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Hair Loss/Medicated Shampoo

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Question
Could overuse of medicated shampoos to treat seborrheic dermatitis cause hair loss and irritated scalp? I was prescribed nizoral 2% shampoo and suffered quite a bit of hair loss in the past few months but I fear I may have overused it and used it for too long because I was afraid the dermatitis would come back. I've stopped using the shampoo and my scalp feels better. Do you think the hair that shed will come back?

Answer
I think it was coincidental. 2% Nizoral can and is used daily by people with seborrheic dermatitis or by men who want to use it to help lower DHT formation in the skin to help prevent male pattern baldness.  Both 2% zinc pyrithione shampoos and 2% ketoconizole shampoos are prescribed by me for my patients to use on a daily basis. I have never seen a patient develop a shed due to the use of either of these shampoos.
 Stress is frequently a cause of flares of seborrheic dermatitis and during the stressful incident hairs go from their active anagen growth phase into a resting phase. One or two months later the hairs fall out in the Telogen Phase - This is called a Telogen Effluvium- At the same time there may be a flare of seborrheic dermatitis also due to stress but not the cause of the Telogen Effluvium. Seborrheic Dermatitis has a natural tendency to come back for a variety of reasons in people who have a predisposition to having this condition.
 
 60 years ago there was a theory that ice cream was the cause of polio because the sales of ice cream co-incided with the incidence of polio. It turned out the common denominator was congregating at swimming pools in the summer heat and eating ice cream.
  Stress can cause both Seborrheic Dermatitis and telogen effluviums.

http://www.dermnetnz.org/dermatitis/seborrhoeic-dermatitis.html
Seborrhoeic dermatitis is not contagious or related to diet, but it may be aggravated by illness, psychological stress, fatigue, change of season and reduced general health.

http://www.dermnetnz.org/hair-nails-sweat/telogen-effluvium.html
If there is some shock to the system, as many as 70% of the anagen hairs can be precipitated into telogen, thus reversing the usual ratio. Typical precipitants include:

Illness, especially if there is fever
Surgical operation
Accident
Childbirth
Nervous shock
Weight loss or unusual diet
Certain medications
Discontinuing the contraceptive pill
Overseas travel resulting in jetlag
Excessive sun exposure
The resting scalp hairs, now in the form of club hairs, remain firmly attached to the hair follicles at first. It is only about 2 months after the shock that the new hairs coming up through the scalp push out the "dead" club hairs and increased hair fall is noticed.

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Peter J. Panagotacos, <B>M.D.</B>

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I have 30 years experience in the field of medical and surgical Hair Restoration and am Board Certified in Dermatology and Hair Restoration Surgery.

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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

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