sudden increase in hair shedding/THINNING, itchy scalp, plugs on the fallen hairs

[rockforlight]

Hey guys-
any sincere help with this, from someone that experienced this same kind of problem first-hand would be greatly appreciated, as this has become a serious worry, for which I can't find help..

In the last 8 months I've suffered from a noticeable increase in shedding, and a drastic increase in the thinning of the hair on the front, top and crown of my head.. many fallen hairs, even outside this area have a big, hard, white/yellow plug at the end (hair cast/sebum-cholesterol plug?), which can be removed with a fingernail to reveal the normal small hair bulb thats normal in telogen phase hairs. Sometimes 2 or 3 hairs can be found together in one plug. These plugs can be with or without hairs and can be felt partially
embedded in my scalp, and easily rubbed out with my finger. In many hairs in the top area theres a VERY obvious difference in the thickness of the hair between the outside end and the root end that meets the scalp. Even in 2 or 3 inch hairs, the outside end can be twice as thick as the part that met the scalp. In the top area which 8 months ago used to be some of the thickest hair I've had, I'm now finding vellus-thin short cycle hairs.

I'll post pictures as soon as i can.

The way it started...

I'm 26 and in the last few years I noticed a very gradual receding in the temples, I understood this as inheriting the MPB gene, so I'd been using saw palmetto shampoo, and taking saw p supplements. The beginning of this year, recently beginning with zinc and a sulfate-free variety of saw p shampoo, with the cold/dry weather, I noticed a dry itch and started seeing these plugs, which alarmed me. Began washing less often to get the natural oils back.. still dry, itchy and plugs. Switched to baby shampoo, tried leave-in conditioner, adding oils (peanut/jojoba/tea tree), head and shoulders, and recently honey after reading about a study on seborreic dermatitis. Also tried
combinations of the above.

Went to a general practicioner and 4 dermatologists, who either diagnosed it as seborrheic dermatitis, eczema/psoriasis, or stress/nothing.

I've been prescribed:

selenium sulfate- tried for a couple weeks but was painful, which I figured was not a good sign

olux-e steroid foam- used for 3-4 weeks, then a couple more weeks in combination with clobex steroid shampoo, noticed pain, redness more than ever before and stopped. (I'm concerned that increased thinning could be a result of long-term steroid use, as it's said to cause skin atrophy in cases)

I recently have had a bit of help with ketoconazole 2% (Nizoral), but the thinning is still bad and itch isnt quite gone.


I understand that MPB is the general culprit, but the itch and drastic thinning is a mystery.

I'm trying to rule out:

diet (but no major change that I can think of, stopped saw palmetto and zinc)
allergic reaction

fungal infection/yeast or mold reaction (found some mold in bed/bathroom but have cleaned thoroughly)

seborrheic dermatitis from other cause (but little/no dandruff, and usually very dry, never over oily)

eczema/psoriasis (but no red/scaly patches)

hormone change/stress

Even if I fix the itch, I imagine the hairs that have thinned aren't going to improve on their own, so I am looking at Rogaine (though it could make the itch/irritation worse), Propecia (very concerned about the safety of this drug for my sexuality and my girlfriend's health in the future) and hair transplantion
(while I'm concerned about having good results with a scalp thats less than 100%)

Anyone who has been kind enough to read this in full and can offer suggestions from first-hand experience, I'll be forever grateful. You could help improve someone's life a great deal. Much thanks in advance.
-Mike