Brief Answer: Kindly see the suggestions below Detailed Answer: Hi, Welcome and thanks for posting your query to Healthcare magic. I can understand your concern for loss of hair and dandruff. I can understand the whole series of problems related to hair. As a young man you are quite worried about all the things related to your scalp. 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 present 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. 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. It then causes itching of the scalp and related problem of hair fall too. It will definitely help us if we take care of dandruff on its best. 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. If the dandruff is too high then you can use any medicated shampoo containing Ketoconazole in it. The shampoos enumerated by you are good one and can use them. 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. * FOR THE PART OF HAIR FALL: 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 26 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 after simple stress too !!!. Other than this it can be due to dietary imbalance, low protein and mineral intake and due to substance abuse such as alcohol or smoking. Your doctor has prescribed you Dutasteride tablets (Dutamax) which are anti-androgenic in nature like finasteride. These have the side effect of loss of libido and inhibition of testosterone temporary till the person is taking it. THat is why your morning erections have been lost. So after knowing all the points my suggestions for your problem is following: 1. I am not in favor of oral finasteride or dutasteride at all. Though many a companies claim to be reversible side effects but I am personally not satisfied with the claiming. You are young man and might be sexually active male so it is important for you to stop dutasteride by mouth. I am against using dutasteride by mouth in sexually active male and especially young males. 2. Rather now a days saw palmetto is better and safer option which is a natural product without side effects. 3. You can apply Minoxidil topical solution. It do not have the systemic side effects and good results can be obtained. 4. A nutritional supplement containing Biotin and mutiple other nutrients would be a good option to take on daily basis. 5. Your dietary improvisation- eat a lot of fruits, sprouts and green leafy vegetables daily. 6. Stop any substance abuse (if any like smoking or alcohol). You can talk to your doctor and explain your anxiety and problems so that the best measures can be applied. Hope these informations will help you. If you have further queries I will be happy to help. "Wish you good health" Regards, Dr Sanjay Kumar Kanodia MD (Dermatology)

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Brief Answer: Kindly see the suggestions below Detailed Answer: Hello, Welcome again and thanks for your follow up. To guide you further regarding the issues: - It is very important in today’s educated world to ask for each and everything which you receive. You have all the rights to ask your doctor regarding the type of treatment, its effects as well as side effects. In hair fall there are innumerable treatments available and each dermatologist has his or her own set armamentarium to treat it. I suggest you to humbly ask your treating doctor regarding type of treatment he is giving. This will not only reduce your apprehension but also be helpful in building faith and hence a good relation between doctor and patient. - Regarding the Dutamax- As I said earlier that I am not at all in favor of this medicine. This is my view with respect to young sexually active male. Had you been post 50 years then I would have considered the same but not even in any sexually active male. Though the side effects are reversible but I feel injustice in debarring anybody form his normal sexual activity. You can ask your doctor regarding the side effects and to change the tablet accordingly. Saw palmetto is better and safer option which is a natural product without side effects. - Your doctor has given a good dietary regimen of flax seeds, walnut and dates each day. I suggest you to 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 contain 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 work stress as all these have bit impact on skin so also on scalp skin. 7. Stop any substance abuse such as smoking and alcohol if any!! Lastly I again suggest you to talk to your doctor and explain your anxiety and problems so that the best measures can be applied. If you have further queries I will be happy to help. "Wish you good health" Regards, Dr Sanjay Kumar Kanodia MD (Dermatology)

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Brief Answer: Kindly follow the suggetions below Detailed Answer: Hello, Welcome again and thanks for your follow up. To guide you further regarding the issues: - 1>Till what time I would be able to recover from my problem which I am facing currently? If at all I am not able to recover in said time what measures should I take and which doc to consult. - It may take few weeks of the period to regain your normal sexual functions. Other than the medicines due to anxiety also there is reduction in the libido. So I request you to reduce your anxiety for anything. 2>I want to know is it necessary to have a medicine for this or without medicine also it can be cured? - It is quite important to know that male pattern baldness is a cosmetic issue and not a disease in itself. It depends on the grade and fall of hair to take medicines. You can preferably apply medicines and take multivitamin tablets which causes no side effect at all. You can continue your treatment with those medicines which doctor feels safe for you according to your young age status. 3>I had heard of this problem earlier and had kept this oin the first meeting with doc but he denied by sayind that he himself takes this treatment from last five years and thee is no side affects for it. - As I said previously, there are different schools of thought with anti-hormonal tablets. In my own personal view I do not prefer it in young sexually active males. So it may be your doctor’s personal observation to have no side effects like the same. But as you have got it, so preferably the things should be well discussed with the doctor. 4>If at all my doc insist to take another medicine should I see another doc? Cause as a layman we dont know what medicines to take in and what are there side affects. - If your doctor insists to take the same medicines then you can humbly request him to change the anti-hormonal tablets. If at all the doctor insists then you are quite grown up to take your decisions accordingly. 5>I also wanted to know about the red light radiation to which I am exposed and the injection in the scalp, Does these also have side affects and I should stop them? - Your doctor has tried to provide a very good treatment which is considered to be latest. He might have used “light therapy” along with “mesotherapy”. This is the latest concept to get fast hair growth and stimulate the hair roots. There is no side effect of the same. You can further ask your doctor for the same. 6> What all questions should I put to my Doc before undergoing any furher treatment which will ensure me that it doesnt harms me anymore. -It is quite important to know that all the part of your treatment is going well and you felt stoppage of the hair fall also. The ony problem came when you lost your morning erections. So in this regard the part of queries form your side should be to asked is the treatment given in details with respect to duration, effect and side effects basically. Take prior appointment with your doctor and explain him about your anxiety regarding the treatment after the part of loss of morning erection. The doctor will definitely listen to your concern and provide you the relevant details regarding the part of treatment along with stoppage of dutamax. 7> What all problem apart from erection could had happened to me and I would be still unknown to it now? What tests should i undergo to see if i facing another problem due to that medicine which I may face in future? - There is no other side effect of any of the treatment except for the impaired erections. Do not put yourself in unnecessary anxiety state. AS I said previously the rest of the part of treatment is quite good except for the part of morning erections. This will also be normalized in coming few weeks of the period. So keep you stress aside and talk to your doctor so that you can be treated at the best. "Wish you good health" Regards, Dr Sanjay Kumar Kanodia MD (Dermatology)

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