Dermatitis and Minoxidil

Hello Dr. Rassman,
First of all I’d like to congratulate you and your partners for your wonderful work on hair restoration. Also, I really felt relieved when I came across your website, because I always kind of felt alone since I first started experiencing hair loss (which was about two years ago).

I am 22 years old and although my hair loss story is not a very long one, I think it is a little bizarre, and here’s why. About two – two and a half years ago, in about March 2006, I first started having a lot of dandruff, which was of the dry type though; my scalp skin was dry and felt normal. So, I did not really pay any attention to it, I would just shampoo twice or three times a week and I thought I was alright. Then in the summer, I suddenly started losing hair. I was terrified because I was always proud of my hair – I would even buzz it and still my scalp would show through very little. The dandruff became flakes, the skin dried off completely, and everytime I shampooed (with a zinc pyrithione shampoo) my scalp would get red and irritated. It was a case of “bad seborrehic dermatitis”, my dermatologist told me. So, I had to shampoo with a coal tar and salicilic acid shampoo. So far so good, I thought I would keep it under control like this. But the hair loss continued and I was left with little hair, compared to my previous strong thick hair. Even today, the scalp balance is totally screwed up and if I don’t shampoo one day, my scalp gets oily in a weird way, it kinda looks like something between oil and sweat. My hair has become fine too. Now about hair loss: I had some diffuse thinning, most of it came back although finer and oilier, but lately I see some temple thinning which is quite alarming. I shampoo with Nizoral 2% but I see very little difference, I am trying to dry my scalp to a normal level and it always oils up again. My questions are:

1. Is the dermatitis killing my hair , causing MPB?
2. I recently started using Minoxidil, is it any good if the scalp is possibly still infected by dermatitis?
3. Will propecia, considering I start using it, have any effect on my hair/sebum/hormones on my scalp?

Thanks a lot, I would really appreciate if my mail is posted, I am sure it would help many guys in the same situation as me.

1. Seborrheic dermatitis should not be a cause of hair loss and it is not caused by an overt infection. I wonder if you have psoriasis.
2. Minoxidil should not hurt you, but it can make the seborrheic dermatitis worse.
3. Before trying Propecia, it needs to be determined by your doctor if you really have male pattern baldness. If you do, then Propecia (finasteride 1mg) is the right way to go. Get your hair mapped out for miniaturization and know for sure what you are treating.