Dear Doctor: How can I diagnose cause of my itchiness?

DEAR DR. ROACH:

I am 76 and have been bothered by sensitive skin, usually dryness on my back and itchiness on my ears.

My dermatologist prescribed medications for my itchy back and ears; however, it does not really stop the recurrence of the itchiness. I started to have an itchy scalp, and I do not know if this was caused by hairspray or shampoo.

Other than dryness of the skin, what could be the possible cause of the itchiness? Could it be eczema? I asked my dermatologist, and he did not give me a definitive answer. — N.D.

ANSWER:

Atopic dermatitis (commonly referred to as eczema) is a common cause of scalp itching and may also affect the ears. However, the list of possibilities is long and includes fungal infections (tinea capitis); other inflammatory conditions like seborrheic dermatitis (which is a frequent cause of dandruff); contact dermatitis (hair care products are the usual culprits); and psoriasis. My textbook lists 30 other less-common causes.

Your dermatologist has a great advantage over me, since he has done an exam, but sometimes even an experienced dermatologist canโ€™t tell the exact diagnosis just by an exam. A trial of medication (often starting with skin hydration and moisturizers, but many times including a topical steroid cream) can be helpful in both treatment and diagnosis. Occasionally, a skin scraping or skin biopsy is necessary to be sure of the diagnosis.

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Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to [email protected] or send mail to 628 Virginia Dr., Orlando, FL 32803.

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