Oily Scalp and painful acnes

Hi, Doctor, I've had extremely oily hair with dandruff since a couple years ago (not sure if this was caused by my overuse on conditioner), I also have thinning hair on center line now. (i have seen my doctor a few time, I have done a hormone imbalance test, and the result was Negative. So, my balanced hormone really did not give me this oily scalp and hair loss really.Then later my doctor had referred me to one of the dermatologist in my area, who told me to use an anti-dandruff shampoo HEAD&SHOULDER classic clean and a prescribed expensive ketoconazole shampoo 2%,so sometimes i alternate them. Though I do tend to used the prescribed shampoo more, since it seems to help reduce the itching and oil. However, the problems are still there!)

  Here's the biggest problem with my crazy oily scale, sometimes my scalp gets these very ITCHY and PAINFUL pimples, (for this problem, my dermatologist  had prescribed me a medicine for it, Clindamycin phosphate get USP, 1%; however this medication doesn't help much in my opinion). So, sometimes i just wait a day or two till the pimple turn white/yellow, so i can squeeze out the pus material (it's gross to me), otherwise the pimple will not heal at all.

Is there something I can do to stop this or reduce all these problems? (itchiness, PIMPLES, oily Scalp, and HAIR LOSS). What do you think I should do to stop this over production of oil and also the thinning hair. Thank you!

cc (P.S. please ignore my bad grammars! This is my first time asking the question. I have noticed a post by user name 'stupidass', topic 'VERY OILY SCALP ITS RIDICULOUS!', who also have the same problem; but there wasn't an answer to his question, but i really want to know if there's any cure for this insane scalp problems or not!); I would greatly appreciates your help if you can explain and give me advices in DETAILS, as much as you can please! Thank you.

[BhumikaMD]

Hi,

This could be seborrhoeic dermatitis. It is a skin disorder affecting the scalp, face, and trunk causing scaly, flaky, itchy, red skin. It particularly affects the sebum-gland rich areas of skin.

Side effects to inflammation may include temporary hair loss. If severe outbreaks are untreated for extended intervals, permanent hair loss may result, because of damage to hair follicles.

http://en.wikipedia.org/wiki/Seborrhoeic_dermatitis

Soaps and detergents such as sodium laureate sulfate may precipitate a flare-up, as they strip moisture from the top layers of the skin, and the drying property of these can cause flare-ups and may worsen the condition. Accordingly a suitable alternative should be used instead.

Among dermatologist recommended treatments are shampoos containing coal tar, ciclopiroxolamine, ketoconazole, selenium sulfide, or zinc pyrithione. For severe disease, keratolytics such as salicylic acid or coal tar preparations may be used to remove dense scale. Topical terbinafine solution (1%) has also been shown to be effective in the treatment of scalp seborrhoea,as may lotions containing alpha hydroxy acids or corticosteroids (such as fluocinolone acetonide). Pimecrolimus topical lotion is also sometimes prescribed.

It would be advisable to consult a skin specialist for your symptoms and a proper clinical examination if your symptoms persist.

Let us know if you need any other information and post us on how you are doing.

Regards.

[iDoWii]

Thank you for taking your time off to answer my long question! The information you gave me was very useful, and I have also checked the link you sent. I think you are right about my condition being seborrhoeic dermatitis, instead of it is ‘STRESS’ like my doctor has been telling me for the past two years.

When my hair loss problem and oily scalp started, I went and see my doctor, she just told me that I am under too much stress (during that time, my mom was undergoing chemotherapy to treat non-H. lymphoma cancer, and I often find myself unable to fall asleep.) So, I was under quite a lot of stress while attending college at that time, so when my doctor suggested that I should eat a balanced diet, and get enough sleep, I believed her and did so. Then the condition got a bit more serious, I went back and see her again half year later, I told her specifically that I think my hair follicles are dying, because they comes off very easily (plus, from the amounts of hair in the drain, it makes me very worry). And again, she told me that I am just under a lot of stress and told me to just get more sleep and relax.

Then a year later, I repeatedly went back to see her regarding the same damn issues (you would think that she will take me seriously, right?), I asked her for a iron deficiency test (because I did lots of research on what causes hair loss & scalp problems, and I noticed that if one is anemic, it can causes hair loss), but the results came out negative ( I asked to see a dermatologist, but she said that she doesn’t think my issues was that serious that needed to see one, Aaaaaaaahhhhhhhhh…… I think I need a new doctor!). Then finally last year, I asked her to give me a hormone imbalanced test (because I was so sick of her telling me that I am just stressed out, and I can’t think of the reason for this oily scalp problem and hair loss), and while she was telling me that the results were negative (I told her I want to see a dermatologist, because these issues bother me so much!) She finally gives in and referred me to one (I think she got sick of my going back to see her for same problem!).
The dermatologist I saw only talk to me for 3 minutes and then asked his assistant to take over to give me prescriptions slip (wow, I guess my condition is not bad in their opinion or maybe they don’t care!) his assistance told me to use Head & Shoulder classic clean shampoo for oily scalp, Rogaine for hair loss, ketoconazole shampoo 2% for oily scalp, Clindamycin phosphate gel USP 1% for acne, and corticosteroids (such as fluocinolone acetonide) to reduce inflammation. Okay, first of all, Head & shoulder really does causes my hair to fall off more, so I kind of stop using it after the first month! Secondly, Rogaine is gross, I mean in the morning you wash your hair, and then during the late afternoon after you put Rogaine on your scalp, seriously you hair looks like it has not been washed for two days. So, I sort of using Rogaine on and off for a month. As for the Ketoconazole 2% shampoo, this stuff really works (but it’s expensive, $28 for 4 ounce), though I don’t mind paying for it since it works, so I have been using this stuff for half year now (it does help in reducing oil on scalp and hair loss, not with the pimples though, since they still comes back often!). As for the Clindamycin phosphate gel USP 1% for acne/pimple, this stuff doesn’t work that well though, it only reduces the itchiness a little. And there is the corticosteroid (such as fluocinolone acetonide), this stuff is basically an oil lotion, it’s gross to have on your hair and scalp (have only used it once!) Okay, I think my dermatologist is giving me some good advice and prescription to fix my crazy scalp and hair, however the problem is not improving much, I still do get the pimples and the itchiness, the oily scalp and the hair loss (just not as severe as before).
Anyway, is there a better prescription out there that can improve or cure this crazy scalp and hair problems??? Was stress really part of the causes to these problems??? Thank you!

Cc

P.S. Sorry for the long detailed message, I just want to let you know what the other doctors are doing for me! (oh yeah, thank you for replying back, I was actually about to give up hope, since I understand how busy doctors are! Again, thank you, I really appreciates your helps!)

[BhumikaMD]

Hi,

It is nice to know that the post was of help to you and also nie of you to post back with an update - a follow up is always welcome and appreciated.

Stress can in fact incraese the symptoms in some case.

Soaps and detergents such as sodium laureate sulfate may precipitate a flare-up, as they strip moisture from the top layers of the skin, and the drying property of these can cause flare-ups and may worsen the condition. Accordingly a suitable alternative should be used instead.

Among dermatologist recommended treatments are shampoos containing coal tar, ciclopiroxolamine, ketoconazole, selenium sulfide, or zinc pyrithione. For severe disease, keratolytics such as salicylic acid or coal tar preparations may be used to remove dense scale. Topical terbinafine solution (1%) has also been shown to be effective in the treatment of scalp seborrhoea,as may lotions containing alpha hydroxy acids or corticosteroids (such as fluocinolone acetonide). Pimecrolimus topical lotion is also sometimes prescribed.

It would be advisable to consult a skin specialist for your symptoms and a proper clinical examination if your symptoms persist.

Let us know if you need any other information and post us on how you are doing.

Regards.

[janie1254]

The person writes back, takes the time to detail what the results are after using the products and you thank the person for writing again and repeat the same advise.  The only reason it I could think is what do doctors really know about hair loss?.  They say it's menopause or thyroid, you take thyroid medications and all of a sudden it becomes the fault of the thyroid pill, you take hormones get everything in balance and then it's the fault of the hormones themselves. Hair follicles are dying and it's a big guessing game on people that once had beautiful think hair.  I wish someone would figure it out by now... someone....they'd be famous.

[janie1254]

Sorry for the typos above, it's early :)

Question for IDOWII, do you still use the Ketoconazole 2% shampoo and is it still helping?  

I've used the T-Gel Coal Tar and it truly soothes the bumps away but they come back. I was fold my problem was/is folliculitis but I've been slowing loosing my hair now for about 5 years.  It's not horrible but it's very verythin on top and makes me very sad about it.  Thanks  Janie,