Dr. Rakesh Kumar Bahunuthula
Dermatology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hi doctor,
My hair looks nothing like I can find on the internet. It seems like stringy black hair wrapped around each strand. It does not look or feel normal. I have lost patches of hair and cut it short, so my scalp can breathe. I am tempted to shave my head but scared to see my bare scalp. I had dandruff issues previously. It has been over a month, and my primary care doctor does not believe me, and they would not take any tests without the doctor's approval. I am taking Wellbutrin (Bupropion), Suboxone (Buprenorphine) but not for this condition. Kindly help.
Hi,
Welcome to icliniq.com.
I have gone through your history and the pictures attached (attachment removed to protect the patient's identity). Certainly, the hair looks pretty dry and tangled, while the scalp does have minimal scaling. There could be several reasons for such an appearance, including various factors which damage the hair cuticle. Repeated hair wash, very strong shampoos, not using a conditioner, working in a rough environment, too much of hair sprays or gels, certain vitamins and mineral elements deficiencies, hypothyroidism, fungal infection (ectothrix, endothrix) are few common causes. In your case, I will suggest avoiding very strong shampoos, always dilute the shampoo with water before using it for head wash, apply conditioner after every head bath, apply coconut oil two hours before head bath, and use supplements containing calcium, pantothenate, and biotin. You can also get a hair microscopy examination to rule out any fungal infection. I hope this helps you out.
Patient's Query
Hi doctor,
Thank you for answering. I think I damaged my hair by using the antifungal shampoo and Chlorhexidine cleanser recommended by a different online doctor for a different stage in this ordeal. I had yellow plaque deposits and a gooey white scalp back then. My diet is terrible. I used embarrassing amounts of sugar as a reward for quitting alcohol and had no vegetables at all. The initial infection was after a horrible depression where I had terrible hygiene and never left my bed. I have attached photographs from the last two months to show how different it was. I believe it must have been fungal at the time, and it is hard to see it now. Thank you.
Hi,
Welcome back to icliniq.com.
I do feel empathetic for the tough things that you have gone through. And all of these do certainly impact the health of your hair. Stress, diet, regular hair care play a vital role in keeping the hair healthy, shiny, and strong. The good thing is that you have yourself been able to identify where things went wrong, and I am confident that you would now work towards a holistically healthy approach to life. In the pictures attached (attachment removed to protect the patient's identity), I could see a lot of erosions and brittle hair lacking luster, but I am glad the erosions have gone now. They are commonly seen in folliculitis, a bacterial infection of the hair, for which the chlorhexidine shampoos were advised. I would suggest you focus on a healthy protein-rich diet, take food rich in antioxidants such as nuts and raisins, work on the stress aspect. You could do a bit of yoga and proper hair care as advised earlier. These will restore your hair to good shape. I hope this has helped you.
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Dermatology
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