Scalp Rash and Burning Itch: Managing Seborrheic Dermatitis in a 27-Year-Old Woman
At Village Dermatology, we frequently see patients who struggle with persistent scalp irritation that disrupts daily life. A common culprit? Seborrheic dermatitis, a chronic, inflammatory skin condition that causes itchy, flaky, and sometimes painful rashes—especially on the scalp. In this case, a 27-year-old woman from the Katy and Houston, Texas area came to us with a burning, itchy scalp rash that had persisted for months.
Patient Presentation
The patient reported:
Burning and itching on the scalp
Symptoms that were moderate in severity
Rash present for several months without resolution
She had not received prior treatment and was seeking relief and long-term management.
Physical Examination
A thorough exam was performed with a dermatoscope to evaluate the scalp and surrounding areas including the:
Face
Ears
Lips
Arms
The patient appeared alert, healthy, and in no acute distress.
Findings revealed signs consistent with seborrheic dermatitis, a chronic condition that commonly affects oily areas of the body, particularly the scalp.
Diagnosis: Seborrheic Dermatitis
Seborrheic dermatitis is a chronic inflammatory condition caused by a combination of yeast overgrowth (Malassezia), genetics, oily skin, and triggers like stress or weather changes. On the scalp, it often presents as:
Flaky, white or yellowish scales
Redness or pink patches
Itching or burning
Periods of flares and remissions
Personalized Treatment Plan
Because the condition was persistent and causing distress, we prescribed a targeted treatment regimen including both topical antifungal shampoo and scalp corticosteroid oil:
Medications Prescribed:
Ketoconazole 2% Shampoo
Usage: Lather into scalp for 5–10 minutes before rinsing. Use 1–3 times per week for maintenance.
Purpose: Helps reduce yeast and inflammation.Derma-Smoothe/FS Scalp Oil (Fluocinolone 0.01%)
Usage: Apply daily for 2 weeks, then use as needed for flares.
Purpose: Reduces inflammation and itching during flare-ups.
Counseling and Expectations
We spent time educating the patient on:
The chronic nature of seborrheic dermatitis
Importance of regular shampooing with antifungal ingredients
Use of topical steroids only for flares, to avoid side effects like skin thinning or discoloration
Avoiding high-potency steroids on the face, folds, and sensitive areas
The patient verbalized full understanding and was provided a written treatment guide.
Follow-Up Plan
We scheduled a follow-up visit in 4 weeks to evaluate progress and determine whether additional therapies or maintenance strategies are needed.
Why It Matters for Katy and Houston Patients
If you're living in Katy or Houston, TX and dealing with chronic scalp irritation, you're not alone. Seborrheic dermatitis is one of the most common scalp issues we treat at Village Dermatology—and with the right plan, it’s highly manageable. Whether you're frustrated by flakes, itching, or persistent scalp redness, our team can help you find lasting relief.
