What could be the reason for chronic dandruff, pus-filled pimples on the scalp, hair fall, and thin hair?

Question

Hello doctor,

I have had dandruff ever since I was a child and was prescribed dandruff shampoo and antifungal medicine. During my teenage years, I began getting dandruff on my eyebrows and mustache. At 19, I had thick flakes on my hairline. I used to pick them repeatedly, and the area would become red and sometimes bleed a little if I picked the flakes too hard. I am now in my mid-twenties, and I have noticed flakes all over my face at times, and my hairline seems pushed back. I have also gotten pus-filled pimples on my scalp that would bleed and form scabs or crusts. I cut my hair all off and noticed that the corners of my hairline had no hair (like completely bald). Six months later the hair has grown back but it is kind of thin. I do suffer from anxiety and stress. But this hair thing stresses me a lot. I was told by a dermatologist that I may have sebopsoriasis. However, they were not very clear on whether it could be causing the thinning of my hair or not or if I am simply experiencing male pattern baldness.

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I have read your query and understand your concern.

I think you have seborrheic dermatitis. Hair look of uniform thickness all over, so at this moment it doesn't look like male pattern baldness (MPB). In MPB there is gradual thinning of hair and you start noticing hair of various diameters. A mild reduction of hair volume can be seen and it can be because of seborrheic dermatitis as well. In any case along with the treatment of seborrheic dermatitis, you can apply Minoxidil foam, which will work in both MPB and hair loss due to seborrheic dermatitis. I suggest the following.

1. Candid-B lotion. (Clotrimazole and Beclomethasone) once at night.

2. Tugaine (Minoxidil) 5 % foam once in the morning. Please use foam and not lotion or solution, or it might irritate seborrheic dermatitis.

3. Use Ketoconazole 2 % shampoo on alternate days.

4. Tablet Levocetirizine 5 mg once at night or if itching is there.

5. Avoid using hair oil.

Consult your specialist doctor, talk with them, and take medications with their consent. Follow up after one month.

Thank you.

Answer 2

Hello,

Welcome back to icliniq.com.

Irregular heartbeat and hypotension are rarer side effects and are not usually seen. Erectile dysfunction (ED) is common with Finasteride, not Minoxidil.

Thank you.