question from a user
Dermatologist wants me to discontinue TRT due scalp inflammation 37m on TRT for 18 months. Started at 200mg and then dropped to 150mg a year ago and haven’t switched since. 2x weekly IM injections like clockwork. I feel great and look great. All low T symptoms gone. 6 months ago, however, I noticed redness and inflammation, itchiness, and tender lumps on my scalp near the top/front. The inflammation has been persistent but fluctuating in severity since then. I was referred by my TRT doc (primary care physician) to a dermatologist. We tried a few different things (topical corticosteroids, oral and topical antibiotics, etc) and nothing has worked. Recent bloodwork attached along with pic of the inflammation. DHT was 39ng/dL (right in the middle of the reference range) and progesterone was 0.5 ng/mL I really don’t want to stop TRT as I feel great otherwise. Any ideas, suggestions or similar experiences?
AlphaMD's Answer
We have had some patients who note an increase in sebum production once they start TRT. On the scalp there are two types of sweat glands. Sebaceous (oily sweat) and apocrine (watery sweat). Your pictures could be a mild case of seborrheic dermatitis of the scalp, or dyhidrosis of the scalp. Often times an antifungal/corticosteroid combination like Lotrisone is needed if all other treatment methods have failed. You can also get ketoconazole shampoo over the counter which can help in some mild cases. Either way, it does not seem severe enough to stop TRT.
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