Quoc, 40, suffered from severe scalp itching for three years, a condition diagnosed as seborrheic dermatitis. Despite using various shampoos and topical medications, his itching only temporarily subsided before recurring, particularly after consuming alcohol or in cold weather.

Doctor Le Nguyen Thuy Vy, from the Dermatology - Aesthetic Dermatology Unit at Tam Anh General Clinic District 7, observed mild red lesions and fine scales on Quoc's scalp. What Quoc mistook for inflammatory acne were actually chronic inflammatory papules, a result of prolonged seborrheic dermatitis combined with years of scratching, leading to thickened skin and small scars.

According to doctor Vy, seborrheic dermatitis is a chronic condition that progresses in episodes and often flares up during cold, humid weather, periods of stress, or after alcohol consumption. The overgrowth of Malassezia yeast, coupled with an inflammatory response and hyperactive sebaceous glands, causes patients to develop white scales, redness, and intense itching. Self-treating with specialized shampoos, constantly changing products, or incorrectly applying strong corticosteroids can easily irritate the scalp, leading to severe peeling and making the condition recur faster and become more difficult to control.

For persistent, hardened papules that respond poorly to topical medications, doctor Vy prescribed triamcinolone injections. This treatment aims to reduce deep inflammation, soften scar tissue, and flatten thickened plaques. It is combined with specialized shampoo and anti-inflammatory topical medications. After two to four weeks, the papules became less prominent, itching decreased, and hair loss was noticeably reduced.

A doctor injects triamcinolone to soften scar tissue for Quoc. Photo: Tam Anh General Clinic District 7

A doctor injects triamcinolone to soften scar tissue for Quoc. Photo: Tam Anh General Clinic District 7

Doctor Vy cautioned that triamcinolone should only be used for hard, lumpy papule lesions and must be administered by a doctor to prevent complications like skin atrophy. Once the skin becomes soft and flat, patients transition to using a specialized shampoo two to three times per week to control sebum secretion and limit recurrence. Continuous treatment, tailored to each stage of chronic seborrheic dermatitis, is more crucial than using strong medication for short periods.

While not life-threatening, seborrheic dermatitis significantly impacts quality of life due to persistent itching, abundant white scales, and prolonged hair loss. Doctors recommend that individuals experiencing persistent scalp itching, numerous white scales, thickened papules, or hair loss should consult a specialist in Dermatology - Aesthetic Dermatology to identify the cause. Avoid self-treating, as this can worsen the condition. Following the correct treatment protocol for each stage helps effectively control the disease and limit recurrence.

Minh Huong

*Patient's name has been changed