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HT and seborrheic dermatitis


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  • Regular Member

Hi guys. Almost all male members of my family have/had some issues with hair loss. I will be 27 in September and started to lose hair when I was ~16. Till 19 years old I had pretty long hair which I cut as my hair loss started to be visible. Then, around 2015 I started to have seborrheic dermatitis (itch, greasy hair, pimples which often caused small bleeding and later scabs).

 

I began a full therapy:

- Finasteride (1 mg/day),

- Minoxidil (5%),

- Isotretinoin (10 mg/day),

 

I have heard that a hair transplant is not possible while taking isotretinoin. I tried to stop taking it in 2019 but it was not possible as all symptoms of seborrheic dermatitis came back so I reduced it to 3 times per week.

 

In February 2021 I visited a dermatologist once again and reduced isotretinoin to 2 times per week. In March 2021 to 1 pill per week. Right now I take/use:

- Finasteride (1 mg/day),

- Minoxidil (5%),

- Saw palmetto,

- Ducray Sensinol shampoo (Water, Sodium Laureth Sulfate, Zinc Coceth Sulfate, Ceteareth-60 Myristyl Glycol, Laureth-9, Coco-Glucoside, 1,2-Hexanediol, Caprylyl Glycol, Citric Acid, Disodium Edta, Hydroxypropyl Guar Hydroxypropyltrimonium Chloride, Sodium Chloride, Sodium Hydroxide) on a daily basis,

- Mediket Ictamo (Aqua, Sodium Laureth Sulfate, Cocamidopropyl Betain, Cocamide DEA, Sodium Shale Oil Sulfonate (Ichthylol Pale), Polyquatemium-7, Sodium Chloride, PEG-120 Methyl Glucose Dioleate, Zinc Pyrithion, Lactic Acid, Benzyl Alcohol (and) Methylchloroisothiazolinone (and) Methylisothiazolinone) twice a week,

- Vitella Ictamo forte (Petrolatum, Mineral Oil, Zinc Oxide, Calcium Carbonate, Talc, Sodium Shale Oil Sulfonate (Ichthyol Pale), Sodium Caproyl/Lauroyl Lactylate, Triethyl Citrate, Piroctone Olamine (Octopirox)) every day, on the temples and the top of the forehead,

- Belosalic (Betamethasonum + Acidum salicylicum) twice a week,

- Vitamine D,

- Zinc.

 

So, quite a lot. The issue is my head is still not under control. I still get pimples on my head. My skin itches and hurts (where the pimples appear). I see small white spots near my hairline that are easy to scratch off and no blood spills from them.

 

According to the Hamilton-Norwood scale I am III vertex right now. Finasteride just stops/slows down the process. I do not know what to do. I know that my skin problems only speed up the hair loss process. I hoped to have my HT in December. Could you please give me any advice?

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  • Senior Member

It sounds like you have a decent regimen, although admittedly I don't recognize those shampoos. I'm in Canada so it's possible the brands are different.

I suffer from seborrheic dermatitis as well. The two things that really helped me take control of it were Nizoral and T/Gel. I use them alternating (small amounts, never huge handfuls), and try to shower every second day when possible. I've also made an effort to lower the temperature where possible, as I've found that hot water over a long period of time tends to aggravate my skin.

Lastly, I notice that you have Minox in your regimen. Assuming it's foam or liquid, I used liquid for a year and it aggravated my dermatitis severely. Consider removing it if you can feel your scalp being dry and generally unhealthy after application.

Since doing these things, my dermatitis has been extremely manageable, and I got my first HT over a year ago and will be getting a second in 4 months. I rarely ever scratch, and almost never have flakes in my hair.

  • Like 1

Follow my second hair transplant journey below

Caucasian - 4613 Grafts - Eugenix, Dr. Arika Bansal

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  • Senior Member

Where specifically do you have the condition? Throughout the entire head, including the donor area?  The whole premise of avoiding hts when the condition is active is to avoid transferring the issue to the recipient area.  So, if you do have SD in the back, (donor area), it will need to be under control if you ever decide to have a transplant.

Glad to hear you are doing some medical therapy to help you with retention.  You can also try PRP and laser.  These help exponentially.  I would avoid Rogaine as it has alcohol and this will likely worsen the issue.

 

 

 

Patient Consultant for Dr. Arocha at Arocha Hair Restoration. 

I am not a medical professional and my comments should not be taken as medical advice. All opinions and views shared are my own. 

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  • Regular Member

Thank you so much. You both do recommend to stop using Minoxidil. I get it but on the other hand, it should help me with my hair loss. The question is: take Minoxidil to slow down the process or to stop taking it to cure SD?

@rob7331 may I ask why you are going to have your second HT so quickly?

@LaserCaps it's mostly my forehead, temples and the top of my head.

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  • Senior Member

My second HT will be almost to the day two years later, which is a fairly standard timeline. I've 'plateaued' in a sense on meds alone and knew from the beginning it would be a two-surgery plan, so this isn't a surprise. I'm very satisfied with the clinic I've chosen for HT #2, which further alleviates any concerns.

You're right about Minox having it's possible use, but the overall health of your hair (do your own research on this) may have a greater impact on your hair loss. For myself it was a no brainer - my dermatitis was off the charts when I used Minox and my head felt dry, flakey and itchy daily. My hair feels much healthier and stronger now. Whatever gains I was making on Minox (if any) were simply not worth it.

Everybody reacts different however. Give it a go for six months and see how it feels. Plus, there's always Oral Minox.

Follow my second hair transplant journey below

Caucasian - 4613 Grafts - Eugenix, Dr. Arika Bansal

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  • Senior Member

I’ve been dealing with seborrheic dermatitis for over 20 years so I’ll share some info. As I’m sure you’re aware, this is a condition that is lifelong so you have to try and manage it.

 

1. Ketoconazole, coal tar, salicylic acid, and some tea tree oil shampoos help me at least temporarily. Try to rotate some of these as it seems like the effect wears off after a while.

2. Diet matters- if I eat high fat foods or tons of junk my body seems to produce more sebum- this sebum is the food source for malasezzia yeast which is thought to be the main cause of seb derm. Try to pinpoint what causes your skin to produce more oil and try to limit it (things like lots of peanut butter, chocolate, etc are known to contribute)

3. Washing daily- especially after sweating and working out. Again, you don’t want that oil sitting on your scalp and building up to feed the malassezia.

4. Sometimes if the itch gets bad, antihistamines help.

5. Try to remain on a good sleep schedule. When I don’t maintain my sleep, it gets exponentially worse. The itching gets intense sometimes 

6. limit stress- easier said than done. Exercise, meditation/mindfulness, socializing all help. Stress affects this condition a lot as with many skin conditions

7. for some reason sebamed everyday shampoo helps to alleviate my itch too. It’s a gentle shampoo and I don’t know exactly which ingredient is responsible for helping but you may want to try a small bottle for yourself.

8. maybe try minixidil foam. The liquid has propylene glycol in it which irritates many peoples scalps. It’s probably not the best idea to further irritate a scalp already inflamed from seb derm

 

by the way, I’ve read of people using oral itraconazole prior to a hair transplant to control seb derm. You may want to look into this if your SD is severe. Of course run it by your doctor 

 

let me know if you have any questions 

 

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  • Regular Member

Thanks again. I have to admit I learned something :) Well, now my skin and hair are oily due to sebum. I really missed Isotretinoin. I do not eat fast foods nor sweets at all. I do exercise three times a week and I really just want to keep it under control as those bloody scabs (especially on my forehead) make me anxious and ashamed. Add a hair loss and you get a lot of complexes.

Well, I will definitely talk to my doctor and ask about everything you mentioned here. Then I will need to choose a HT clinic and hopefully everything gets better :)

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  • 1 year later...
  • Senior Member

Just bumping this thread if anyone can shed some light if sebum is connected to any hair loss medications.

 

I visited my GP today regarding a few pimples around my brow area and she said it was an issue with sebum. A natural oil our body produces.  She told me to cleanse every day and wear sunscreen.

 

After a little research I have read that sebum could be connected to testosterone, hormone levels or dht.

I take 0.5mg of finasteride 4 times a week and use Nizoral shampoo every 4 days, could any of this be removing the sebum from my scalp but giving me issues on my face? 
I exercise regularly and have a reasonable balanced diet. 
 

thanks in advance 

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