasezzia furfur which is a common commensal (resident flora) is responsible for initiating or perpetuating inflammation as it feeds on the oil that is produced. The goal is to keep the scalp as clean as possible and not to use any hair oil. An Oral antifungal rather than oral antibiotics, specially Itraconazole 100mg capsules, 2 capsules once daily(after meal) for a week would help in seborrheic dermatitis and itchy bumps over the scalp by decreasing the resident flora(Malasezzia furfur) which is implicated as one of the factors for causing scalp seborrheic dermatitis and itchy bumps. I would suggest that you use a 2% ketoconazole shampoo once daily or every alternate day as well. Ketoconazole is antiinflammatory antifungal as well as antiseborrheic. Lather it well into the scalp skin and leave it for 5 min before you rinse. Regards
Note: Hope the answers resolves your concerns, however for further guidance of skin related queries consult our Dermatologist.Click here to book a consultation
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Dr. Kakkar

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Practicing since :2002

Answered : 9612 Questions

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What Do Painful Lumps On Scalp Indicate?

Brief Answer: Antidandruff shampoo+oral Itraconazole Detailed Answer: Hi. Thanks for the kind words and appreciation. The problem that you mention is commonly seen in those who have an excess of oil secretion or oily scalp. This can manifest as seborrheic dermatitis(itchy greasy adherent scales in the scalp) and also as itchy bumps. A yeast called Malasezzia furfur which is a common commensal (resident flora) is responsible for initiating or perpetuating inflammation as it feeds on the oil that is produced. The goal is to keep the scalp as clean as possible and not to use any hair oil. An Oral antifungal rather than oral antibiotics, specially Itraconazole 100mg capsules, 2 capsules once daily(after meal) for a week would help in seborrheic dermatitis and itchy bumps over the scalp by decreasing the resident flora(Malasezzia furfur) which is implicated as one of the factors for causing scalp seborrheic dermatitis and itchy bumps. I would suggest that you use a 2% ketoconazole shampoo once daily or every alternate day as well. Ketoconazole is antiinflammatory antifungal as well as antiseborrheic. Lather it well into the scalp skin and leave it for 5 min before you rinse. Regards