OUR resident specialist and NHS GP, Dr Zoe Williams, shares her expert advice.

Today, Dr Zoe helps a reader who has been suffering from an itchy flaky scalp for over a year.

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Q: I’M a 72-year-old healthy woman and nothing has alleviated my dry, itchy, flaky scalp for more than a year. I am at my wits’ end.

I’ve tried ketoconazole two-per- cent shampoo and betamethasone valerate 0.1-per-cent steriod cream.

A: Ketoconazole (anti-fungal) shampoo and steroid scalp application are really sensible treatments to try for a persistently itchy, flaky scalp.

They treat seborrheic dermatitis, which is one of the major causes of these symptoms.

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Seborrhoeic dermatitis is like dandruff but with inflammation of the under-lying skin.

This inflammation is what causes the itchiness.

If you have used the treatments persistently for several weeks and it is no better, the next step would be for your GP or nurse to take some scraping of the flakiness from your scalp.

This can be sent to a laboratory, where it can be analysed to see if there is a fungal infection – and if so, which type of fungus.

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This can then provide your GP with information on which oral anti-fungal medications may help. It could also be psoriasis or eczema of the scalp, which may both be alleviated somewhat by the betamethasone (also known as betnovate).

If you have any hair loss, then this would usually be a reason to refer you to a dermatologist.