Brief Answer:
Hair loss treatment

Detailed Answer:
Hello and welcome to healthcaremagic

I am Dr. Kakkar. I have gone through your concern and I have understood it. I have also seen the images as well as test report (normal except reduced Vit D levels)

I would like to know whether you have dandruff/ seborrheic dermatitis? If yes, 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. If NOT suffering from dandruff, you can use any of the daily use OTC shampoos along with a good conditioner after shampoo.

I would keep a possibility of either Chronic Telogen effluvium OR Androgenetic Alopecia, as the cause of your hair fall and decreased hair density.

As the thinning seems more over the crown, as appreciated by wide part-width, which is more suggestive of Female pattern androgenetic alopecia.

Scalp hair grows for 2-3 years (Anagen phase) after which it enter the catagen phase (transition phase) which is followed by resting/shedding 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: A few of them can be ruled out by investigations e.g Thyroid(already ruled out) and Serum ferritin levels

--Deficient Iron Stores
--Hypothyroidism or hyperthyroidism
--Post partum(after delivery, begins 3 months after delivery and last 6 months)
--Post Surgical or following a Medical illness (typhoid, malaria, dengue etc)
--Weight loss/ dieting etc

-Is there any history of significant weight loss?
-Is there any preceding history of medical illness, in the past 3-6 months?
-What were the stressful events (that lasted couple of weeks) that you mention here?

However, Female Pattern Androgenetic Alopecia, 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 my patients of Chronic Telogen Effluvium to take an oral Iron Supplement along with a Biotin supplement e.g Follihair tablet.

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.

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).

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

Apart from this oral antiandrogens like spironolactone, finasteride also can be prescribed in case of Androgenetic Alopecia, but with a warning: PREGNANCY TO BE AVOIDED WHILE YOU ARE ON FINASTERIDE OR SPIRONOLACTONE, because they can cause feminization of a male fetus.

Finally I would suggest Vit D supplement for her, 1 XXXXXXX of calcirol 60000 IU, once every week, with milk.

Regards

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Brief Answer:
Hair fall treatment

Detailed Answer:
Hi.

Orofer-xt contains a higher does of elemental iron. You may rather take a lower dose e.g Livogen tablets. Take it either 1 hr before or 2 hr after meals.

Follihair contains biotin and other minerals, which are good for hair. I would suggest 1 tablet daily for 4-6 months.

Minoxidil 2% solution, should be continued for 6 months as well.

I initially avoid spironolactone/finasteride in reproductive age group of patients.

The blood report was fine. I wont ask for a review. The one test that i would suggest before starting Iron is Serum ferritin levels. If it is below normal range, you definitely require an iron supplement.

Regards

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