Diffuse Hairloss and Sebum Plugs

I’ve have consistent diffuse hairloss universally around my head for about a year and a half, to the point where I believe I’ve lost about 60-70% of my hair. Many of the hairs that fall have large white plugs attached to them (see pictures), which I believe may be sebum.

Is this in fact sebum? Can these plugs cause diffuse hairloss? Any idea what may cause them or what might treat them? So far, I’ve tried zinc, ketoconazole, salicylic acid, coal tar, and other “sebum reducing” shampoos. I have also been on propecia for 6 months, but with no noticeable reduction in the pace of my loss.

Sebum is a waxy substance from the production of oil from your sebaceous glands. It can be seen on ends of hair follicles that fall out but this does not mean you have a hair loss condition or disease process (because of the sebum). There are products that claim better control of sebum and Internet posts that claim the sebum is the cause of hair loss. It generally makes for great marketing campaign to sell a product to those who are looking for a hair loss cure. Sebum does not cause hair loss, if it did, the many men and women on skid-row would be balding as they often do not shampoo their hair and reduce their sebum buildup. If you are experiencing diffuse hair loss, I doubt sebum is the root cause (no pun intended). You need to see a doctor for your hair loss condition to establish a good diagnosis.