Hi!,

Thank you for posting your query,

You have provided with good information regarding your sisters hair problem and it is a very good description. I appreciate it.

In females the most common cause of hair loss is –iron deficiency, hormonal imbalance, thyroid problem, stress,change of place , lack of sleep, familial ,or use of chemical on scalp ,procedures like perming or straightening etc. Other rare causes are zn & copper def. One has to find the exact cause of hair loss and treat.

In females there are various patterns of hair loss,which can be judged clinically by a dermatologist. As you have mentioned its the frontal area getting involved (M pattern) that would mean a hormonal patter of hair loss.She should get her hormonal level checked along with an ultra sound of lower abdomen if necessary to rule out PCOD ( poly cystic ovary disease) . This usually seen in obese patient with irregular periods. This is also since she had acne some time back. In hormonal imbalance acne is usually associated with M pattern hair loss.

Other simple test which we do are hair pull test and trichogram to diagnose which type of hair loss is there.

Also check her thyroid levels too ,which again is a important cause for diffuse hair loss.

Mintop( Minoxidil 2%) is usually prescribed in female hair loss & it has to be used twice daily on scalp .This solution is best ,but takes at-least couple of months to show results .So she needs to have patience & frequent change of medicines won't help her.This needs to used for at-least 8-10 months and maintenance course also has to be taken for long. Along with this , tab biotin once daily & zinc tablet should also be taken .Other hormonal medicines are also available if needed which can be prescribed by a dermatologist after proper investigations .

She should also improve her diet with XXXXXXX leafy veg, fresh fruits, plenty of water, sprouts ,pulses, high protein diet, avoid items with high sugar content like sweets & chocolates, less of Chinese foods, less of pizza & burgers ,more of milk & ghee, dry fruits .
Good sleep also has a important role to play .

As far as shampoo is concerned for the flakes I would advice her to use anything which contains ketoconazole (2%) & zinc pyrithione .You may get this by the name Triatop shampoo .Use this twice a week only.

Hope I've answered your query.

Should you have additional concern regarding the same ,I would be happy to address it.

Please accept my answer in case you do not have further queries.

Regards,
Dr.Bharat chawda XXXXXXX specialist, Dermatology.

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Hi! XXXXXXX

Thank you for writing back.
Wishing you and your family a very happy new year too.

There are five symptoms of PCOD(Poly cystic ovary disease) :
1) Irregular periods
2) Weight gain
3) Acne (pimples)
4) Scalp hair loss
5) Facial hair (thick hair)

If you feel she has most of these problems then it would be worth getting the tests done (i.e. ultrasound of lower abdomen ) .Along with ultrasound she can also go for some blood investigations like LH/FSH RATIO, DHEA-S ,SERUM TESTOSTERON & SERUM INSULIN LEVELS . Since these are costly tests I would advice only if she has above symptoms . Other routine tests would be for Hemoglobin and thyroid(T3,T4,TSH) .

In any case she has to use minoxidil solution (mintop) for long time.You can also start with tab biotin which comes by the name Menofit or extend fort etc. You can also add zinc tab to it.
There are few doctors who give mesotherapy injections also for controlling hair loss.You have to find a good dermatologist for the same. These are small injections which comes in vials and are injected on the scalp by multiple pricks. But unfortunately no doctor can give you any guarantee of these injections to you.

Triatop shampoo is good for dandruff and should be used twice a week .You should avoid frequent use of shampoos .If really needed you can use any other cosmetic shampoo once a week .Other days you can wash it with plain water. Usually shampoos don't help in controlling hair loss. They are just to remove the sebum ,dust and dandruff. You can add any good conditioner along with .You have to find one by hit and trial method ,since most of them are good.She can use triatop for long ( say 6 months) .

I thank you again for submitting your question. I hope you found my response to be helpful and informative. If you have any additional concerns I would be happy to address them.

Regards,
Dr.Bharat chawda XXXXXXX specialist, Dermatology.

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