Suggest Treatment For Severe Dandruff And Hair Loss

Posted on Wed, 14 Jan 2015

Question: My Query to Dermatologist-Sir/Madam Good evening.I am medical student from XXXXXXX I have moderately severe dandruff since 10 years.I am able to keep it under control by periodical hair washes through 2% Ketoconazole shampoo.But since the last one year,but dandruff has become quite resistant and is frequently recurring.Since last 6 months I have been having hair fall as well .I used terbinafine 250mg/day for 2weeks but is of no use.I tend to have more flakes on my scalp.Can I use Griseofulvin orally now?please I need your valuable advise .

Answered by Dr. Geetika Paul (5 hours later)

Brief Answer:
Kindly provide details of treatment

Detailed Answer:
Hi

I understand your concern regarding your skin problem and I hope I am able to help you in the same.
From the description you have provided,it looks like you have developed moderate to severe dandruff.
Now I can see that you have been taking oral antifungals on and off for your problem.I would like to know if you are applying any other topical drug over the scalp other than the shampoo .
I am asking this since topical therapy is also equally important to manage seborrheic dermatitis .
Also I usually do not recommend griseofulvin to my patients for dandruff .
Fluconazole or Itraconazole works well in most cases .

Dr Geetika Paul

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Geetika Paul (14 hours later)

Hi Dr XXXXXXX

thanks for your prompt reply.

I have used terbinafine only once ,six months ago for a period of 14 days.So its definitely not on and off.
I regularly use topical 2% ketoconazole shampoo.

What is the dosing regime of itraconazole to treat my condition.?

Is this ENDOTHRIX what I have?

Why should I not use Griseofulvin?its an age old traditional drug to treat Tinea capitis know.

Kindly respond

Answered by Dr. Geetika Paul (3 hours later)

Brief Answer:
Treatment of seborrheic dermatitis

Detailed Answer:
Hi again

Thanks for the details

I can understand from the details that you have moderate to severe resistant to treatment Seborrheic dermatitis.
You seem to be not taking adequate topical therapy .
I would suggest that you should start application of zydip lotion regularly at night over the scalp .
Continue to use ketoconazole shampoo for washing hair on alternate days .
Take tablet fluconazole 150 mg once a week for four weeks.
Take oral vitamin a capsule daily once a day for two weeks .
This is the regimen I follow in my patients with similar presentation.
It includes antifungal management along with topical steroid therapy to repair the damaged skin epithelium.
It is always good to start with baseline drugs ,so my approach would be to use fluconazole in your case.
We can think of alternatives like griseofulvin or Itraconazole if the problem tends to persist .
Your problem is seborrheic dermatitis .

Dr Geetika Paul

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Geetika Paul (15 hours later)

Madam,thanks for your response,i shall certainly adhere to them.

Please suggest me trade name for Selenium sulphide shampoo and salicylic acid 2.5 % shampoos?

Answered by Dr. Geetika Paul (3 hours later)

Brief Answer:
Take treatment

Detailed Answer:
Hi again

You can buy Selsun shampoo or protar or protar k or t/sal shampoo.

Dr Geetika Paul

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Geetika Paul (1 hour later)

can you suggest me tab flucoznazole 150 mg trade name with very high oral bioavailability Dr Geetika?

Answered by Dr. Geetika Paul (4 hours later)

Brief Answer:
Medicines

Detailed Answer:
You can take tablet flucos .

Dr Geetika Paul

Note: Hope the answers resolves your concerns, however for further guidance of skin related queries consult our Dermatologist.Click here to book a consultation

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar