Please help, I can’t stop scratching my scalp

Dear Doc,

I was diagnosed with scalp psoriasis 10 years ago. I have tried all prescribed remedies including tar-based shampoos and soaps, elocom, salycilic acid ointments and others, but nothing has helped. What’s the best treatment available?

Psoriasis is a condition where the immune system makes the skin cells grow faster than the old ones can be shed off.

This causes cells to pile up leading to raised scaly patches. It can affect any part of the body, including the scalp, and cause itching, a burning sensation and hair loss.

Psoriasis should be managed by a dermatologist. The first line of treatment is topical medications like coal tar, medicated shampoos, topical steroids, salicylic acid, and antibacterial and antifungal medications for secondary infection.

Other medications include vitamin A derivative e.g. tazarotene, soriatane, vita-min D derivatives e.g. calcipotriene and anthralin cream. The skin overgrowth is triggered by your immune system, so the disease cannot be completely cured.

Medication helps with the symptoms or to soften the scales, or to suppress the immune system and reduce the overgrowth of skin cells.

Avoid scratching your scalp, shampoo gently, use a scale softener (salicylic acid) and remove the scales gently.

Dear Doc,

My wife suffers from hormonal imbalance. She has irregular periods which make conception difficult. A gynaecologist prescribed some medication and her period came once and then stopped. Which is the best treatment and medication for this condition?

Hormones are chemical messengers that are produced by organs and glands and they influence specific cells, causing an effect on many processes in the body. The level of the hormones can be affected by other hormones, by glands and organs, and by feedback loops.

The menstrual cycle occurs due to changes in the levels of the hormones oestrogen and progesterone, causing the different phases of the cycle. If something causes a problem with these hormones, then there is a hormonal imbalance and the cycle is disturbed.

Hormonal imbalance means that there is too little or too much of one or several hormones.

The menstrual cycle is different for every woman, but menses can occur every 21 to 42 days, and can last from two to eight days. Menses are considered irregular if the time between one period and the next changes significantly, if the number of days when you are on your period changes a lot or if the amount of bleeding changes a lot.

Irregular periods usually mean that there is no ovulation. Hormonal changes affecting the menstrual cycle can happen due to pregnancy, breastfeeding, menopause, using hormonal medication, stress, too much exercise, severe weight change (losing or adding a lot of weight), thyroid disease, polycystic ovarian syndrome, diabetes, diseases of the adrenal or pituitary glands, and tumours.

In some cases, the problem can be rectified permanently, but in many cases, there is no permanent solution. In most women, the cause of imbalance is polycystic ovarian syndrome, which cannot be cured completely.

You need to visit a gynaecologist so that she can be examined.