Ask Dr Miriam

Q I have dermatitis of the scalp. It itches constantly and sheds pieces of skin. I’m scared of losing my hair. What advice would you have?

A From your description I’m not sure you have dermatitis, it sounds to me more like psoriasis given that you’re shedding a lot of scales. Of course this is only a suggestion because I cannot diagnose you by post, it’s unethical.

But you may find some clues that would make psoriasis quite likely, such as pitting of the fingernails so that they look like the dimples on a thimble, and thickening and whitening of your fingernails and toenails. The nails may also lift up from the nail bed.

You may want to ask among your relatives to see if there’s a family history of psoriasis as this would make the diagnosis more likely. To sort this, however, I think you need to see a dermatologist. So ask your GP for a referral.