the Link Between Hormones and Oily Scalp in Women

Q: the Link Between Hormones and Oily Scalp in Women

Hello： Based on your description, your condition may be seborrheic dermatitis or female pattern hair loss. A definitive diagnosis requires a visual examination. 1. The treatment for seborrheic dermatitis primarily involves shampoos and topical medications. The

The relationship between oily scalp in women and hormones?

Hello Dr.
Jiang,
I seem to have had slightly red, swollen, and itchy scalp since middle school, but I didn't pay much attention to it.
As a result, there weren't any serious issues at first, but gradually, I noticed that I was experiencing hair loss.
I also observed that my scalp has been oily, and I have to wash my hair every day; otherwise, it looks like I haven't washed it for many days.
Initially, I didn't think much of it, but around the age of 18, I noticed that my hair seemed to be thinning and my scalp was itchy, so I went to a dermatology department at a hospital.
The doctor prescribed a bottle of brown medicated shampoo (something with "Na" in the name), but after using it, my symptoms didn't seem to change, although I felt more at ease.
It wasn't until March of this year (at 23 years old) that I really felt my hair situation was worsening (as it became more noticeable), so I visited a hair restoration clinic.
The doctor diagnosed me with female pattern hair loss, stating that after blood tests, my male hormone levels were slightly elevated while a certain female hormone was low.
I started treatment and was advised to see a gynecologist to improve my female hormone levels.
During the treatment, the oiliness of my scalp sometimes persisted, but overall it has decreased.
However, my concern is that the current treatment for my scalp is only addressing the symptoms, not the root cause (since the regimen involves thorough washing and applying hair growth solutions, but if my scalp continues to produce excessive oil, won't it worsen once I stop the treatment?).
Can the oiliness of the scalp really be managed through hormonal treatment? If so, can I undergo hormonal testing and treatment at any gynecology clinic?
P.S.
I once suspected that I might have seborrheic dermatitis; is that possible? Thank you, Dr.
Jiang.

Yuan Yuan, 20~29 year old female. Ask Date: 2006/06/12

Dr. Jiang Yujiao reply Dermatology

Hello: Based on your description, your condition may be seborrheic dermatitis or female pattern hair loss.
A definitive diagnosis requires a visual examination.

1.
The treatment for seborrheic dermatitis primarily involves shampoos and topical medications.
The types of shampoos typically include tar-based formulations (such as the Polytar solution you have used), or those containing ketoconazole, zinc pyrithione, ciclopirox, sulfur, salicylic acid, or selenium sulfide.
When shampooing, it is advisable to use your fingertips to massage the scalp rather than scratching with your nails, and to leave the shampoo on the scalp for an additional five minutes to enhance its effectiveness.
Topical medications include mild topical corticosteroids, topical immunomodulators (such as tacrolimus or pimecrolimus), and antifungal creams (such as ketoconazole or ciclopirox).
In daily life, it is important to maintain a regular lifestyle and get sufficient sleep, avoid staying up late, and manage stress appropriately.
Although this condition is not caused by inadequate scalp hygiene, proper scalp cleanliness can help control the disease and reduce the likelihood of recurrence.
Some shampoos contain ingredients that inhibit Malassezia yeast, which, based on clinical experience, can reduce the frequency of flare-ups.
2.
Androgenetic alopecia is a hereditary, progressive form of hair loss.
Women can also experience androgenetic alopecia, leading to thinning of hair in the central part of the scalp.
This presentation is similar to age-related hair thinning.
Treatment options for female androgenetic alopecia include:
1.
Topical minoxidil (Rogaine) for treating hair loss.
2.
Oral anti-androgens such as spironolactone, or oral contraceptives like cyproterone or flutamide, although these should not be used by pregnant women.
3.
Hair transplantation.
Regarding your concern: androgens can indeed stimulate increased sebum production; however, further diagnostic evaluation is recommended.
It is advisable to consult a professional dermatologist and undergo testing at a hospital to obtain the best treatment.

Sincerely, Dr.
Lin Ming-Hsiu, Dermatology.

Reply Date: 2006/06/12

More Info

Hello! Thank you for your detailed question regarding the relationship between hormones and an oily scalp, particularly in the context of your experiences with hair thinning and scalp issues.

From what you've described, it seems that you have been dealing with scalp issues, including redness, itching, and excessive oil production, for quite some time. The diagnosis of female pattern hair loss (also known as androgenetic alopecia) is significant, especially since you mentioned that your testosterone levels are on the higher side and certain female hormones are low. This hormonal imbalance can indeed contribute to both hair thinning and oily scalp conditions.

Hormones play a crucial role in regulating various bodily functions, including the health of your hair and scalp. In women, androgens (male hormones) like testosterone can affect hair follicles, leading to hair thinning or loss. When there is an excess of androgens, it can lead to increased oil production in the scalp, which may explain your need to wash your hair daily. The oiliness can also create an environment conducive to scalp conditions like seborrheic dermatitis or dandruff, which could be mistaken for or coexist with conditions like seborrheic dermatitis.

You mentioned that you were prescribed a medicated shampoo, which is often the first line of treatment for oily scalp and dandruff. However, if the underlying hormonal imbalance is not addressed, the symptoms may persist or return after stopping the treatment. This is where hormone therapy could potentially play a role. Hormonal treatments, such as oral contraceptives or anti-androgens like spironolactone, can help balance hormone levels and may reduce oil production and hair loss. However, the effectiveness of these treatments can vary from person to person.

Regarding your concern about whether the oily scalp can be treated solely with hormonal therapy, it is essential to understand that while hormone treatment can help manage symptoms, it may not be a standalone solution. A comprehensive approach that includes proper scalp care, dietary adjustments, and possibly topical treatments may be necessary to achieve the best results.
As for your question about whether any gynecologist can perform hormone testing and treatment, the answer is generally yes. Most gynecologists can assess hormonal levels through blood tests and provide treatment options based on the results. It would be beneficial to discuss your symptoms and concerns in detail with a healthcare provider who specializes in hormonal health or reproductive endocrinology.

Lastly, you mentioned the possibility of having seborrheic dermatitis. This condition is characterized by red, itchy, and flaky skin, often exacerbated by oily skin. It can indeed coexist with hormonal issues, and a dermatologist can help diagnose and treat this condition effectively.

In summary, addressing your oily scalp and hair thinning may require a multifaceted approach that includes hormonal evaluation and treatment, proper scalp care, and possibly dietary changes. Consulting with both a gynecologist and a dermatologist may provide you with a comprehensive treatment plan tailored to your specific needs. Thank you for your question, and I hope this information helps you on your journey to better scalp and hair health!

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