- Scaling rash affecting face and scalp.
- Affects any age after puberty, fluctuates in severity and may persist for years.
- Ill-defined dry pink or skin-coloured patches with yellowish or white bran-like scale.
- May spread to affect the entire scalp, eyebrows, edges of the eyelids, inside and behind the ears and creases beside the nose.
- Skin-folds of the armpits and groin, the middle of the chest or upper back can be affected.
- Shampoos containing ketoconazole, selenium sulphide, zinc pyrithione, coal tar, salicylic acid.
- Steroid scalp applications.
- Anti-yeast tablet such as itraconazole.
- Back of the head is a common site; multiple discrete areas of the scalp or the whole scalp may be affected. May extend beyond hairline.
- Thick silvery white scale on red skin. Scales not shed easily.
- Asymptomatic or itchy.
- Permanent balding is rare.
- Coal tar shampoos.
- Topical steroid and calcipotriol.
- Salicylic acid and coal tar creams.
- Coconut compound ointment.
Contributed by Dr Vasa Gnanapragasam, a GP in Sutton, Surrey.