<s>[INST] I am suffering from hair loss due to dandruff. After I take a head bath for 2 days everything is normal but after that trouble starts - sever itching, hair fall. My age is 27 no past history of fungal infections of the scalp except dandruff. I have tried ZPT for many years , then Selenium Sulfide shampoos and even 1% Nizoral, flaking has decreased but itching and hair fall continues. [/INST] Hello. Thanks for writing to us at healthcaremagicYou seem to have scalp seborrheic dermatitis.Dandruff Or Seborrheic Dermatitis is a common cause of increased hair shedding.Controlling dandruff effectively would control excessive hair fall too.Various antifungal agents (e.g ketoconazole, sertaconazole, ciclopirox olamine, piroctone olamine) are available either as shampoo or as overnight leave-on lotions, for dandruff.Nizoral shampoo contains ketoconazole. It is available OTC and is the most commonly used antidandruff shampoo.You may continue with Nizoral shampoo. However, since this alone has'nt proved to be sufficient in your case therefore your treatment needs to be modified.In such cases, along with the antidandruff shampoo, I usually ask my patients to use a topical steroid lotion (Mometasone furoate Or Clobetasole propionate lotion) once daily at night for a short period of 2 weeks Or I might switch them to an overnight leave-on antidandruff preparation.Seborrheic dermatitis is a steroid responsive condition, therefore, topical steroids are usually effective in this condition.A two weeks course of topical steroids brings about remarkable improvement, which can then be maintained with just an anti-dandruff shampoo, every alternate days.You may visit a dermatologist in your region. Your dermatologist may want to switch to a different antifungal shampoo e.g Ciclopirox olamine, Piroctone Olamine based shampoo Or choose to prescribe an overnight leave-on antidandruff lotion.Your dermatologist might also choose to prescribe a topical steroid lotion for a short duration of 2-4 weeks.Regards </s>