Brief Answer:
Hair fall and fungal infection treatment

Detailed Answer:
Hello and welcome to healthcaremagic

I am Dr. Kakkar. I have gone through your query and I have understood it.

First of all, as you have dandruff problem therefore, I would advice that you should use a ketoconazole based antidandruff shampoo thrice weekly for 2-4 weeks and followed by once or twice weekly. Dandruff is an important cause of scalp itching and increased hair shedding.

I would keep a possibility of chronic telogen effluvium OR Androgenetic Alopecia, as the cause of your hair fall and decreased hair density. As we can see from the photograph, the thinning is more over the crown and the sides/area above the temples, therefore I would like to consider my first possibility of Female Pattern Androgenetic Alopecia(FAGA)

Scalp hair grows for 2-3 years (Anagen phase) after which it enter the catagen phase (transition phase) which is followed by resting phase (Telogen phase).

Hair can prematurely enter from growth phase(Anagen) to resting phase(telogen) therefore resulting in shorter length and increased shedding. After a major stressing event like medical/surgical illness OR post-partum OR weight loss (in your case), scalp hair is prematurely pushed into resting phase (Telogen) from the growth phase (Anaphase). This phase usually starts in the third or fourth month after a major stressor and ends by six months if the stressor is removed.

There are certain well known causes of Telogen effluvium:

--Deficient Iron Stores
--Hypothyroidism or hyperthyroidism
--Post partum(after delivery)
--Post Surgical or following a Medical illness (typhoid, malaria, dengue etc)
--Weight loss/ Dieting etc

Some of them have to be ruled out in you case with Thyroid testing and Serum ferritin levels

However, Female Pattern Androgenetic Alopecia, which seems to be the most likely cause in your case, can be difficult to distinguish from Telogen Effluvium in females, specially early in the course. Later on, Androgenetic alopecia presents as widened part-width and decreased hair density from the vertex and crown of the scalp. The hair loss is gradual over the years and although the scalp remains covered, the hair volume is reduced.

In my practice I usually ask patients such as your case, to take an oral Iron Supplement along with a Biotin supplement for 4-6 months together. This you have been already taking.

Follihair tablets are basically hair supplements and contain multiple ingredients like Biotin, Iron, Calcium pantothenate etc. They are helpful in controlling hair fall and help to restore good hair health.

However they need to be taken for at least 4-6 months at a stretch. The action is slow, therefore don't expect immediate results. It is advisable to take them for a good 1-2 months to judge whether they are going to be effective Or not.

A good healthy diet, a gentle cleansing shampoo and a good conditioner can be used for dry frizzy hair.

Androgenetic alopecia in females is commonly managed with 2% minoxidil solution is a non-specific hair growth promoter can be applied at the scalp skin in this type of hair loss, twice daily with a dropper (1ml twice daily). Minoxidil is a hair growth promoter and helps in rapid transition of hair follicle from resting phase to growth phase (Anagen).

Hair fall is slow to respond and treatment may have to be continued for months to see noticeable improvements, say 4-6 months.

Regarding your other concern of patches in the groin, this seems to be a case of fungal infection(Tinea cruris); well defined red, circular patches, limited to the groin region.

If I was the treating doctor I would have asked you to use a topical antifungal cream e.g clotrimazole 1% cream twice daily for 2-4 weeks.

An oral antifungal e.g fluconazole 150 mg tablet, once every week, for 4 weeks is also advisable.

An OTC antihistamine e.g cetrizine 10 mg once daily would provide you symptomatic relief from itching.

Hope this information helped
regards

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Brief Answer:
Hair fall treatment and fungal infection treatment

Detailed Answer:
Hi.

I would suggest you get tested for Thyroid (TSH Levels) and serum Ferritin levels, which would serve as a baseline.

-Tab perfectil is fine and may be continued.
-Candiforce 100 mg is an oral antifungal and would work well for the fungal infection, you should take it twice daily for 2 weeks. Also apply a topical antifungal e,g Clotrimazole ceam 1% twice daily to the groins for 2 -4 weeks.
-Tab cetrizine 10 mg once daily would provide symptomatic relief from itching.
-Hemfer is an Iron supplement. You may take it once daily, 1 hour after lunch for 4-6 months to replenish your iron stores (ferritin levels).
-For dandruff, continue Logidurf shampoo every alternate day. Also use a topical steroid e.g Elocon lotion at night at scalp skin.
-For hair fall apart from oral tab (perfectil) you may also use minoxidil 2% solution twice daily (1 ml, morning and evening). In the evening use it 2 hours after applying Elocon lotion.
-Besides these, a healthy wholesome diet, rich in all the nutrients e.g adequate intake of cereals, pulses, green leafy vegetables, milk, paneer, eggs, meat etc and supplements as mentioned by Dr. Batra would be fine for you

Regards

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Brief Answer:
Female pattern androgenetic alopecia

Detailed Answer:
Hi.

I would keep a possibility of Female Pattern Androgenetic Alopecia in your case.

Platelet rich plasma therapy (PRP) is a very good alternative if your hair fall is not responding to conventional medical therapy.

PRP has also revolutionised the treatment of androgenetic alopecia. It is done as Mesotherapy. It can be done in both males and females.

To get satisfactory results, 2 - 3 treatments should be performed at intervals of 3-4 months.

Platelet rich plasma OR PRP, is an autologous concentration of human platelets in a small volume of plasma has a higher platelet concentration (4-7 times) above the baseline. It is obtained from the patient's own blood after processing in an automated centrifuge and it is injected subcutaneously into the area of alopecia.

The beneficial effects of PRP in Androgenetic Alopecia can be attributed to various platelet-derived growth factors causing improvement in the function of hair follicle and promotion of hair growth.

Advantages: It is safe, cheap, and non-allergic and it appears to be a useful adjuvant in the management of AGA.

It is commonly performed by dermatologists. You can visit a dermatologist in your area and inquire about it.

Regards

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