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Diagnosed with G6PD. Started itching and losing hair. What treatment should be done?

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Practicing since : 2006
Answered : 2015 Questions
I have been diagnosed with G6PD for approx 8 yrs now. I am female and African American. I itch all the time and have scars from scratcing esp on my back and legs. But most importantly my hair falls out to the point I must wear wigs. I hate it!! I read where a blood transfusion would replace bad red cells with good ones. How do I go about requesting this procedure? And, if not possible, what treatments can I use to help with the itching and loss of hair. Thank you
Posted Thu, 14 Mar 2013 in Skin Hair and Nails
Answered by Dr. Kalpana Pathak 2 hours later
Thanks for writing to us.
In most of the females G6PD deficiency is asymptomatic that is it does not lead to any jaundice , anemia etc. Blood transfusion is only required when one gets severe anemia. I would like to know if you are having any symptom pertaining to G6PD def.

Now coming to your skin problems
To treat your dry skin, youmay follow these general recommendations
1) use XXXXXXX warm water to bathe
2) use a mild soap like cetaphil
3) always dab or blot your skin dry, never rub the towel too hard to dry your skin
4) apply a moisturiser containing lactic acid, urea immediately after bath and preferably twice to thrice in a day.
5) if the skin is very itchy, may apply topical steroid lotion like mometasone for few days at areas of extreme dryness

As far as hair fall is concerned
I would like to know since how long are you having it
Pattern of hair fall- if its diffuse thinning or losing hair from frontal, temporal or central portion scalp
Any associated scalp pathology like severe dandruff, change in color of scalp( like it has become atrophic white with no hair follicle seen)
Any nutritional deficiency, thyroid disorder etc
I would also like you send me images of concerned area ( scalp,back and thighs) so that it becomes easy for me to ascertain the underlying cause for hair fall and dry skin
Hoping to hear from you soon.
Above answer was peer-reviewed by
Follow-up: Diagnosed with G6PD. Started itching and losing hair. What treatment should be done? 31 hours later
Thank you Dr. Pathak for your reply.

I don't have a dry skin probem, in fact, my skin is very oily. I use a moisterizer daily. So the itching does not come from dry skin., I also don't have dandruff on my scalp or changes in scalp color. My hair has been falling out in cycles all my life esp just before my period. And mostly in the same area, at the back of my head. I beleive I am scracting my hair out because of the itching at night along with scratching my back.

This is not a daily occurance. Mostly just before my period or during extreme stress. The itching and scratching happens severly about every three to four months. I use Benedryl to help relieve it. Which it does, but does nothing about the scalp.

I was diagnoses with G6PD after taking a regiment of aspirin and developed a rash on my back about eight years ago. As well as hyper thyroid but was told the medication increased the thyroid levels too high. That was a few years ago.

I take a daily iron pill to help with the blood flow and have tried folic acid as well. It seems as I get older, the problem gets worse.

I don't have pics since I don't have a camera. But will try to get you a few pics.
Answered by Dr. Kalpana Pathak 18 hours later
Going by the areas of itching involved, you might be having neurodermatitis.
It is a case of itchy skin where as such there is no cause for itching. It is characterised by itching and scratching of easily accessible areas like thighs, legs, upper back and back of scalp.
This chronic itching and scratching can lead to pigmentation, scarring of involved area or hair loss at site of itching.
In most of the cases itching is stress or anxiety induced.
To treat the same
Take tablet cetirizine in morning and tablet doxepine in night( it relieves itch and has anti anxiety role also)
If required, take anti anxiety drugs for few days
Apply betamethasone or mometasone lotion/ cream at sites of itching including scalp
Apply emollients daily
Wear full cotton clothes while sleeping. The idea is to keep the areas of itching covered.
Keep your nails short to decrease itching induced trauma
Once the itching is under control, you may start with topical minoxidil solution 2 percent twice daily over scalp for two to three months to induce hair growth.
If possible, go for long walks, meditate or get involved in stress busting exercises or activities.
Hope that helps.
Above answer was peer-reviewed by
Follow-up: Diagnosed with G6PD. Started itching and losing hair. What treatment should be done? 44 hours later
Thank you Ma'am,
Do I understand that you are suggesting that my condition is NOT G6PD related and that it may all be caused by stress/anxiety? I currently take Zanax for anxiety for well over three years but have not noticed a decrease in the itching or the hair loss. Also I have used the minoxidil treatment for a very long time and the benefits are always short lived.
I have not considered my condition as a rersult of stress since I have suffered with it for many years. Is this possible? I am an active duty member of the Army so daily excercise is a must. Don't have a spouse or children so I spend alot of time alone. I am a clinical social worker so I do see 4 to 6 clients daily. Other than that my daily life is less than remarkable. I can't understand while this radical reaction to stress or why without a direct trigger I continue to itch,scratch and go bald. As we speak, my back and scalp is itching in high gear and I have been relaxing all day as it is a holiday.

Lastly, are these lotions available over the counter. Could you suggest some type of treatment with stronger, lasting results to help control this condition once and for all.

Thank You
Answered by Dr. Kalpana Pathak 1 hour later
Thanks for writing back.
Your skin concern is not at all G6PD related but could have been thyroid related. However in thyroid disease itching is generalised and hair fall is diffuse. While in your case sites of itching are easily accessible sites, where you can itch subconsciously or even while sleeping.

Neurodermatitis initially is precipitated by stress or anxiety, sometimes tight clothing, insect bite or any trivial stimulus but once the itching is initiated, it converts into a vicious itch scratch cycle that is the more you scratch, the more will itching increase and hence more will be the damage to skin in form of skin thickening, pigmentation, scarring or hair fall. So even if stress or anxiety has been treated, itching might persist

Your problem of itching might have begun with stress in the beginning but now to prevent the same, we have to break the itch scratch cycle . It is not necessary that whenever you are stressed, the itching in those areas will flare up. Gradually over a period of time, itching in neurodermatitis becomes a habit, so even if you are not stressed and in laid back attitude, you might feel an urge to itch.

Whatever treatment I have suggested in my previous post is available over the counter and with treatment once the area is healed and itching is prevented with oral antiallergic tablets , your problem will be solved. Be assured of that.
Your hair fall is primarily due to injuries induced by itching. So initially apply steroid cream and lotion in the area, later on when the itching is gone, minoxidil can be used to induce hair growth. With minoxidil you have had response but the response was short lived as the underlying cause for itching was not treated

To understand your condition better, you may check this link WWW.WWWW.WW
Hope that helps.
Above answer was peer-reviewed by
Follow-up: Diagnosed with G6PD. Started itching and losing hair. What treatment should be done? 2 days later
Makes a lot of sense to me. Thank you, Dr. P!!
I'm on it, as I want nothing more than this cycle of itching and falling hair to stop!!

I will keep this link as I would love to follow up with you after I have used your suggested treatments.

God Bless!
Answered by Dr. Kalpana Pathak 11 hours later
Wish you a speedy recovery
Take care
Above answer was peer-reviewed by
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