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Have heavy dandruff problem and hair fall resulting in low density and bald patches. Suggest?

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General & Family Physician
Practicing since : 2005
Answered : 2308 Questions
I have got some heavy dandruff problem since about 7 years, never did i observe any high amounts of hairfall, i used to have high and dense curly hair but off late i have realised that my hair density has gone down rapidly and even friends started teasing me saying that bald patches on my head are visible. I am worried that if this continues so then i would become bald very soon. Please suggest me a proper solution to this. Should i apply hair oil or not? If so then at what time of the day? Should i apply any other hair creams for hair density increase? Should i eat more of certain kind of vegetables for increasing back my hair density? Is there any specific diet i need to follow for this?
Posted Wed, 11 Sep 2013 in General Health
Answered by Dr. Prasad 44 minutes later
Brief Answer:
Treat dandruff now...

Detailed Answer:

Thanks for sharing your concern here.

Dandruff is caused by fungus. Therefore it is essential to treat the fungus with proper shampoo - chemical or medicated to solve this issue. As heavy dandruff is an important cause of hair fall, it is important that you first treat dandruff. Hair fall problem is likely to improve.

To my patients, I suggest ketoconazole containing shampoo such as Nizoral for regular use. You can also try it if you haven't used this in the past. Apply this shampoo thrice weekly for 2-3 months for best results.

As far as oiling is concerned, natural coconut hair oil can be used once a day. It can be helpful.

Eat plenty of fruits and vegetables. Root vegetables like beetroot, radish, carrot, potato, turnip and so on are healthy for hair nourishment. Make them part of your regular food. In addition keep yourself stress free with regular sleep and exercise. Diet and exercise will contribute to nourish your hair back to its previous state. In addition you can also use biotin (tablet biotin forte) supplements for additional benefits.

I would not recommend any other hair cream or products for the next 2-3 months. You can try other treatment options once you are able to control dandruff issue with the available treatment.

Hope it is clear to you. Write back for clarifications.

Above answer was peer-reviewed by
Follow-up: Have heavy dandruff problem and hair fall resulting in low density and bald patches. Suggest? 10 minutes later
Sir i have already used Nizoral, it was the first shampoo that the doctor prescribed for me, but i couldn't see any better results so the doctor had it changed.

As far as oiling the hair is concerned, is it better to apply oil at night before sleeping and then have a head bath the next morning or shall i apply it after bath in the morning?
Answered by Dr. Prasad 36 minutes later
Brief Answer:
Application before bath is better....

Detailed Answer:

Nizoral is effective in most case. One of the reasons for ineffectiveness might be incorrect usage. Applying to the scalp directly for 10 to 15 minutes and not just rubbing / washing hair is the way to use Nizoral. Further, it has no role in preventing dandruff from recurring again; therefore continued usage is the key.
I stress on treating dandruff because hair fall is going to be evident if you continue to harbor plenty of dandruff.

If you feel Nizoral has been inefficient, you can try alternative antidandruff shampoo... 8x (ciclopirox) is the next choice of mine.

As far as oiling is concerned, there is no clear scientific data to discretely define the best way to use hair oil. That being said, I do not like you to layer the scalp with excess oil for very long time. Hair and scalp like any other part of skin needs fresh oxygen. Therefore massaging the scalp with oil for 15-20 minutes before bathing should suffice.

Hope this answers your query. Let me know if you need clarifications.


Above answer was peer-reviewed by
Follow-up: Have heavy dandruff problem and hair fall resulting in low density and bald patches. Suggest? 18 minutes later
Sir, now i have realised that i haven't used Nizoral in the proper way. having said that, if i am not bothering you much could you please elaborate a bit more about how Nizoral should be used and before applying nizoral to the scalp directly before 10 to 15 minutes should i wash the hair & scalp with plain water once. And also while having a head bath, is it advised to repeat shampoo usage i.e. should the head be shampooed twice because personally i felt that during the 2nd usage there will be more lather produced and that the shampoo wouldn't reach the scalp effectively
Answered by Dr. Prasad 2 hours later
Brief Answer:
Apply on the scalp....

Detailed Answer:

With Nizoral, the ONLY instruction is you need to apply it directly over the scalp. Massage the scalp thoroughly (and not just hair) for 10 - 15 minutes before washing under running water. For better and uniform application wash your scalp with plain water once before applying it.

This needs to be repeated every time you shampoo. For better results, I recommend you to use this shampoo three times a week for 2-3 months before deciding to change the shampoo.

Hope this answers your query. I will be glad to address your other concerns.

Above answer was peer-reviewed by
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