Seborrheic dermatitis. Will this results to baldness?

Posted on Fri, 25 May 2012 in Skin Hair and Nails
Question: possible hair loss
Hello Doctor. I went to see a dermatologist today because I am afraid of losing my hair. Some background information about me. I am 28 years old. I have next to none history of baldness in my family history. My great-grandfather on my mother's side was bald. However, all my male and female relatives have never lost their hair. My hairline is what you could call a "mature" hairline. Meaning it is around a norwood 1.5 ish. The doctor took a look at my crown and could not notice any visible thinning. However, when he used a magnified camera he noticed a small amount of vellus hairs around my crown. I have major anxieties and stresses on a major basis and I also at the moment have a case of Seborhaic Dermatitis.
My question is. Are the vellus hairs a sure sign of future balding or could they be caused by stress or my dermatitis? The doctor told me that they could be caused by stress.
Basically at the beginning he told me the vellus hairs were a sign of male pattern balding but after i explained my stress problems he said he could not be sure whether or not I had male pattern baldness for sure. Oh he also used the camera to to look at the corners of my hairline and could not find any vellus hairs there.
Basically, am I suffering from early stages of MPB or could my stress and dermatitis be causing the small amount of vellus hairs?
Answered by Dr. Bharat Chawda 1 hour later

Thank you for posting the query,

You have provided with good information regarding your hair problem and it is a very good detail description. I appreciate it.

Well let me tell you that there are various causes of hair loss in males (or in females).

Firstly the genes of baldness usually comes from mothers side( X genes). As you said that your great grandfather from mothers side where bald, so probably there seems to be the link.

The most important cause in males is Androgenetic Alopecia, where in hormones and genes both play a role in causing hair loss. Testosteron hormone works at the base of hair follicle where it gets attached to an enzyme called 5 alpha reductase, which converts testosteron into DHT(dihydrotestosteron ), which is responsible for thinning of hair. This thin hair is ultimately called as vellus hair.These type of hair is either seen over the frontal hair line or over the vertex, thus causing patterned hair loss.

Apart from hormones, stress, thyroid hormones ,lack of sleep,crash dieting, zinc and copper deficiency etc can lead to hair loss.In such condition also there is conversion of terminal hair (thick hair) in to vellus hair. But this is more diffuse i.e it is seen through out the scalp rather than patterned. So there is a more diffuse hair loss in such a case. But then usually there is no one reason for hair loss, so two or more than two reason can lead to hair loss.

Seborrheic dermatitis doesn't lead to vellus hair formation. And I won't consider seborrheic dermatitis as a cause of hair loss at all.

If one can do a trichogram for you ,probably one can find that there is a chance of future baldness or not in your case. A trichogram is done by taking out good number of hairs from different areas of the scalp and looking out for ratio of telogen hair, anagen hair and vellus hair.

But unfortunately you can hardly find any good doctor do a strict trichogram for you. Most of the places I've seen that doing a trichogram is more of a money making process. I can say this with surety because in my postgraduate days trichogram was my thesis topic, and I know how a authentic trichogram is done.

Probably in your case as you said stress is an important factor too,I would say that stress along with hormones and your genes are playing a role in causing hair loss in your case. And thus we can say that you are at an early stage of MPB(Male pattern baldness). But before I can actually say this I would like to have a closer look at your hair line pictures. S o if you can send me some pictures of the scalp (front and top), I can probably help you better.

Awaiting for your reply.

Dr.Bharat chawda XXXXXXX specialist, Dermatology
Above answer was peer-reviewed by : Dr. Yogesh D
Follow up: Dr. Bharat Chawda 6 days later
I read in an earlier post that Seborhaic Dermatitis does not cause hairloss. However, I have read a bunch of internet sites that claim it does cause hair loss. I have noticed that when my dermatitis is bad my hair seems to shed alot more and it just generally feels thinner.
I looked at my hair last year at this time and it doesn't seem much different to me at all. If I am losing my hair it seems to be at a very slow rate. I am being overly optimistic thinking that it could be years before I am noticeably balding? I have read before that balding is unpredictable and that it could start and then stop for a while. Sorry for all the questions but this is really killing me right now and worrying me beyond words

Also my diet and generally lifestyle are not good. I have lost around 10 pounds and my sleep schedule is highly erratic. I don't think the doctor saw it, but when i used to mirrors today i saw some noticeably thinning not on the crown but in front of the crown.
Why I am thinning at the top while my hairline isn't that bad?

Thank you for your reply doctor. I am so stress right now it is not even funny. I can't think or even sleep. So are you saying that there is a possibility that stress and lifestyle is cause my hair to thin? Although it is not diffuse all over the head.
Basically you are saying I don't for sure have MPB. Is that correct?
Answered by Dr. Bharat Chawda 1 hour later

Thank you for writing back.

After going through your complete history again, I think that stress, hormones and your genes have a major role to play in causing hair thinning and hair loss.

As you said that your diet, sleeping habits and lifestyle is not according to schedule as it should be. Also, the weight loss further aggravates you hair loss. If you have experienced drastic weight loss, I would suggest that you get your thyroid hormones checked. You can get a serum thyroid stimulating hormone (TSH ) level and a free serum thyroxine level (FT4) level done.

As far as seborrheic dermatitis is concerned, a mild case does not lead to hair loss, but very severe dermatitis can lead to hair loss. So you should get this treated too if it is very severe. I would suggest the following:
•     Use a good anti dandruff shampoo (medicated)
•     Apply a steroid lotion at night. Since this is a prescription drug, I would suggest that you consult your dermatologist for the same.

I would again say that a multitude of reasons are working in your case and thus I suspect that you have an early case of male pattern baldness.

I can completely understand your condition and thus I would suggest the following:
•     Tablets like finasteride, biotin & lotions like minoxidil should help you delay the process of baldness. Please consult your dermatologist for the same.
• XXXXXXX leafy vegetables, high amount of proteins and a good sleep is also a must.

I thank you again for submitting your question. I hope you found my response to be helpful and informative. If you have any additional concerns I would be happy to address them.


Dr.Bharat chawda XXXXXXX specialist, Dermatology.

Above answer was peer-reviewed by : Dr. Aparna Kohli
Answered by
Dr. Bharat Chawda


Practicing since :1996

Answered : 988 Questions


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