Transplants & general hairloss with psoriasis/dermatitis

[TrialAcc]

Hi all,

Been exploring the possibility of a frontal FUT procedure to restore my frontal zone (currently NW3 heading to 4A with some crown thinning) and have seen a couple posts along doing my research in regards to psoriasis/dermatitis in both overall hairloss and with transplants. I was going to schedule some online consultations as covid restrictions start to get lifted, but right now we are in full lockdown in Canada. 

I'm 28, hairloss was greatly slowed by finasteride but every few months I will get bouts of insane itchiness, red scalp pimples/inflammation and bumps all around the hairline/mid scalp where I am about to experience thinning. I always assumed this was just aggressive genetic hairloss, as I see people talking about the "itch" associated with loss. After seeing these threads though, what I experience seems likely scalp psoriasis, and I'm wondering how much this could have played a role in my hairloss and my future as a transplant candidate... I would assume that the possibility of a scaring alopecia could exist as well, but I think my loss is pretty patterned and I don't want to assume things until I see a derm. 

Has anyone experienced something similar? If this is a chronic condition should I avoid hair transplants all together? Anyone know of any treatments outside of the basic coal tar/nizoral/head and shoulders?

I know I need to see a dermatologist for a biopsy but like I said, we are in lockdown and I'm experiencing a pretty severe bout of it right now coupled with shedding. I can post pictures later if it would help but I just showered and styled my hair so they will have to wait!

Thanks guys!

Edited December 26, 2020 by TrialAcc

[mcr7777]

Yes post pics if you can...sometimes scarring alopecias can look like MPB, especially cases of frontal fibrosing.  I really wonder how many go undiagnosed.  It cause itching too.  Also sometimes you can have both MPB and a scarring alopecia at the same time.

[TrialAcc]

On 12/27/2020 at 12:19 PM, mcr7777 said:

Yes post pics if you can...sometimes scarring alopecias can look like MPB, especially cases of frontal fibrosing.  I really wonder how many go undiagnosed.  It cause itching too.  Also sometimes you can have both MPB and a scarring alopecia at the same time.

Here you go. Have it alongside the entire front and center leading back to the crown. Also it's at the nape area as well but no thinning present there that I can see. 

[mcr7777]

Can you post one of the centre of the hairline too? 

 

Seems like it could be a number of things based on the bumps and inflammation -there may also be some minitaurisation too from what I can see. But don't think you would normally get bumps like that from only MPB.  It's possible there can be another condition going on in addition to MBP.

 

 Good idea to do a biopsy when you can - definitely before moving forward with any HT.

[aaron1234]

MPB and an itchy scalp are not necessarily related.  Try to find some products that will keep the inflammation at bay.  I wash my hair with the tar based T-Gel about once a week.  I also lather aloe vera onto my scalp every other day.  If things start to get itchy then I love to use scalpicin (1% liquid hydrocortisone) and that really helps quite a bit.  My scalp used to be psoriasis prone but now I seem to have it under control with these products.  

[splitting hairs]

Hi, it's always best to get seen by a derm to get a diagnosis and a treatment.  It looks like it's seborrheic dermatitis.  Psoriasis has plaques and a lot of scaling.  Have you tried an antifungal shampoo such as Nizoral?  Having this condition doesn't exclude you from a transplant.  Usually surgons get you to use a topical steroid for a week before a procedure.  I have seen quite a few cases of patients with dermatitis by Dr Lorenzo.  

[TorontoMan]

Is the redness only limited to the front there? Or does it show in other parts of your scalp 

[pkipling]

Hey man! Fellow lifelong member of the itchy scalp/dermatitis club here! I've never found anything to completely cure it, but I have found different ways of preventing breakouts over the years through my own trial and error. Yours may be a tad more severe than mine, but here are some things to consider that have really helped me: 

• Be mindful of the products you're using on your hair. I've noticed that my scalp is very sensitive to certain products, and I've had to learn which ones to avoid, which ones work, etc. As a general rule, I tend to use products that are perhaps a tad more expensive, but that don't have as many harsh chemicals and additives in them. Getting stuff that is plant-based/natural also tends to help. 
• Don't go too long without washing your hair. Most people can go 2-3 days without shampooing their hair. In fact, most stylists/barbers recommend this so as to not strip your scalp of a lot of the essential oils it produces on its own. However, if I have product in my hair, I can't go more than 2 days max without washing it, otherwise I start to breakout. 
• Don't use super hot water, especially when the weather is on the colder side. It'll dry your scalp out and exacerbate any problems you have. 
• If you're able to reach a point where your scalp is stabilized, start to notice and pay attention to the early stages of a breakout. If I catch it early, I can essentially nip it in the bud. This happened last night actually, and I pulled out my trusty doctor-prescribed topical steroid and put it on before bed. It was already back to normal by the time I woke up.
• Apple Cider Vinegar has worked wonders in the past as a natural way to treat my scalp when I have a breakout. It's worth a shot. 
• For whatever reason, my scalp is more susceptible to breakouts the longer my hair gets. I suppose it's do to more oils and whatnot being trapped and causing more buildup to happen. I dunno. All I know is that it's easier to manage when my hair is shorter. 

I still use Nizoral on occasion and I think you should get a professional opinion on the matter, but use these as some pointers and a starting off point to find a solution that works for you. 

As for any increased hair loss, I definitely have more "hair fall/shedding" when I have a breakout. However, that's different from any hair loss related to MPB and has more to do with the scalp not being in a healthy enough state to support healthy hair. I sort of look at it like I look at soil and plants... The healthier the soil, the better chances the plants have of growing tall and strong. Fix the soil, and many problems with the plants themselves will be resolved. I also don't believe that this condition makes you a poor candidate for a hair transplant, though that's something you'll want a professional opinion on as well.  

[TorontoMan]

24 minutes ago, pkipling said:

Hey man! Fellow lifelong member of the itchy scalp/dermatitis club here! I've never found anything to completely cure it, but I have found different ways of preventing breakouts over the years through my own trial and error. Yours may be a tad more severe than mine, but here are some things to consider that have really helped me: 

• Be mindful of the products you're using on your hair. I've noticed that my scalp is very sensitive to certain products, and I've had to learn which ones to avoid, which ones work, etc. As a general rule, I tend to use products that are perhaps a tad more expensive, but that don't have as many harsh chemicals and additives in them. Getting stuff that is plant-based/natural also tends to help. 
• Don't go too long without washing your hair. Most people can go 2-3 days without shampooing their hair. In fact, most stylists/barbers recommend this so as to not strip your scalp of a lot of the essential oils it produces on its own. However, if I have product in my hair, I can't go more than 2 days max without washing it, otherwise I start to breakout. 
• Don't use super hot water, especially when the weather is on the colder side. It'll dry your scalp out and exacerbate any problems you have. 
• If you're able to reach a point where your scalp is stabilized, start to notice and pay attention to the early stages of a breakout. If I catch it early, I can essentially nip it in the bud. This happened last night actually, and I pulled out my trusty doctor-prescribed topical steroid and put it on before bed. It was already back to normal by the time I woke up.
• Apple Cider Vinegar has worked wonders in the past as a natural way to treat my scalp when I have a breakout. It's worth a shot. 
• For whatever reason, my scalp is more susceptible to breakouts the longer my hair gets. I suppose it's do to more oils and whatnot being trapped and causing more buildup to happen. I dunno. All I know is that it's easier to manage when my hair is shorter. 

I still use Nizoral on occasion and I think you should get a professional opinion on the matter, but use these as some pointers and a starting off point to find a solution that works for you. 

As for any increased hair loss, I definitely have more "hair fall/shedding" when I have a breakout. However, that's different from any hair loss related to MPB and has more to do with the scalp not being in a healthy enough state to support healthy hair. I sort of look at it like I look at soil and plants... The healthier the soil, the better chances the plants have of growing tall and strong. Fix the soil, and many problems with the plants themselves will be resolved. I also don't believe that this condition makes you a poor candidate for a hair transplant, though that's something you'll want a professional opinion on as well.  

How do you use the apple cider vinegar?

[aaron1234]

1 hour ago, pkipling said:

Don't go too long without washing your hair. Most people can go 2-3 days without shampooing their hair. In fact, most stylists/barbers recommend this so as to not strip your scalp of a lot of the essential oils it produces on its own. However, if I have product in my hair, I can't go more than 2 days max without washing it, otherwise I start to breakout.

This is also true for me.  I will actually have an itchy scalp if I miss one day of washing, so I shampoo daily.  

[shami26]

Is this psoriasis/dermatitis? I've been dealing with this for some months now and it's frustrating me.

I went to a dermatologist and they said it's inflammation then gave me a prescription for Tretinoin and Clobetasol Propionate topical solution but I think it's treating it, not curing. 

[pkipling]

On 12/29/2020 at 3:18 PM, TorontoMan said:

How do you use the apple cider vinegar?

I just apply it directly to my scalp - although depending on how bad my scalp is irritated/broken out, it definitely stings a bit. However, the sting quickly subsides, and personally I find it to be a "good sting", if that makes sense.  You could dilute it with water as well to help mitigate this. It serves as a natural alternative to the Steroid I have from my doctor, and honestly works just as well in my experience. The worst part is honestly the smell, which is why I don't always use it.

[MillerOliver]

Have you applied to a doctor melbournefunctionalmedicine.com.au? What did he say? It's hard to find at 28 that you general hair loss with psoriasis. What was the cause of this disease? I've read that psoriasis is most commonly triggered by hereditary factors. Besides, you feel sure that hair loss is permanent? My friend has psoriasis and the doctor said him that he can lose a lot of hair during relapse, but this loss is not permanent. The hair follicles do not suffer from inflammation and are active during remission. I hope you feel better now!

Edited March 19, 2021 by MillerOliver