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What Causes Acne Lesions On Scalp And Hair Fall?
Question: I am 29 year old female.
I have acne on scalp and hair from very long time (from 2009)
I went to dermatologist and tried lot of medication. but no change.
I have thyroid, I take thyronorm daily and my TSH levels got normal but I still had hair fall and acne.
I have Vit D deficiency and I read in Internet that vit D is one of the reasons for acne and took Vitamin D sachets. (60,000IU 1 each week for a month. 2 sachets in next month, 1 XXXXXXX per month hereon). I saw a total reduction in acne and hair loss.
From few days I suddenly realized increase in hair fall and Acne again. I took test and found.
1. I still have Vit D deficiency. ( 18.17ng/dl. Deficiency: <20 ng/dl . The last time it was 15.35)
2. Abnormal TSH (7.46. But I can say that when my TSH , T3, T4 levels were normal, I still had hair fall and acne)
3. My testosterone levels are high. 86.4 ng/dl. Reference Range: Adult female 14 - 76
They were normal when I took test 6 months back. Another point to mention is I took Nexito 10mg for 20 days (From May 4th to May 24th 2014). I didnt see any change in hair fall and acne during this period.
Present condition:
1. My hair fall and acne were still there. I dont know why. I dont know why there was sudden stop in hair fall for few days and why it resumed again?
2. Has Nexito increased my Testosterone levels? And I heard High testosterone levels can be due to PCOS and lead to hair fall and scalp, in that case why am I seeing this change in hair fall again much after I stopped using Nexito?
How do I reduce my hair fall and acne in scalp, back and face? How do I reduce my testosterone levels?
I have acne on scalp and hair from very long time (from 2009)
I went to dermatologist and tried lot of medication. but no change.
I have thyroid, I take thyronorm daily and my TSH levels got normal but I still had hair fall and acne.
I have Vit D deficiency and I read in Internet that vit D is one of the reasons for acne and took Vitamin D sachets. (60,000IU 1 each week for a month. 2 sachets in next month, 1 XXXXXXX per month hereon). I saw a total reduction in acne and hair loss.
From few days I suddenly realized increase in hair fall and Acne again. I took test and found.
1. I still have Vit D deficiency. ( 18.17ng/dl. Deficiency: <20 ng/dl . The last time it was 15.35)
2. Abnormal TSH (7.46. But I can say that when my TSH , T3, T4 levels were normal, I still had hair fall and acne)
3. My testosterone levels are high. 86.4 ng/dl. Reference Range: Adult female 14 - 76
They were normal when I took test 6 months back. Another point to mention is I took Nexito 10mg for 20 days (From May 4th to May 24th 2014). I didnt see any change in hair fall and acne during this period.
Present condition:
1. My hair fall and acne were still there. I dont know why. I dont know why there was sudden stop in hair fall for few days and why it resumed again?
2. Has Nexito increased my Testosterone levels? And I heard High testosterone levels can be due to PCOS and lead to hair fall and scalp, in that case why am I seeing this change in hair fall again much after I stopped using Nexito?
How do I reduce my hair fall and acne in scalp, back and face? How do I reduce my testosterone levels?
Brief Answer:
Acne and hair fall management
Detailed Answer:
Hello,
Welcome to healthcare magic.
I understand from your history that
1. You have acne lesions on your scalp and hair fall
2. You have hypothyroidism and are on medication
3. Your Vitamin D levels were low
4. Your S.Testosterone levels are high
Taking into consideration your history of hair fall, acne and raised serum testosterone levels, I would want to rule out Polycystic Ovarian Disease. (PCOD)
I think you are already aware of this entity.
PCOD could lead to female pattern hair loss along with acne.
Hypothyroidism is one of the causes of hair loss, a pattern called as chronic telogen effluvium. A person having female pattern hair loss may also experience increased hair shedding ( telogen effluvium) on and off during illness, stress, thyroid abnormalities, anaemia, etc.
Why were you on Nexito? Nexito is escitalopram which is given as an anti-depressant. It has no role in worsening hair fall or in increasing testosterone levels.
I would advise you the following -
1. Please get a complete evaluation done to rule out PCOD- this includes serum LH levels, Serum FSH levels and a pelvic ultrasound.
2. Repeat your TSH level and also get you hemoglobin and Serum Ferritin level checked.
3. A low Vitamin D level may be an incidental finding. I feel it has no major role in hair loss in your case.
4. Please consult an endocrinologist for evaluation of hypothyroidism and PCOD.
5. If you find that you have low hemoglobin/ ferritin, you may need to take iron supplements.
6. You will benefit from using 2 % Minoxidil solution. This is US- FDA approved for the treatment of female pattern hair loss. However, This is also beneficial for chronic telogen effluvium.
7 You could also take supplements containing Biotin, cysteine and methionine. ( e.g - Follihair)
I hope I have addressed your issues.
I would advise you to get the above evaluation done and consult a good endocrinologist and a dermatologist.
Wishing you good health,
Dr. Johny Chacko
Acne and hair fall management
Detailed Answer:
Hello,
Welcome to healthcare magic.
I understand from your history that
1. You have acne lesions on your scalp and hair fall
2. You have hypothyroidism and are on medication
3. Your Vitamin D levels were low
4. Your S.Testosterone levels are high
Taking into consideration your history of hair fall, acne and raised serum testosterone levels, I would want to rule out Polycystic Ovarian Disease. (PCOD)
I think you are already aware of this entity.
PCOD could lead to female pattern hair loss along with acne.
Hypothyroidism is one of the causes of hair loss, a pattern called as chronic telogen effluvium. A person having female pattern hair loss may also experience increased hair shedding ( telogen effluvium) on and off during illness, stress, thyroid abnormalities, anaemia, etc.
Why were you on Nexito? Nexito is escitalopram which is given as an anti-depressant. It has no role in worsening hair fall or in increasing testosterone levels.
I would advise you the following -
1. Please get a complete evaluation done to rule out PCOD- this includes serum LH levels, Serum FSH levels and a pelvic ultrasound.
2. Repeat your TSH level and also get you hemoglobin and Serum Ferritin level checked.
3. A low Vitamin D level may be an incidental finding. I feel it has no major role in hair loss in your case.
4. Please consult an endocrinologist for evaluation of hypothyroidism and PCOD.
5. If you find that you have low hemoglobin/ ferritin, you may need to take iron supplements.
6. You will benefit from using 2 % Minoxidil solution. This is US- FDA approved for the treatment of female pattern hair loss. However, This is also beneficial for chronic telogen effluvium.
7 You could also take supplements containing Biotin, cysteine and methionine. ( e.g - Follihair)
I hope I have addressed your issues.
I would advise you to get the above evaluation done and consult a good endocrinologist and a dermatologist.
Wishing you good health,
Dr. Johny Chacko
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hi,
Thanks for your prompt reply.
The results I produced in my previous question was when I took the test 6 months back on XXXXXXX 22nd.
1. In previous test and today's test I dont have low haemoglobin.
From todays tests:
Iron - 62.74 µg/dl (Reference Range:Male : 70 - 180 Female : 60 - 180 µg/dl )
Iron binding capacity: 404.22 (Reference Range:Male: 225 - 535 µg/dl Female: 215 - 535 µg/dl µg/dl )
% TRANSFERRIN SATURATION - 15.52 Reference Range:13 - 45 %
HbA1c - 5.3 (Reference Range:Below 6.0% - Normal Value 6.0% - 7.0% - Good Control 7.0% - 8.0% - Fair Control 8.0% - 10% - Unsatisfactory Control Above 10% - Poor Control %
)
-----------
I have a bit low LDL- 79 (Reference: 85-130) Is it dangerous?
LDL / HDL RATIO (Reference: 1.5 - 3.5)
-------
I took Nexito when I consulted a psychiatrist as I was going through depression for some time. I took them 20 days and stopped as I was noticing side effects. (very delayed orgasms)
When I took the test in XXXXXXX 22, my testosterone were normal. I had hair fall and acne even when testosterone was normal. So hair acne and acne was not due to PCOD. Only in today's test I noticed a hike.
In 6 months testosterone increased. So I though Nexito could be a reason.
I have used biotin previously, hair fall may reduce initially but it kept coming back after a while even though I have been taking biotin regularly. So the problem is something else. Also please note that is not just hair fall both hair fall and acne on scalp and on face. Both are related. I was having hair fall and acne and if acne reduced, hair fall also reduced for certain time.
Thanks again for your prompt reply.
Thanks for your prompt reply.
The results I produced in my previous question was when I took the test 6 months back on XXXXXXX 22nd.
1. In previous test and today's test I dont have low haemoglobin.
From todays tests:
Iron - 62.74 µg/dl (Reference Range:Male : 70 - 180 Female : 60 - 180 µg/dl )
Iron binding capacity: 404.22 (Reference Range:Male: 225 - 535 µg/dl Female: 215 - 535 µg/dl µg/dl )
% TRANSFERRIN SATURATION - 15.52 Reference Range:13 - 45 %
HbA1c - 5.3 (Reference Range:Below 6.0% - Normal Value 6.0% - 7.0% - Good Control 7.0% - 8.0% - Fair Control 8.0% - 10% - Unsatisfactory Control Above 10% - Poor Control %
)
-----------
I have a bit low LDL- 79 (Reference: 85-130) Is it dangerous?
LDL / HDL RATIO (Reference: 1.5 - 3.5)
-------
I took Nexito when I consulted a psychiatrist as I was going through depression for some time. I took them 20 days and stopped as I was noticing side effects. (very delayed orgasms)
When I took the test in XXXXXXX 22, my testosterone were normal. I had hair fall and acne even when testosterone was normal. So hair acne and acne was not due to PCOD. Only in today's test I noticed a hike.
In 6 months testosterone increased. So I though Nexito could be a reason.
I have used biotin previously, hair fall may reduce initially but it kept coming back after a while even though I have been taking biotin regularly. So the problem is something else. Also please note that is not just hair fall both hair fall and acne on scalp and on face. Both are related. I was having hair fall and acne and if acne reduced, hair fall also reduced for certain time.
Thanks again for your prompt reply.
Brief Answer:
Hair fall and acne management
Detailed Answer:
Hello,
Greetings!
I went through your history again.
I understand that the serum testosterone which was normal 6 months back has now got elevated. You were having same problem inspite of the normal testosterone and that is what is confusing you.
Let me explain to you how the hormones work for you to get a clear picture.
The hormones level in the blood is only a part of the picture. The hormone acts on the "receptors" in various organs like liver, pancreas ( insulin), thyroid gland ( thyroid hormone), hair cells and face oil glands (Testosterone). The action is seen when the hormone acts on the receptor in the respective organ. Sometimes, though the blood level of the hormone is normal, the receptors will be more sensitive to even the normal level of circulating hormone in the blood ( This is termed as end-organ sensitivity). That time, the blood test will be normal, but the disease process can still happen.
Hope you could understand this complex mechanism.
Therefore, even though you feel that the testosterone level was normal, the disease process was still happening at the "receptor level". It takes many years for the gross abnormality to become manifested in the blood. ( elevation of hormones to be manifested in the blood test)
As you yourself have observed acne and hair loss flare up together. This is because both are caused by the same disease process.
Do not worry about LDL.
Unless you address the underlying issue, biotin and even other supplements will not give you a permanent solution.
I hope this has thrown more light on your problem.
Do not take too much mental stress as this also can worsen hair fall. The depressive episode could have triggered more hair fall and you are attributing it to nexito.
Do undertake the tests I have mentioned on the 3 rd day of your next period and also do the pelvis ultrasound.
Hope this helps you.
Wishing you good health,
Dr. Johny Chacko
Hair fall and acne management
Detailed Answer:
Hello,
Greetings!
I went through your history again.
I understand that the serum testosterone which was normal 6 months back has now got elevated. You were having same problem inspite of the normal testosterone and that is what is confusing you.
Let me explain to you how the hormones work for you to get a clear picture.
The hormones level in the blood is only a part of the picture. The hormone acts on the "receptors" in various organs like liver, pancreas ( insulin), thyroid gland ( thyroid hormone), hair cells and face oil glands (Testosterone). The action is seen when the hormone acts on the receptor in the respective organ. Sometimes, though the blood level of the hormone is normal, the receptors will be more sensitive to even the normal level of circulating hormone in the blood ( This is termed as end-organ sensitivity). That time, the blood test will be normal, but the disease process can still happen.
Hope you could understand this complex mechanism.
Therefore, even though you feel that the testosterone level was normal, the disease process was still happening at the "receptor level". It takes many years for the gross abnormality to become manifested in the blood. ( elevation of hormones to be manifested in the blood test)
As you yourself have observed acne and hair loss flare up together. This is because both are caused by the same disease process.
Do not worry about LDL.
Unless you address the underlying issue, biotin and even other supplements will not give you a permanent solution.
I hope this has thrown more light on your problem.
Do not take too much mental stress as this also can worsen hair fall. The depressive episode could have triggered more hair fall and you are attributing it to nexito.
Do undertake the tests I have mentioned on the 3 rd day of your next period and also do the pelvis ultrasound.
Hope this helps you.
Wishing you good health,
Dr. Johny Chacko
Note: Hope the answers resolves your concerns, however for further guidance of skin related queries consult our Dermatologist.Click here to book a consultation
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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