fungal infection, hair loss, itchy scalp, dandruff.

Dear Doctor,

I am 26, been losing hair since 2002. I inherited dandruff problem from my father. I take head bath everyday, if i dont my scalp gets filled with dandruff and extremely itchy. I used Head & Shoulders shampoo everyday which worked for dandruff but not itching. And it seemed that the shampoo worsened the hair loss problem; I started using herbal essence shampoo since last 15 months, i use it everyday. Dandruff and itching are controlled but I still loose lot of hair. I am not completely bald now but noticeably very very less hair over my head and still losing.

I also have fungal skin infection, found out that it is Tenia Corporis from google, not quite sure about that. Had this infection since around 8yrs, dermatologist suggested to use clotrimazole, it works but i have to use it everyday cause if I stop the infection recurs.

My family line is good with thick hair. my father is in his late 50's with plenty of hair. But my father's brother became bald in his mid 60's. I had very very thick hair before i started to lose them. I used to study a lot when its exams time, did night outs; used to feel a lot of stress and pressure.

Did I inherit my father's brother's baldness?

Does this has anything to do with my Fungal infection problem?

Is this because of stress(but now I have no stress, finished my bachelors in 2005)?

Could you also help me with the skin infection, using the cream has become a part of daily life. Is there a permanent solution?


Best Regards,
Paul

[Vanessa Lacuesta]

Hi,

I do understand how discomforting this is for you. How old are you?

There are two kinds of hair loss. There is hair loss with visible scalp disease and there is hair loss without scalp disease. In your case, the hair loss may be associated with both the fungal infection and another underlying condition of seborrheic dermatitis.

At this point, there is really no effective medical therapy for hair loss. If your hair loss is associated with tinea and seborrheic dermatitis then the underlying disorders need to be addressed first.

Hair loss also has a genetic basis. Male or female pattern baldness may follow a hereditary pattern. Treatment of the tinea and seborrheic dermatitis may help resolve the hair loss. Creams may not be sufficient for scalp infections. You may need oral antifungal therapy. But first a microscopic evaluation of the scalp scrapings may be done to ascertain the diagnosis.

[helpaul]

Hi Ms Vanessa Lacuesta,

I am 26. When I shaved my head there wasn't anything visible except dandruff, so is my hair loss without scalp disease? My father has dandruff too but not hair loss. so, is my hair loss associated with tinea?
Once I did take pills suggested by a dermatologist but that did not really help.

[Vanessa Lacuesta]

Hi,

Dandruff is a manifestation of seborrheic dermatitis. At this point the cause of seborrheic dermatitis is vaguely known. Malassezia yeast has been associated with seborrheic dermatitis but the exact cause of the condition is yet to be defined. Given this, what you have is still hair loss with scalp disease as dandruff is a disease. Your physician is treating you in the line of a fungal infection hence, the intake of oral medications.

Seborrheic dermatitis may recur and persist given the right triggers. Unlike tinea capitis, wherein a fungal infection is established, seborrheic dermatitis  may involve several factors such as stress and environment. Genetics may play a role also.

There is no definite treatment for seborrheic dermatitis. Frequent and vigorous shampooing are the mainstay of therapy. If the symptoms persist even with treatment, a biopsy may be indicated.

[helpaul]

Hi Ms Vanessa Lacuesta,

So do u say that my hair loss is due to the dandruff I have? I am fine with dandruff and itchy scalp  because shampooing everyday really helps. I am not taking any pills right now and not taking any treatment except for shampooing my hair with herbal essence every day. I took the pills few years back; took a lot of them, which did not help so I gave up. I am trying out myself here on internet to understand the cause. what type of baldness does mine come under? I loose hair only on the top, the circumference or the border of the head are good.
Could you please suggest me to do something to stop this or atleast control. I am sure there should be a way.

Thank you,
Paul

[Vanessa Lacuesta]

Hi,

In your case, I would say that if seborrheic dermatitis is present it may contribute to the hair loss but it is of course possible that the hair loss and dandruff are separate conditions. Male pattern baldness if  baldness runs in the family may be considered here. But a presence of a scalp condition like seborrheic dermatitis or other fungal infections may cause some degree of hair loss. However, it is necessary to note that hair loss with seborrheic dermatitis appears to be more diffused and not well demarcated or patchy.

At this point,  I have not encountered any effective medical therapy for hair loss. Some have tried minoxidil and corticosteroids but there is really no single effective way. For severe cases , hair transplants may be considered.

Discuss this further with your physician so you may be guided accordingly. I understand that you are highly anxious about this. However, if the underlying scalp infection has been present for years ,I believe these recurring scalp infections may be contributing to the hair loss.

[helpaul]

Hi.

Yes you are exactly right; my hair loss is diffused and not patchy. I never tried Nizoral( ketaconazole), do you think that is appropriate to me? I am curiuos.

Thank You,
Paul

[shipra15]

hi
I am 24 year old girl.For the last four months i am experiencing severe hair loss (thinning of hair).I dont have any dandruff,so what can be the reason for this severe hair loss.

[Mel674]

Are there any expert doctors in the NYC area that you would recommend for scalp infections or scalp related fungus issues?

[danny964]

hi im 22 and i just shaved my head but i still have dandruff in patches on my head when i scratch it its lik snow(lol) and leaves white patches on my scalp. i have also been loosing my hair since i was 15,( luckly im still goodlooking) but what do u think of this. oh and the sides of my hair is much thicker that the top.


danny.