AboutPeter J. Panagotacos, <B>M.D.</B> Expertise I have 30 years experience in the field of medical and surgical Hair Restoration and am Board Certified
in Dermatology and Hair Restoration Surgery.
Experience I have 30 years experience in the field of medical and surgical Hair Restoration and am Board Certified
in Dermatology and Hair Restoration Surgery.
More information can be found at my website
www.hairdoc.com
Question Dear Dr. Panagotacos,
I'm a 32 y.o. male experiencing thinning hair. It is true that, although my father still got his hair, my maternal grandfather loss his at a quite early age. Yet I'm not sure that it's male pattern baldness that I'm experiencing. My first reason for doubting this is that I'm experiencing thinning hair all over (including on the sides of my head). Although few has even noticed it, I would say that I've lost nearly 50% of my overall thickness/density. (I'm not sure whether it is mainly due to shedding or miniaturization.) Furthermore, I've had, for at least 15 years, this slight odor from my scalp (and sometimes accompanied with an itche). For about two years now I've been using a shampoo with sulfur, which seems to help. Recently I've also started using a shampoo containing ketoconazole. This too seems to help. Yet another reason why I'm unsure whether what I'm experiencing is male pattern baldness is the fact that I'm often pulling my hair. However, I do it with hardly any force. (I guess I use slightly less force that one could use to pull on a strand of boiled spaghetti without it snapping.) I imagine that I lose 50 strands of hair a day this way. Yet even if this is part of the problem, I find it hard to imagine that this could lead to miniaturization, which I do believe has occurred. (Please let me know whether I'm right about it. That is, whether or not this kind of pulling could lead to miniaturization.) I did see a dermatologist back in June, but all he told me was that it is natural for the hair to miniaturize a bit as we age, and that he saw no signs of male patterned baldness or much loss of hair. Yet there is absolutely no doubt in my mind that I have lost density/thickness. And a very god friend of mine pointed it out to me, unbeknownst that it already was something that I was concerned about. Anyway, I started using Rogaine 5% in June. But then, after two months, I stopped using it. Then I started using it again, and have been using it for about three weeks now. I am very grateful for any comments or suggestions that you might have concerning this. Many thanks!
Answer Your ongoing scalp condition with intermittent itch is most likely seborhheic dermatitis especially if it responds to the shampoos you are currently using. The thinning all over can still be inherited male pattern baldness even though you do not have a typical pattern. Without actually seeing you my suggestion to my patients with similar history is to shampoo daily first with a ketoconizole shampoo for a week then a selenium sulfide shampoo and finally with a zinc pyrithione shampoo. The application of 5% minoxidil twice a day for six months may cause some improvement but if the dermatitis persists you may need a topical prescription cortisone lotion. If you want to stop ongoing loss due to inheriting the genes for thinning then you should take Propecia. You can learn more about that at www.Propecia.com
