18 and thinking of starting treatment

[OH202]

Hey everyone:

About a year ago I started noticing excessive itchiness on my scalp and increased shedding in the shower, on my pillow, etc. I went to a dermatologist in November 2014 and was diagnosed with seborrheic dermatitis and was prescribed a clobetasol propionate shampoo - a lot of the itching stopped, and the shedding went down for about six months. Cue summer and I start noticing a lot more hairfall, often getting 5 or so hairs in my hand just running it along my scalp (which had begun to itch again, though not quite as badly as before). I've always had a pretty high hairline, but at this point I began to wonder if male pattern baldness was on the table. There's no history of early onset baldness on either side of my family, but my grandfather on my dad's side started going bald in his 40's and my dad who is 60 now is probably a Norwood 2/2.5.

I saw another dermatologist on August 17th who repeated the same diagnosis, and started me on a ketoconazole shampoo which in conjunction with head and shoulders has made the itching/redness go down considerably. Call me paranoid, but I'm pretty sure the derms have it wrong here. The top of my scalp is much less dense than it was and it looks as though I'm developing a bald spot on the vertex of my scalp - I've enclosed plenty of pictures so you can see what I'm talking about (not sure if there's a limit to how many I'm allowed to post, but I can remove some if necessary). Anyway, I'd appreciate any and all input/advice you could give! Thanks

Pics from today (dry):



Pics from about when I last went to the derm (wet/dry):



I can also attach pics from 6 months ago, 2 years ago etc. if that would help but I figure I should hold off for now.

 

[thatguywelbz]

Male Pattern Hair Loss - confirmed.

You look exactly like I did when I was 18 but you have lost more on your crown. Go to a different doctor or maybe more than one to make sure they are not screwing you over.

 

[checkbienca]

looks like male pattern baldness.

how much were you shedding hen you started noticing it?

 

[kmm179]

I wouldn't let these two guys on a forum confirm anything... Honestly I think its tough to tell with curly hair. Ask a doctor to see if they can see any miniaturization.

 

[IA2015]

Don't listen to those first 2 guys.

Losing hair doesn't always mean male pattern baldness.

Get checked out by yet another doctor (I know, pain right?) if they say the same - believe them. I know doctors can be wrong, sometimes 2 - but 3?

Nah.

 

[OH202]

Thanks for all the replies guys! I've been thinking of seeing an endocrinologist or another derm soon - do you think it would be possible to get my dht levels checked? Not sure if that's a thing or what...

thatguywelbz - Honestly from what I've seen on here I agree, but I'm pretty hesitant to jump the gun and start taking medication where I haven't gotten any confirmed medical diagnosis. The history for it in my family is (relatively) weak and didn't start for my relatives until they were in their late 30's so I'm somewhat skeptical.

checkbienca - I was probably finding 10-12 hairs on my pillow in the morning and losing about 20-40 in the shower - which I was told was normal. 99.9% of the hairs that I see fall out are relatively long and have a white bulb on the end though some are thinner and shorter than others (not sure if that means they're at a different stage in their growth cycle or what). Among those, I'd say probably about 1/5 have some kind of buildup or dead skin around the root.

kmm179 - What would a miniaturization test entail? The two derms took a hair from my head and put it under the microscope but I don't think they did an actual scalp biopsy, not sure if that would be required.

IA2015 - I know right? It seems odd that multiple doctors would have a confirmation bias. I was just looked at a month ago so perhaps it's ridiculous to assume anything would've changed, but I'd like to get a third opinion as soon as possible. Would you recommend going to another derm or what?

 

[Pequod]

From what you posted it sounds like the derms have it right, they gave you medication and your scalp responded. That condition is probably causing the hair loss and until you get it under control the hair won't grow back for some time and you will keep losing hair. I doubt finasteride would change any of this.

 

[OH202]

Hey Pequod:

Could you explain what you mean by my scalp responding to the medication? I've been looking into other ways to get it under control in addition to the shampoos but nothing so far has really changed much. Thanks!

 

[Pequod]

Hey Pequod:

Could you explain what you mean by my scalp responding to the medication? I've been looking into other ways to get it under control in addition to the shampoos but nothing so far has really changed much. Thanks!

Hi,

Your hair loss is probably 99% due to your seborrheic dermatitis, and until you get that under control you will keep losing hair. The medication I mentioned is the shampoo they gave you, there are other medications too but you will have to research it. You can do an internet search for seborrheic dermatitis and hair loss and see that is likely what is happening to you. You have to get it under control as the longer it lasts the harder it may become to get rid of it permanently. You might want to start see a dermatologist every month so they can inspect your scalp and keep track of how this is advancing or improving. You seemed to have a second relapse of it without knowing so maybe having monthly checkups would be a good idea. Don't mess around as you don't want to keep losing hair. I would not worry about male pattern baldness at your age if it is not in your family, that is why I say 99% chance it is this condition.

 

[OH202]

Hi,

Your hair loss is probably 99% due to your seborrheic dermatitis, and until you get that under control you will keep losing hair. The medication I mentioned is the shampoo they gave you, there are other medications too but you will have to research it. You can do an internet search for seborrheic dermatitis and hair loss and see that is likely what is happening to you. You have to get it under control as the longer it lasts the harder it may become to get rid of it permanently. You might want to start see a dermatologist every month so they can inspect your scalp and keep track of how this is advancing or improving. You seemed to have a second relapse of it without knowing so maybe having monthly checkups would be a good idea. Don't mess around as you don't want to keep losing hair. I would not worry about male pattern baldness at your age if it is not in your family, that is why I say 99% chance it is this condition.

Ah okay I see what you mean. Sounds like a good idea - only issue is that I doubt that that would be covered on my insurance but I'll have to check. Thanks again!