Brief Answer: Kindly send details Detailed Answer: Hi, Welcome and thanks for posting your query to the forum. I can understand your concern for the hair fall and dandruff. It is really quite distressing for anyone to have hair fall. You have provided quite brief history to guide yourself. Kindly elaborate certain important points so that I can guide you better: - How many hair falls everyday. Do you observe these on your pillows, on floor or in bathroom or during combing. - Do you see any bald areas on the front or side of scalp. You can upload a pictures of your front and side of scalp so that I can analyze the grade of hair loss. - How often you wash your hair and your hair routine. Do you apply any hair oil. - Do you feel itching as mild/ moderate or severely and urge to itch. - Your occupation and daily routine. - Any history of illness or stress in past 1 year. - Comment on your diet- do you take fruits, vegetables and green leafy. Hope to hear soon from your side. Dr Sanjay Kumar Kanodia MD- Dermatology

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Brief Answer: male pattern baldness & pityriasis capitis Detailed Answer: Hi, Thanks a lot for posting the important details so that I can guide you better regarding your problems. After reading your query I can make out two basic problems- one is hair-fall and the other is dandruff or also known as Pityriasis capitis. Both of these problems are quite common in your age group persons. Now taking all the problems one by one: FOR DANDRUFF : Scientifically and medically our skin is a multiple layered structure. Our skin gets renewed every day. The layer which is present on the top today will be fallen off tomorrow. It will not be present tomorrow and would be dead skin in form of scales. This process is not actually visible on normally. So we can say we are just one day old from our skin most superficially. Now in some persons it is renewed at a faster pace. Because of hygiene and scalp hair this dead skin in form of scales gets entangled and trapped in form of visible of scales known as dandruff. It varies from person to person and also on other of factors which makes the difference inter-individually. Coming on to your problem which is scientifically known as “pityriasis capitis” is highest in twenties and thirties and then recedes by itself in later part of life. It is due to the fact that the renewal of skin and the fatty acid secretion in scalp is highest at this part of life. So there is a tendency to grow fungus as well which makes the flaking more perceptible. There are no such important predisposing factors except for few which can make the situation worsened such as individual's own tendency to renew the skin, application of hair oil and environmental factors. We can not change our own tendency to renew the skin but the personal measures of hygiene as well as the environmental factors can be modified. For the remedy part follow the things below: 1.Wash your scalp daily. I guide my patients to wash twice in a single bath. It means when you are washing your scalp apply first time shampoo for washing the hair part only, then rinse it off immediately with water. Reapply the shampoo again immediately, leave it for around 5 minutes, do a good gentle massage by your fingers for around 2 minutes and then wash it off. By doing so for around 7 days you will get good benefit. 2. Stick to one good shampoo which is suiting your hair, don’t change the shampoos frequently. If you are using any conditioner also then to be used over the strands of hair only and not over the scalp skin. There is no difference of shampoos, the only part is to use good company shampoos such as Laureal or Tresemme shampoo. IF the dandruff is too high then you can use any medicated shampoo containing Ketoconazole in it. 3.Do not use any kind of hair oil or any oily or creamy stuff any time on your scalp. 4.Comb your hair at least 3-4 times a day and most importantly at night time so that the dust particle and other of dead skin is taken off. So for betterment of high oil secretion the only good solution is daily washing with any good shampoo. Reduce your exposure to hot and humid climate with any consumption of spicy food. FOR THE PART OF HAIR FALL: To tell you simply let me explain you some medical facts regarding the hair fall. We have a hair cycle divided into three parts: 1. Growing phase (Anagen): more than 85 -90 % of hair are in this phase 2. Senescence phase(Catagen): around less than 10 % of hair are in this phase and is the phase before falling. 3. Falling phase (Telogen ): a very few percentage of hair. We have almost 1 lac hair on our scalp and amongst them few percent of hair are in falling phase and then another 0.1% (around 50-100) of hair can fall everyday. In certain conditions such as poor nutrition or any stressful event or even due to simple stress also, some more of the hair may come in falling phase. These extra of the hair which comes in senescence are actually visible as falling hair. The reason for the acute turning of growing hair to telogen hair is due to one or more of above reasons. It is quite common to find air fall in men which is known as "male pattern baldness" is most common cause of hair fall in young men like you. This process of falling starts by 18-20 years and is highest in between the age of 20 to 30 years. I can see you are a young man of 28 years. So it is quite obvious that you can have the starting of this problem of hair fall just because of hormonal influence. Other than male pattern baldness there can be falling of hair all over the scalp can occur after simple stress too !!!. Nevertheless in hair fall poor diet contribute to increase the hair fall. So you should eat healthiest of diet. For the betterment of diet kindly follow the 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 contains 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 stress as all these have bit impact on skin so also on scalp skin. If I were your dermatologist then would have prescribed you tablet containing Acetylcysteine, Calcium Pantothenate, Selenium, Zinc, Biotin, Copper as active ingredients. You can take these vitamins in the form of biotin, calicium pantothenate and other vitamin B complexes which are available at your local place. Other than this an iron supplementation in diet and in tablet form is also helpful. Additionally I would have started with a lotion contains minoxidil which is one of the very good hair vitalizer approved by USFDA. I would have started with 2 % lotion and continued all the treatment for next 3 months to see the visible results. All these things are quite helpful and are not harmful. I hope these informations will help you. I will be glad to help if you have any further queries or if not then can close the discussion and rate the answer. "Wish you good health" Regards, Dr Sanjay Kumar Kanodia MD (Dermatology)

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