How do I manage oily scalp, greasy hair and hair loss at 22?

Question

Hello doctor,

I have had an oily scalp, greasy hair, and hair loss for the past year, and I am 22 years old.

I get oil buildup and itching again within 12 hours of washing my hair. I have tried various kinds of shampoos, but nothing has helped.

Please suggest a proper skincare and hair care plan.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

You have a history of a very oily scalp with hair becoming greasy within 12 hours of washing. You have had itching and hair loss for the last year. This is likely seborrheic dermatitis of the scalp.

This condition is very common in young adults and is caused by overactive sebaceous (oil) glands and sensitivity to a yeast called Malassezia. It can make the scalp oily, itchy, mildly inflamed, and, at times, cause more hair to fall out. Hair fall is usually secondary to scalp inflammation and is often reversible once the scalp condition improves.

Using random shampoos frequently will not help unless they are medicated and used correctly. Here is a structured plan:

First, use a Ketoconazole 2 percent shampoo two to three times per week. Apply it to the scalp (not just the hair), leave it on for five minutes, and then rinse. On other days, use a mild daily shampoo.

To control the condition more effectively, I would suggest a two-week course of a mild steroid scalp lotion such as Betamethasone lotion, applied once at night. This will help reduce inflammation, itching, and hair fall associated with seborrheic dermatitis.

Too much oil on the scalp can make seborrheic dermatitis worse and should not be done too often. If you apply oil, keep it on for only 30 to 60 minutes before washing, rather than overnight. Also, avoid very hot water and harsh shampoos.

If hair fall is significant, it may be due to a combination of seborrheic dermatitis and telogen effluvium (stress-related shedding). Once scalp inflammation settles, hair fall usually reduces within six to eight weeks.

Wash your scalp regularly to keep it clean (even every other day if the scalp is very oily). Manage stress, get enough sleep, and eat a healthy diet. If the scaling is thick, persistent, or extends to the eyebrows or beard area, a dermatologist should be consulted.

It is a common condition and controllable. If you use medicated shampoos properly and are consistent with treatment, you should see improvement in three to four weeks. Be patient; scalp problems get better with the right routine.

I hope this has helped you.

Please feel free to reach out to me again if you have further queries.

Thank you.