My scalp’s so itchy I can’t even use a HAIRDRYER

QFOR two years I’ve been plagued by a very itchy, sensitive scalp — even using a hairdryer is too much to bear. I also get painful flare-ups, during which it feels like someone is pulling my hair. I’m worried it’s a sign of a more serious problem.

Jennifer Davies, Crymych, Pembrokeshire.

AIt appears you have seborrhoeic dermatitis, a skin condition in which the scalp becomes red, itchy and flaky. any areas of oily skin, such as the sides of the nose, eyebrows, ears, eyelids, and centre of the chest can also be affected.

the symptoms are thought to be caused by an overgrowth of Malassezia, a normally harmless fungi that lives on the skin, or by an over-reaction of the immune system to this fungi.

It’s very common — occurring in around one in 25 people — and similar to dandruff (which is actually a mild form of seborrhoeic dermatitis that causes flaking itchy skin, but without the sensitivity you also experience).

Nizoral, a medicated shampoo containing the antifungal ketoconazole, is often prescribed (and is also available over the counter) to reduce the growth of the yeast. Nizoral is usually effective and should be used twice a week for two to four weeks.

In severe cases, corticosteroid lotions and ointments that are rubbed into the scalp can dampen down inflammation.

But be aware that topically-applied steroids can lead to thinning of the skin, increased body hair, weight gain, muscle weakness, and other potential damaging responses — so don’t use them for more than a month.

You mention in your longer letter that you’ve tried Nizoral and topical steroids. so I wonder about your hair washing regimen. You should wash your hair with something mild, such as baby shampoo, so as not to further irritate the scalp.

Or you could try sachajuan shampoo, which contains the antifungals piroctone and climbazole, and salicylic acid. these eradicate the yeast and calm the inflammation and should be used once a day for a month and then once a week.

However maddening, be assured the itch is not a sign of anything serious.