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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Have Graying Hair, Hair Loss, Dandruff, Itchy Scalp. Seen In Family. Can Any Online Doctor Help?

Hi, I am a 19 year old male. For quite some time, I've had gray hair. It was spotted first by a relative when I was 9 years old. It was just a single strand of hair, so I didn't really care. But now, almost 50% of my hair have turned gray which is quite unusual for a guy my age. Also, I'm suffering from heavy hair loss and dandruff. My hairline currently looks like a II on the left and a III on the right, according to the Norwood scale. Also, it itches around my hairline. My father has male pattern baldness, if it helps.
My concerns are:
1. What kind of Doctor should I consult? (I've considered Endocrinologist because of DHT and Alopecia)
2. Is it possible to improve my hairline? (or maybe increase density - Very thin on the right)
3. What is the possible cause of my gray hair? (3 of my uncles had the same problem)
4. What kind of habits I should develop or avoid for healthy hair?
5. How to arrest hair fall? (Heavy hair fall during shower and combing)
Tue, 9 Apr 2013
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General & Family Physician 's  Response
Hello Qaiz,

Causes of hair loss are:
1. Environmental factors
2. Stress
3. Deficiency of certain minerals, vitamins & amino acids in diet. e.g. Iron, zinc, Vit B complex, lysine.
4. Hormonal factors. e.g. Thyroxine
5. Any incidence of surgery, shock, etc.

Management includes:
1. Treating the underlying cause
2. Avoidance of stress
3. Dietary modifications
4. Minoxidil solution to be applied locally to stimulate the hair follicles
5. Multivitamin & multi mineral supplementation

But these medications have to be used regularly under the guidance of a Dermatologist, as hair loss tends to return on stoppage of these medications.

And before initiation of these medications, the problem of dandruff should be addressed.

Dandruff is basically Seborrheic dermatitis & can be treated with shampoos or lotion containing salicylic acid, coal tar, ketoconazole, or selenium.

So, it will be better to consult a Dermatologist to find out the underlying cause & start treatment accordingly.
Those cases which do not respond to medical therapy, are managed by hair transplantation.

It is believed that it is normal to shed 100 hairs each day, which is based on the assumption that the average scalp has 100,000 hairs, and 10% of these are in the resting phase.

So, there is no need to worry.
Your hairs will grow back again.

The greying of hairs is genetically determined (as seen in your uncles) & also depends on environmental factors & lack of certain essential nutrients in diet.

Wishing you a Good Health.

Let me know if I need to clarify further.

Thanks & take care.
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Dermatologist Dr. Johny Chacko's  Response
Hello

Welcome to health care magic.

Thanks for the query.

You have male pattern baldness, Premature Greying and Dandruff. Let me address your concerns

1. You should consult a dermatologist, not an endocrinologist for all three concerns

2. Of course we can improve your hairline. We have US FDA approved medications like minoxidil and finasteride for it but you need to take it for a long time as we cannot cure the genetic problem but can halt the process.

3. Premature Greying is still a poorly understood entity. The causes suggested are genetic, Vitamin deficiencies, Stress etc. The treatment recommended is vitamin supplements with atleast 100 to 200 mg of calcium pantothenate. Even Biotin and anti oxidants help. Now a new product has come in the market(Melitane) which has peptide which stimulates the pigment producing cells of hair. Sufficient studies and experience is not yet available for it.

4. Wash your hair with an anti dandruff shampoo containing ketoconazole 2% and ZPTO 1% thrice a week. It is better to avoid oil. If you want to apply oil for conditioning effect apply it half an hour before bath and wash it off with a mild shampoo during bath. Eat a balanced diet with proteins , fruits and green leafy vegetables.

5. Once you start treatment your heavy fall will decrease. Give at least 3 months time for the medication to show any result.
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Have Graying Hair, Hair Loss, Dandruff, Itchy Scalp. Seen In Family. Can Any Online Doctor Help?

Hello Qaiz, Causes of hair loss are: 1. Environmental factors 2. Stress 3. Deficiency of certain minerals, vitamins & amino acids in diet. e.g. Iron, zinc, Vit B complex, lysine. 4. Hormonal factors. e.g. Thyroxine 5. Any incidence of surgery, shock, etc. Management includes: 1. Treating the underlying cause 2. Avoidance of stress 3. Dietary modifications 4. Minoxidil solution to be applied locally to stimulate the hair follicles 5. Multivitamin & multi mineral supplementation But these medications have to be used regularly under the guidance of a Dermatologist, as hair loss tends to return on stoppage of these medications. And before initiation of these medications, the problem of dandruff should be addressed. Dandruff is basically Seborrheic dermatitis & can be treated with shampoos or lotion containing salicylic acid, coal tar, ketoconazole, or selenium. So, it will be better to consult a Dermatologist to find out the underlying cause & start treatment accordingly. Those cases which do not respond to medical therapy, are managed by hair transplantation. It is believed that it is normal to shed 100 hairs each day, which is based on the assumption that the average scalp has 100,000 hairs, and 10% of these are in the resting phase. So, there is no need to worry. Your hairs will grow back again. The greying of hairs is genetically determined (as seen in your uncles) & also depends on environmental factors & lack of certain essential nutrients in diet. Wishing you a Good Health. Let me know if I need to clarify further. Thanks & take care.