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Old 11-15-2010, 03:01 PM
Little Star Little Star is offline
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Default Painful scalp. What could be causing this?

My scalp is sore, and I don't know why. I did have Telogen Effluvium (and lost about half my hair) which came to an end about a month ago. It was shortly after that time that my scalp began to hurt. I have heard of people experiencing scalp pain/itchiness during TE but never after it ends so I am at a loss for what could be occuring.

My scalp appears normal most of the time although it is very sensitive and can become inflammed looking if I aggravate it i.e. put a product on it that it doesn't like. I never had sensitive scalp prior to or during TE so I am so confused. My family thinks I'm crazy because I complain of my sore/burning scalp but they can't see anything wrong. I can't get into the derm for another month and in the meantime I am freaking out.

My hair is definitely not falling out anymore (my derm confimed this as well) and I can feel/see new regrowth.

The only thing I can think of that might have caused this is topical steroid use. I did have a very minor case of Seb. Derm during my TE which eventually went away on it's own. But my doctor insisted that I use topical steroids to treat it to prevent inflammation from the dermatitis. I used them as directed for about a month, but they did not seem to help the condition. I haven't used the topical in about three weeks, which would coincide with the time my scalp started to hurt. Could steroids cause an aggravated scalp, even weeks after you discontinue use?

Any ideas or thoughts would be appreciated!
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Old 11-15-2010, 04:17 PM
pilar pilar is offline
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Hi Little Star:

My TE also came to an end about 1.5 months ago and I also had some scalp pain and itching. I saw a derm in September (when TE was coming to an end) and she saw inflammation and dandruff scales. I've never had scalp issues in my life and since coming off the pill (that I was on for only 2 months) I was hit with TE and a mild case of Seb Derm. My derm prescribed Nizoral 2% and a steroid lotion to apply once a day for 7 days. I ended up using the lotion for 8 days and now the pain is completely gone. Some of the redness and scales are still there, but slowly diminishing with the use of the Nizoral 2%.

Besides the steroid, did your derm prescribed a medicated shampoo?

I also never had a sensitive scalp, but since going through TE it seems that my scalp has become very picky. If I use the same products I used before all of this happened, my scalp becomes itchy and painful. I've had to try out a lot of products and find which ones don't aggravate my scalp. My derm told me that during TE and TE recovery, your scalp is a lot more sensitive than it ever was. So many follicles were shocked into the telogen phase and I guess this has an effect on the entire scalp.

What shampoos are you using now?
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Old 11-15-2010, 04:38 PM
Little Star Little Star is offline
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Pilar,

THANK YOU SO MUCH FOR RESPONDING. I was starting to think I was crazy. Not that I wish this torture on anyone, but it is good to know that someone else has experienced this. I have tried numerous anti-dandruff shampoos including Nizoral, T Gel and now Head & Shoulders. I was on the steroid meds for about a month. I was on Clobetasol, which is very potent, and I am worried I may have irritated my scalp with its use. My dermatologist did not tell me that it is one of the most potent topical steroids nor did he tell me that I should not use it for more than two weeks at a time. My dandruff cleared up on its own but I know my scalp must still be inflamed if it's hurting like this. I find it weird that this didn't start until after the TE stopped.

Currently I use baby shampoo because it is pretty gentle on my scalp. If I notice any flakes, then I use the Head & Shoulders.

Even with the flakes and inflammation you have noticed do you have regrowth? I am fairly certain I can feel a lot of it (it feels kinda spiky when I run my hands over my scalp) and I see some as well. But I'm worried that if this pain continues my hair will fall out again.
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Old 11-15-2010, 04:58 PM
pilar pilar is offline
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Little Star:

You're definitely not crazy! Going through TE and all these scary scalp sensations will sometimes make you feel that way...but it all seems pretty common.

I was also prescribed a pretty strong steroid (can't remember the name) but it was similar to Clobestol (Clobex). My derm said that there was an inactive ingredient in Clobex that could possible aggravate the Seb Derm even more so she prescribed another one. So I wonder if that's what you're experiencing now - irritation from the inactive ingredient in Clobestol? After the 2nd-3rd day of applying the steroid, the pain and itching went away. I was also told by my derm that since the inflammation on my scalp wasn't too bad, that she only wanted me to use it for 7-10 days tops. She said it could be used up to 4 weeks, but that was for severe cases of inflammation.

A month ago I tried Head & Shoulders and it seemed to irritate my scalp. My scalp became really itchy and red. I think my scalp reacts to the Pyrithione zinc. Have you tried prescription strength Nizoral? The 2% seemed to work a lot better than the over the counter 1%.

Yes, even with the scales and inflammation I have noticed re growth. I've noticed that I've lost some of the new growth, but my derm says this is normal, especially after TE. She said sometimes the follicles need a few runs to get it right. But I also wonder if the inflammation if having an effect on those new hairs. Right now I'm using a Tea Tree Oil shampoo and Nizoral 2% twice a week. This routine seems to be working really well and slowly getting rid of the redness and scales.
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Old 11-15-2010, 06:18 PM
Little Star Little Star is offline
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Yes, it is normal to lose some of the new growth. My derm said the same thing. As my TE was coming to an end I wasn't losing any long hairs, but a bunch of the baby hairs were coming out, and my derm said not to worry. I dry my hair over the sink every morning upside down to see what I lose, and now I'm not even losing the baby hairs any more. You should notice the loss of new growth decrease and then eventually stop as time goes on.

My pharmacist friend also said Clobetasol has a lot of inactive ingredients in it that could be irritants so perhaps that is the problem. But it seems weird that the irritation would continue 3 weeks after discontinuing use. I would think that if that was causing my issues, I would have experienced it while using the steroid, which I didn't. I have read that inflammation can sometimes worsen once you stop steroid meds so perhaps that's the issue. I know people with psoriasis who have told me it gets way worse once they stop steroids. I may go refill my prescription and try it on my scalp tonight to see what happens. I put a call into my dermatologist, and I am hoping he gets back to me today with an answer. I need some relief from this! My scalp has gone from being mildly sensitive to sore to the touch in certain areas. I will ask him about Nizoral prescription strength when he calls as well.

I also read somewhere that an Apple Cider Vinegar rinse is good for infection/inflammation of scalp. I think I might try that. Like you, I have to be very careful what I put on my scalp because even products I used in the past now make my scalp extremely irritated. I put Jojoba Oil on it the other night which I have used several times before with no problems, and my scalp turned bright red and broke out in little red bumps. And Jojoba Oil is supposed to have anti-inflammatory properties! It's just incredible how sensitive my scalp has become since TE.
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Old 11-15-2010, 06:45 PM
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From what I've read (and told by my derm) is that you don't want to use steroids too frequently. When I first saw her at the end of September, the inflammation on my scalp wasn't too bad and she didn't want to prescribe a steroid lotion. She wanted me to continue using the over the counter Nizoral which had been working at the time. Then I went and used Clarifing shampoo, Nizoral, T/Sal, Head & Shoulders and dyed my hair...all in 4 days. That completely irritated my scalp and then I needed steroids. But from what I've heard, they shouldn't be used too often.

Yes, I have also read about Apple Cider vinegar and a friend of mine that suffers from Seb Derm has done the rinses. For her it worked at first and then she noticed it was making her scalp itchier. I've bene tempted to try it, but the routine I'm on right now seems to be doing the trick. It's usually when I go chaning it that my scalp suffers.
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Old 11-15-2010, 07:00 PM
Little Star Little Star is offline
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I am a little annoyed with my derm because I feel he jumped the gun in prescribing steroids to me. My Seb. Derm was very mild, and I was not experiencing much scalp pain, just a little itching. He basically put the fear into me and said I needed to use it because if I didn't my Seb. Derm could cause hair loss. I have since learned that only severe Seb. Derm can do that. It seems like since coming off the steroids things have gotten worse. I sincerely hope he didn't make things worse by having me on Clobetasol for that long. I just don't know what to do at this point. If one of the most potent steroids didn't help my inflammation, what will?
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Old 11-15-2010, 07:19 PM
pilar pilar is offline
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Me too! When I first saw my derm, my scalp was only itchy and I had some tingling. But I didn't have any scalp pain and that's why she didn't think a steroid was necessary. It wasn't until I totally irritated my scalp by using products I wasn't suppose to that she thought a steroid was necessary. But even then, she only wanted me to use it once a day, for 7-10 days. No more than that.

My derm also said that only severe cases of Seb Derm actually cause hair loss. But she does think that in my case, the Seb Derm did contribute to an increase in shedding. She said that during TE, our scalps are already really sensitive. So having a Seb Derm flare up, even if it's mild, will have an effect on our scalp/hair. It wasn't until I started using the Nizoral that the shedding started to decrease.

For me, I think the Nizoral 2% has helped with the Seb Derm and also the inflammation. I used the steroids for 8 days and then stopped. Even though the steroid got rid of the itching and pain, I still had a lot of redness on my scalp. Since then I'm still using the the Nizoral 2%, twice a week and the redness is slowly decreasing (the scales too).

I don't remember the name of the steroid I was prescribed, but I'll look for it when I get home and post it here. My friend that also has Seb Derm was prescribed Capex shampoo. This is also a steroid but a VERY mild one. Maybe you can ask for something like this.
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Old 11-15-2010, 07:26 PM
Little Star Little Star is offline
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I think I will ask for a more mild steroid. I am now so terrified to put anything on my scalp that I will probably have a heart attack when I have to apply it. lol

I will let you know how everything goes, and if I ever get some relief from this. Good luck with your issues as well and please keep me posted.
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Old 11-16-2010, 12:24 AM
Little Star Little Star is offline
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Pilar,

One more question: did you experience a burning/tingling sensation when your scalp was at its most sensitive? I am feeling this pain, but my scalp is not red at all.

Luckily I got my dermatologist appointment moved up to next week. I am so very worried about all this mainly because I fear a return of the shedding, and I have so little hair left as it is.
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