Brief Answer:
Upload a photograph; provide more information

Detailed Answer:
Hello and welcome to healthcaremagic

I am Dr. Kakkar. I have gone through your query

I would like to gather more information from you regarding your concern

-What is the duration of hair loss? Approx number of hair lost per day?
-Is the hair fall diffuse or is it more from the frontal scalp and crown? Is there anterior hair line recession too?
-Is there a family history of balding?
-Was it preceded by a stressful event like medical/surgical illness?
-Can you upload a photograph which would provide me a better understanding of the pattern and severity of your hair loss?

Hair fall in males can be due to various causes. Common ones being Dandruff, Androgenetic alopecia, Telogen effluvium etc.

While dandruff is an important cause of increased hair shedding it may be not be the only one responsible in your case. Moreover, androgenetic alopecia and dandruff, together can be responsible for increased hair shedding. Dandruff related increase in hair shedding is reversible, moreover the patient never complains of decreased hair volume in dandruff related hair shedding. Whereas hair fall due to androgenetic alopecia has a pattern to it. Thinning is more over the central part of the scalp and is associated with gradually receding anterior hair line.

For dandruff, I would suggest you to continue with 2% ketoconazole shampoo, thrice weekly for 2-4 weeks. Since dandruff is bound to recur, therefore rather than using a regular shampoo, people with dandruff should use an antidandruff shampoo (twice weekly for maintenance) to keep dandruff under check.

You may also use a topical steroid lotion e.g mometasone lotion (Elocon lotion) once daily at night X 2weeks, for better control of dandruff/scaling

Though controlling dandruff effectively would control your hair fall problem, however there might be another reason for your hair fall and decreased density, which needs to be evaluated after examining e.g Androgenetic Alopecia is the most common cause of gradually progressive hair thinning and hair fall from the frontal scalp and crown. Usually there is a positive family history.

Minoxidil and finasteride are FDA approved for androgenetic alopecia related hair loss and hair thinning. These drugs are available on prescription from a doctor and hence I recommend you to visit a doctor before trying them.

Another important cause of hair fall is Telogen effluvium, usually there is a preceding stressful event e.g medical/surgical illness like dengue, malaria etc OR post-partum OR weight loss (in your case), scalp hair is prematurely pushed into resting phase (Telogen) from the growth phase (Anaphase), manifested as increased hair shedding.

Treatment of hair fall depends on accurately diagnosing the underlying cause and managing it accordingly.

Regards

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Brief Answer:
Upload photograph again

Detailed Answer:
Hi.

Unfortunately, I have not received the photograph.

Kindly try and upload the photograph again. You may go to the reports section and upload photograph there Or you may even mail the photograph at YYYY@YYYY with the subject line as "Attention Dr. Kakkar". Once you post the photographs I would be able to see them and guide you better.

In addition to dandruff, you do seem to have androgenetic alopecia as well, as can be judged from the fact that your hair loss is more from the centre/top part of the scalp and also there is a history of baldness in your grandfather. Treatment should be directed accordingly addressing both the causes.

However, I would be able to confirm the diagnosis of androgenetic alopecia, once I get to see the photograph.

Regards

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Brief Answer:
Androgenetic alopecia

Detailed Answer:
Hi

I have looked at the photograph. I can see thinning of hair from the crown of the scalp. This is Androgenetic alopecia.

If I was the treating doctor I would have asked you to continue Nizral 2% shampoo. Along with that I would have started you on Momate lotion once daily at night for the stubborn dandruff.

Regarding Androgenetic Alopecia (hair thinning from the central part of the scalp) you may use Q-sera liquid once daily (2 ml, to be applied at the scalp).
Tab Finax 1 mg once daily is also specific for androgenetic alopecia and needs to be continued long term (say 2 -5 years). The treatment would halt further progression of baldness and may regrow new hair, as well.

Regards

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