How to properly identify hairloss from seborrhea vs male pattern baldness?

I have been dealing with a very oily, itchy, flaky scalp for several months. I am starting to treat it now with Nizoral shampoo (1% Keto) twice weekly and 2% SA shampoo on all other days. I noticed that the hair whorl center on my scalp has gotten a bit larger. It has become slightly more "L" shaped from the original circular shape. Is this possibly due to chronic seborrhea of the scalp or should I see a doctor for hair loss medication such as propecia? (My hairline has not changed)

Doctor Answers 1

Oily itchy scalp

Great question. I would strongly advise you see a dermatologist who is knowledgeable about hair & scalp issues.

It is certainly possible you have seborrhea and genentic hair loss in the crown. So a good 2 month trial of the shampoos you mentioned is a good plan.

But there are dozens of other causes of hair loss that could mimic what you described perfectly - for example lichen planopilaris and folliculitis decalvans. These are uncommon problems and it's very unlikely you have them. But they can only be diagnosed by close examination if the scalp.

In summary, it's impossible to know what you have without close examination of your scalp. If you don't improve with those shampoos, see a dermatologist.

Vancouver Dermatologist

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.