A few questions for Dr. Redmond

[samantha]

I would like to know what blood work I need done to rule out anything physical.
How do you know if you have a scalp disorder? Are there any specialists you know of that are knowledgeable?
Do you recommend biophysical 2000?
I am on spiro 200 mg a day. This helps but I continue to have burning/shedding in the hairline and right behind the frontal hairline. This happens cyclically and then stabilizes. Zinc shampoos seem to help with the burning discomfort.
I am looking for direction on how to rule things out. Any suggestions.
Thanks,
Samantha

[Geoffrey Redmond, MD, FACE]

I would like to know what blood work I need done to rule out anything physical.
How do you know if you have a scalp disorder? Are there any specialists you know of that are knowledgeable?
Do you recommend biophysical 2000?
I am on spiro 200 mg a day. This helps but I continue to have burning/shedding in the hairline and right behind the frontal hairline. This happens cyclically and then stabilizes. Zinc shampoos seem to help with the burning discomfort.
I am looking for direction on how to rule things out. Any suggestions.
Thanks,
Samantha

To rule out an inflammatory process in the scalp evaluation by a dermatologist or other experienced physician is usually necessary. The most common cause is seborrheic dermatitis, which is inflammation due to excess oil production. It can also produce dandruff and sores on the scalp or behind the ears. The best non-prescription treatment, in my experience, is Neutrogena T-Gel shampoo, regular strength and washing hair daily or almost daily. Dermatologists often prescribe topical steroids, such as Olux foam. Used excessively these can cause skin thinning.

Since seborrhea is caused by testosterone action on the oil glands, testosterone blockers such as spironolactone often work best and also help acne and hair loss. They do take a few weeks to work.

There are other causes of scalp discomfort. It is a common symptom of menopause, because decreasing estrogen levels are associated with dyesthesia, abnormal sensations. This resolves with estrogen replacement, if appropriate.