Brief Answer: Dryness due to lotion is usual; stop for few days Detailed Answer: Hi XXXXXXX Thanks for showing your confidence in me for your hair fall condition and its related things. I have gone through your query with diligence and after analyzing the complete situation I can make out that you have the condition called as "male pattern baldness" or medically known as “Androgenic alopecia”. Before I come directly to your point let me give you certain important information regarding your condition: Medically the number of normal hair falling varies from few hairs to up to 50-100 per day. Now if your hair falling more than 100s per day then it is definitely a problem. If it is not then you have to understand hair fall as normal process of day to day life. We have almost 1 lac hair on our scalp and amongst them around 5% of hair are in falling phase and then another 0.1% (around 100) of hair can fall everyday. In males this is super-added with hormonal influence of testosterone hormone (the male hormone) which we call as "male pattern baldness". This also depends upon genetics- meaning type and pattern of hair your family pattern (from your father and mother's side). This process of falling starts by 20 years and is highest in between the age of 20 to 30 years. I can see you are a young man of 27 years. So it is quite obvious that you can have this problem of hair fall just because of hormonal influence. So, as I said earlier your problem is basically Androgenic alopecia or simply saying male pattern baldness. It affects mainly frontal and parietal region of the scalp. The side of scalp region is rarely affected and occipital region is never affected in this condition. So the most important thing is not to be worried about this normal physiological age related men's problem. Now regarding the part of treatment: There are innumerable products in the market claiming to be useful for hair growth. We dermatologists believe in application of Minoxidil lotion. It is one product which is unanimously used by all dermatologists. It is to be started with 2% lotion applied over the scalp once or twice in day. It is to be applied when the scalp is dry. Only 1 ml is sufficient to be applied at the root of hair in frontal region. If for one month there is no burning and irritation then we increase the percentage to 5 % to 10% gradually. Many a times we do start with 5 % directly when we see that the hair fall is on higher side. The same we do to taper off the medicine. That means we do not stop the medicine at once and gradually taper it off to 5% and then 2% and then alternate day or off and application of lotion before stopping it completely. Many times we see crystal kind of deposition over the scalp area. This is due to either over application of the lotion or due to the preservatives in the higher concentration. This results in dryness and irritation over scalp and resultant breaking and falling of hair. It is quite usual response in most of the minoxidil lotions. Along with it a tablet containing Acetylcysteine, Calcium Pantothenate, Selenium, Zinc, Biotin, Copper as active ingredients is quite helpful in regaining the strength of hair. So you got some idea regarding your condition and part of treatment. You can get that your doctor has tried to give you best treatment form her side but there comes certain more important things in relation to your treatment: 1. If I were your treating dermatologist then would have advised you to use only 1 ml strictly to be applied once at night time for initial few days and then two times after 15 days of period. 2. The 1 ml lotion is to be applied finger tips rather than the directly by dropper as it causes more deposition of lotion in the scalp skin. 3. The lotion is to be applied at a gap of 5 cm mainly on frontal and parietal areas. Now correlating all these facts: you are given minoxidil in lotion form so it is quite usual to get dryness and falling of hair accordingly. I suggest you to stop lotion for few days period and use a mild shampoo to take care of dry scalp condition. After a gap of few days you can start the 5 % lotion at night time ( as you are already using 5 % so I would not suggest you t taper it off abruptly). Start with just ½ ml initially and that too very gently. If at all you feel comfortable and no dryness appears then can make it to 1ml in next 2 weeks and then twice daily according to the dryness. If still the dryness part occurs then either alternate days application or reducing the concentration or changing the lotion form to either gel based preparation or foam based preparation in the same concentration. I suggest you to talk to your treating dermatologist and appraise her suggestion with due respect. Rest of the part of Adgain capsule is quite a good capsule and you can continue the same For the betterment kindly follow the further suggestions below: 1. Eat at least 3-4 different fruits saplings per day. Every fruit is good but you can make a combination of sour with sweet fruits such as oranges, papaya and other of seasonal fruits. 2. Pulses are good source of proteins. So everyday have a small bowel full of mixed pulses. Add green leafy vegetables additionally in the pulses which contain lot of iron and vitamins in it. 3. Sprouts are the best source of fibers, minerals especially iron, vitamins and proteins too. so add it at-least alternate day if you can not make in every-day's part of meal. 4. Over night soaked and peeled almonds will give you good vitamin E which is good for the hair growth. 5. Milk and milk products should be included in every-day's schedule. 6. Do light exercises, reduce your work stress as all these have bit impact on skin so also on scalp skin. 7. Stop any substance abuse such as smoking and alcohol if any!! Hair growth is a slow process and need some time to get better. SO have patience young man. I hope these informations will help you. If you have further queries I will be glad to help. "Wish you good health" Regards, Dr Sanjay Kumar Kanodia MD (Dermatology)

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Brief Answer: fiber rich diet; improve daily routine Detailed Answer: Hi XXXXXXX Thanks for your follow up an I am really happy to know that you are now relaxed after knowing the facts regarding your hair fall as well as the treatment part. Now for your further query regarding constipation with hemorrhoids and relation with hair fall: there is no direct implication of both constipation with hemorrhoids on hair fall. But in case of constipation, it leads to hemorrhoids which in turn on one side can cause blood loss and on other side both constipation with hemorrhoids can cause impaired dietary balance due to poor intake and accordingly poor absorption of nutrients in diet. I have many times seen that due to both constipation and hemorrhoids, there is dietary aversion and it also induces a lot of stress on the affected person. SO if you have both constipation and hemorrhoids then it is better to consult a surgeon for the best help and get treated at the earliest. There is additional information regarding reducing your constipation: 1. Improvise your water/ liquid intake: drink at least 2-3 liters of water. 2. Increase fiber content of diet. 3. Increase fruits, vegetables and sprouts. 4. Eat an XXXXXXX at night time and drink a glass of warm milk after that. 5. As soon as you wake up, drink 1-2 glass of warm water in the morning. 6. change your life style of sedentary work to bit active one. DO yoga or light exercises daily. 7. Do not eat any kind of fast food items. These are just glimpses of the few things which you have to do. You yourself need to be strongly motivated to change your lifestyle. You are quite an intelligent and smart fellow and I am pretty confident that you will find the wrong things in your daily routine and correct them accordingly. I hope these informations will help you. If you have further queries I will be glad to help or if not then can close the query and rate the answer. "Wish you good health with healthy skin and hair" Regards, Dr Sanjay Kumar Kanodia MD (Dermatology)

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