I have excessive dandruff and thinning hair—what should I do?

Excessive dandruff and thinning hair may be caused by physiological factors or pathological conditions such as tinea capitis (scalp fungal infection) and seborrheic dermatitis. Treatment options include proper scalp care and topical medications. Specific causes are outlined below:

I. Physiological Factors

If scalp hygiene has been neglected recently—such as infrequent shampooing—it can lead to excessive sebum production, clogged hair follicles, and result in increased dandruff and hair loss. Maintaining proper scalp cleanliness with a gentle shampoo can help improve these symptoms.

II. Pathological Factors

1. Tinea Capitis (Scalp Fungal Infection)

This condition is typically caused by a fungal infection. The pathogens multiply excessively on the skin, causing irritation, itching, dryness, hair loss, and flaking. It is recommended to apply antifungal medications such as compound ketoconazole cream, triamcinolone acetonide/econazole cream, or clotrimazole cream under medical supervision.

2. Seborrheic Dermatitis

A chronic inflammatory skin disorder associated with genetic factors and impaired skin barrier function. It manifests as oily, scaly patches on the scalp accompanied by severe itching. Treatment may include topical applications of tacrolimus ointment, hydrocortisone butyrate cream, or salicylic acid ointment, as directed by a physician.

In addition to the above common causes, androgenetic alopecia (male pattern baldness) could also be responsible. This condition may be managed with low-level laser therapy, along with consistent scalp skin care during treatment.