Suggest Treatment For Hair Loss And Dandruff
I use 10% minoxidil once at night everyday as prescribed by doctor. Also advised Anaphase shampoo and Bontress lotion, which I haven't started yet. Please let me know if these Anaphase and Bontress are effective in treating hair loss. And is there any shampoo/lotion that can address both dandruff and oily scalp issues?
Seborrheic Dermatitis and Androgenetic Alopecia
Detailed Answer:
Hello and welcome to healthcaremagic
I am Dr. kakkar. I have gone through your concern and I have understood it.
You seem to have Androgenetic Alopecia along with dandruff/seborrheic dermatitis possibly worsened by Minoxidil use
Dandruff or seborrheic dermatitis is an important cause of scalp itching and increased hair shedding. Dandruff is bound to recur again, therefore people with dandruff should use an antidandruff shampoo to keep the dandruff under check, rather than using a regular shampoo.
If I was your treating doctor I would have asked you to use an antidandruff lotion/shampoo. My choice is 2% ketoconazole shampoo(Scalpe lotion), thrice weekly OR even daily, for 2-4 weeks.
However sometimes a shampoo alone seems insufficient. In such a case your dermatologist might choose to prescribe you a topical steroid lotion(clobetasol or mometasone lotion e.g Topisal 3% lotion OR Elocon lotion ), to be applied once daily for 2 weeks.
The topical steroid lotion can be stopped once the dandruff is well controlled and thereafter the improvement can be sustained with just an anti-dandruff lotion/shampoo.
For Androgenetic Alopecia, Treatment modalities include Topical Minoxodil 5% OR 10% and oral finasteride. While minoxidil is a non-specific hair growth promoter, finasteride is specific for androgenetic alopecia, it inhibits as well as reverses miniaturization. There are well controlled trials and US FDA approval for them for this kind of hair loss in males.
However, since minoxidil is available in an alcohol base (the solution contains 40% v/v alcohol). Once applied over the scalp alcohol evaporates and causes dryness of the scalp skin. Therefore, dryness OR scalp scaling is very common with Minoxidil use. Since you already have pre-existing dandruff and oily scalp, it may have been worsened further by Minoxidil use.
Bontress lotion is also an anti-hair fall treatment (contains capixyl) which unlike minoxidil does'nt cause any further dryness. However it does'nt yet has FDA approval for Androgenetic Alopecia. It is recommended to be applied once daily at night. You may use it instead of minoxidil.
As you already have dandruff and oily scalp issue, therefore rather than using Anaphase shampoo which is just a nourishing cream shampoo, I would suggest that you continue with Scalpe lotion as before along with a topical steroid lotion once daily during the day time (as discussed previously)
You could also add oral Finasteride tablet+Essvital tablets along with Bontress lotion for Androgenetic alopecia.
hope this helps you
regards
Thanks a lot for your detailed answer.
Just few things I'd like to add which I'd not mentioned in my previous query.
1. My scalp is very sensitive and anything other than Scalpe doesn't work :(. It also couldn't take Minoxidil (even the one that comes in foam alcohol base). Then doctor gave me a sample medicine which is Minoxidil in adhesive base (Biominox A10). I've been using it for a month now and there's no scalp irritation.
2. Doctor hasn't advised Finasteride possibly because I was a little reluctant as I read in an article that it causes minor libido loss and I'm newly married, so didn't want to take chances :)
3. Instead of Finasteride, doctor hence advised Essvital for 90 days and has asked me to change to Androanagen tablets.
So please let me know if I can take Androanagen + Finasteride once a day and Bontress in the morning + Minoxidil in adhesive base at night?
Androgenetic Alopecia
Detailed Answer:
Hi.
You are a very well informed patient. That makes my job easier!! :-)
Yes, you can use Tab. Androanagen once daily along with Essvital (No need to take both Tab. Androanagen as well as Tab. Finasteride together, as both of them inhibit the same enzyme i.e 5-alpha reductase, present in the outer root sheath of hair follicle. You can take either one of them. Since you have concerns about Finasteride, therefore Androanagen is an option for you)
Yes, MinoxidilA 10 for night time use and Bontress for day time use would be optimum therapy.
regards
I'm sure going to follow this routine then..
One last advise to control excessive sebum secretion would be very helpful.
Thanks n regards,
XXXX
Androgenetic alopecia+seborrhea
Detailed Answer:
Hello
Scalpe lotion contains 2% ketoconazole which is an effective sebostatic for scalp. You are already using it. You can use it even daily.
For excessive sebum secretion on face, you could use a 2% salicylic acid face wash, once daily (Spongysal face wash, marketed by curatio).
regards