Help - very Itchy scalp - might this be a first psoriasis outbreak? What to do?

I have mentioned this already somewhere on here. My whole scalp has come out in terribly itchy dry skin and red patches. Plus ears keep getting peeling stuff just inside them (not itchy). I switched from T-Gel to baby shampoo back to T-Gel again. My husband massaged my head for me a week ago with olive oil which was amazing - but a bit gross to wash out and took several washes and I smelt like a salad minus the balsamic so I was told! (cant smell anymore! ). Its back again with a vengeance anyhow.

I don't know if this is relevant but it arrived in week two off the injectable MTX and week 4 off Hydroxy - which makes me wonder if its actually autoimmune i.e psoriasis? I haven't had an itchy scalp for years since my bad old alopecia/ eczema days when I suffered terribly and used Betacap (betnovate) on it regularly to very good effect. This is different. Its far more itchy and not scabby but the odd flake and bleeding from some of the scratching I've tried not to do! It woke me last night ragingly itchy and hubby says its much worse now and all over my scalp. I've picked up some good sounding non drug remedies from others posts on the psoriasis foundation site but not sure if this is psoriasis at all or just eczema come back to haunt me?

As many of you know I've bothered GP with bad tum and drug problems and flares lately. Presenting again with an itchy scalp feels a bit desperate therefore - but it is driving me absolutely nuts! What should I do?

Ps my hairdresser was the one who suggested it looked like psoriasis to her. I haven't been diagnosed with PsA just RA but nothing would surprise me anymore!

12 Replies

  • Got exactly the same problem myself- i'm week 4 off hydroxy after itchy side effects and hair loss ( and two major surgeries in 4 mts!). The hair thinning is slowing down but now my scalp and flaky ears are driving me mad .

    I've gone back to selsun which I used years ago- a stronger version of the tgel- smells awful but seems to be calming things down a bit. I'll be seeing my rheumy in a couple of weeks and will ask him if not cleared up to see if related to the RA. Good luck with yours,

    Polly x

  • Thanks Polly - mine doesn't sound as severe as yours yet but its getting worse and I'm keen to try and nip it in the bud. If you can it would be really helpful to know what your rheumy says about it. I have an apt to see GP a week today but its meant to focus on stomach related stuff and MTX. Scalp starting to feel like the new priority to me though! Tilda x

  • Joico bioba treatment shampoo i use this everyday for my hair. It keeps my scalp clear and uf you have skin patches it will help those. You have to leave it on for five minutes. I use put it on my hair then wash my body before taking it off the hair. You can purchase online about 12 ,99 per bottles. I have been using it for about five years now. Better smelling then some of the mediated ones.

  • Thanks Georje - I'm off to town today so will cut and paste and look out - otherwise will but some online. I can't smell these days (Sjogrens or drugs or meno?!) but its not nice to think of others smelling me like a newly laid road or a salad! Xx

  • Thanks Georje - I'm off to town today so will cut and paste and look out - otherwise will but some online. I can't smell these days (Sjogrens or drugs or meno?!) but its not nice to think of others smelling me like a newly laid road or a salad! Xx

  • Hello Tilda

    Just wonder if there is any chance it is a fungal skin infection? The reason I say this is because I have had itchy scalp at times (sometimes for prolonged periods) and strange "patches". Because I also had a fungal skin infection at the time GP thought the scalp stuff was connected and prescribed an anti-fungal shampoo (Nizoral) which sort of helped. Nizoral shampoo can be bought over the counter I believe. How about Seborrhoeic Dermatitis? I have attached a link below which I found when I had the problem and it gives a fairly good description of what was happening to me. It also mentions the fact that it can affect the inside of the ears as you are describing. As for the cause - well my understanding is that a number of the meds make us more susceptible to fungal infections and I think it can also occur as a result of immunosuppression generally.

    Not sure if any of this is helpful Tilda but you have all my sympathy because I know how itchy scalp can drive you mad.

    Thinking of you.


  • Hello again Tilda

    Just tried the link I put in above and it didn't work. Sorry. But if you type "" into Google and then search on the" site for Seborrhoeic Dermatitis you will find the page I was looking at.


  • Coincidentally I saw this name on the special T -Gel I just bought in Boots. Wondered what it was! Thanks so much Tilly - I will ask GP when I see him a week today as i cant keep buying stuff and teying it once! Hopefully I'm barkimg up the wrong ally worrying about psoriasis. Xx

  • TAKE PHOTOS! Obviously you aren't going to b able to do that yourself, but get someone else to take really good close up photos at fairly high resolution of all those flaky scaly bits. Then select out the best ones, and email them to the rheumatologist, saying "do I need to see a dermatologist? Is this related to my RA?"

    Reason for taking photos is because those rashes almost always disappear the moment you get an appointment. I had my rosacea finally diagnosed primarily by photos - it was equivocal at the appointment, but photos showing several different phases of it made it clear that it really wasn't lupus at all, and I'd never have got that clarity on one appointment every three months, with a different dermatologist each time.

  • I got my husband to take some yesterday and a few weeks ago too. Its helpful for me as I can only feel it. I won't send it to rheumy but will show my GP a week today and see what he thinks. I'm hoping it will just pass and waked it in the special T-Gel extra today which seems to have worked well I that I'm not scratching tonight. X

  • it sounds like it could be psoriasis.. i suffered from what i was told was cradle cap when i was around 5 or six but looking back i should have been to old for that and it was probably plaque psoriasis. i've suffered from some awful flares of it since then and there were times my scalp would feel like bark - and the itching was explicit! i don't know if cocois is available over the counter but it can help to moisturise and calm the flare up if you have got mild psoraisis - it'll be messy but even olive oil could help to dampen it down until you can get something a bit stronger for it.

    since i stopped the mtx my psoriasis has flared up worse than it was before so maybe you're having a flare because you're stopping and starting new meds too?

    psoriasis is basiciclly your skin cells growing quicker than they are shed so that there is new skin cells building under the layers unable to 'get out' and it piles up and forms plaques.there are other types but i don't really know much about them and it sounds like you're describing plaque psoriasis.

    earthwitch is right about taking photos - my urticaria nearly always goes into hiding when i need a dermatoligist or doctor to see it!

  • Thanks that's really helpful. After a lifetime of eczema everywhere including scalp you would have thought I'd be pretty good at judging how to tackle itching but my scalp eczema wasn't really like this - it really was sore but wasn't nearly as itchy and I would just stick some Betacap in it and it would disappear as if by magic!

    Looking back I was never referred to a dermatologist - or only twice in 45 years at any rate - and rarely saw the GP about it. It was just how life was - constantly itchy and painful and I found methods for dealing with it by myself with some help from repeat prescriptions of steroid creams and the odd burst of prednisone. I don't even know for sure that the stuff on my scalp was eczema but it was really crusty and foul - but it didn't carpet my head as this does. But then as it was all I'd ever know I rarely thought about it.

    This last few years without eczema has been so great that this is why I have such a horror of PsA compared to RAI think - I have no other signs of it though and my rheumatoid factor is a low positive which doesn't correspond so I just have to stop expecting the worst I think!

    Nice to see your photo Rats you look lovely! Xxx

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