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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Helps Flaking Scalp?

I am 74 years old. For the first time in my life, I have terrible flaking of my scalp. I have been on Atenolol for about six weeks. At first, my hair was falling out by the handfuls. I have tried dandruff shampoos and milder shampoos, but they haven't helped, Even the area around my face is red and flaky.
Mon, 21 Apr 2014
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Dermatologist 's  Response
Hello and welcome to healthcaremagic

You seem to suffer from dandruff/seborrheic dermatitis of the scalp and facial skin.

Dandruff or seborrheic dermatitis is an important cause of scalp itching and increased hair shedding. Dandruff is bound to recur again, therefore people with dandruff should use an antidandruff shampoo to keep the dandruff under check, rather than using a regular shampoo.

If I was your treating doctor I would have asked you to use an antidandruff lotion/shampoo. My choice is 2% ketoconazole shampoo, thrice weekly for 2-4 weeks followed by once or twice weekly for maintenance. It is available OTC as Nizral 2% solution.

Sometimes a shampoo alone seems insufficient. In that case you should consult a dermatologist. Your dermatologist might prescribe you a topical steroid lotion(clobetasol or mometasone lotion), to be applied twice daily for 2 weeks.

The topical steroid lotion can be stopped once the dandruff is well controlled and thereafter the improvement can be sustained with just an antidandruff lotion/shampoo.

Controlling dandruff would improve your hair fall problem too.

Facial seborrheic dermatitis presents as red scaly itchy patches on the face. You could apply a moderately potent topical steroid e.g fluticasone propionate for the itchy patches on and around the face.


regards
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What Helps Flaking Scalp?

Hello and welcome to healthcaremagic You seem to suffer from dandruff/seborrheic dermatitis of the scalp and facial skin. Dandruff or seborrheic dermatitis is an important cause of scalp itching and increased hair shedding. Dandruff is bound to recur again, therefore people with dandruff should use an antidandruff shampoo to keep the dandruff under check, rather than using a regular shampoo. If I was your treating doctor I would have asked you to use an antidandruff lotion/shampoo. My choice is 2% ketoconazole shampoo, thrice weekly for 2-4 weeks followed by once or twice weekly for maintenance. It is available OTC as Nizral 2% solution. Sometimes a shampoo alone seems insufficient. In that case you should consult a dermatologist. Your dermatologist might prescribe you a topical steroid lotion(clobetasol or mometasone lotion), to be applied twice daily for 2 weeks. The topical steroid lotion can be stopped once the dandruff is well controlled and thereafter the improvement can be sustained with just an antidandruff lotion/shampoo. Controlling dandruff would improve your hair fall problem too. Facial seborrheic dermatitis presents as red scaly itchy patches on the face. You could apply a moderately potent topical steroid e.g fluticasone propionate for the itchy patches on and around the face. regards