Dr Bernadette Carr answers your questions on dry scalp and warts

I have always had a dry scalp, but it has worsened. Some areas are so itchy that they are sore. I thought it was just dandruff, but wonder if it could be dermatitis. Should I ask my GP for a referral to a dermatologist?

Dry scalp can be very annoying. It can be associated with flakiness and dandruff and be irritating and itchy. It can also lead to cosmetic issues.

Some people will suffer with dry scalp alone and it can also be common in people who have eczema or psoriasis. In the case of psoriasis, the patches will be raised and scaly, with silver or red areas, and may extend behind the ears or onto the scalp, and there may also be patches on the elbows and knees.

Seborrhoeic eczema is another cause of dry scalp. It is a similar condition to cradle cap in babies, which causes dandruff and scalp itch and which is related to yeast infection. Psoriasis may develop at any age and symptoms can come and go, especially at times of stress.

If the protective skin barrier is broken, which may happen with very dry skin, you may be more prone to infection and inflammation of the skin. Itchy, sore patches may indicate a skin infection, especially if they are red or inflamed.

Your GP may be able to treat this infection with antibiotics or creams. Sometimes, a steroid cream can reduce itch and inflammation.

There are then a number of things you can do to help the dry scalp. Medicated anti-dandruff shampoo, which should be used twice a week, instead of regular brands, can improve the condition of the skin on your scalp and reduce scale and flakes.

Sometimes, the use of other creams advised by your GP, which contain tar extract or salicylic acid, will be used for the treatment of psoriasis. If these measures fail to improve your scalp condition your GP may refer you to a dermatologist.

What would you recommend for the treatment of warts? My teenage son has three warts on his right hand and is self-conscious about them.

Warts are caused by a virus called HPV (human papilloma virus). Contact with this may result in a skin infection, which causes a wart to develop. If there is a break in the skin, like a cut or a scrape, the virus is more likely to cause infection. The virus is usually picked up from contact with someone else who has warts, and the same virus may present as a verruca on the sole of the foot.

Some people may be more likely to get warts than others. Wear flip flops at a swimming pool, as this is a common location to contract verrucas.

Warts may be of cosmetic concern, if they are visible on the hands, but should be painless and most will disappear on their own without any intervention. However, treatment can be used to speed up the process.

Topical treatments, such as creams and ointments, are sold over the counter in pharmacies. These can be applied directly to the wart. Options include salicylic acid or freezing sprays. In some cases, cryotherapy with liquid nitrogen may be an option to remove warts and some GP surgeries will offer this service.

Cryotherapy can be painful, but it may be quicker than home remedies. It involves several sessions of freezing of the wart, which kills the virus. In time, the wart will shrink and disappear. In all cases, persistence will be needed to treat the warts and several sessions will be required.

Most home remedies should be applied daily, for at least three months, to ensure the warts are fully treated.


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