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Hair Loss/No miniaturization

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Question
Hello,

I am a male in his mid-20's and I have been experiencing diffuse hair loss for 4 1/2 months now.  No family history of MPB.

I have seen a dermatologist and she indicated that she did not see miniaturization of the follicle.  A month ago, she prescribed Topicort and ketoconazole shampoo to treat some minor itchiness and flaking she saw on my scalp, thinking that it could be the cause of the hair loss.  However, after a month I have not seen my hair loss decrease, and the itchiness and flaking is still present.

During my follow-up, she prescribed a different steroid for my scalp and a different shampoo.   Is this an appropriate course of action to take?  Also, as it relates to the lack of miniaturization of the follicle, does this mean that I do not MPB? Or can DHT still be causing my hair loss but not manifesting itself miniaturization?  

Thank you very much for your assistance.

Answer
Did the doctor do a scalp biopsy to determine the type of hair loss that you have? Many times that is the only way to determine the type hair loss you have is a scalp biopsy. If you have MPB the only treatment is Rogaine for Men or Propecia. If you have a telogen effluvium which is caused by hair shedding the treatment we use is B12 shots once a month. But again you have to determine the type of hair loss you have. The best way to do that is by a scalp biopsy.

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Michael S. Fisher, <B>Ph.D., M.D.</B>

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