BH02 (P100) Critically Appraised Topic: Is Dupilumab a Cause or a Treatment for Alopecia Areata? A Case Series and Literature Review to Guide Discussions in Clinical Practice

Scalp biopsies are crucial for diagnosing hair loss conditions like Diffuse Unpatterned Alopecia (DUPA) and retrograde hair loss, as treatments like finasteride and dutasteride may not be effective if other conditions are present. Combining PPAR-GAMMA agonists with retinoids could improve treatments for conditions like Lichen Planopilaris.

A 27-year-old male with diffuse hair loss, including the donor area, did not respond to finasteride, dutasteride, or minoxidil. He suspects his hair loss may be linked to a mild connective tissue disorder, possibly affecting the structural support of hair follicles, rather than being purely hormonal.

An arthritis drug restored significant hair in people with alopecia areata, but it is not effective for male pattern baldness. The drug, Upadacitinib, has serious side effects and is expensive.

The user switched from finasteride to dutasteride for hair loss and saw significant improvement in under two months. They also microneedle, take supplements including collagen and vitamin D3, use ketoconazole shampoo, and noticed accidental hair regrowth with retinol application on their face.

A 32-year-old experiencing diffuse hair loss despite long-term use of finasteride and oral minoxidil is considering additional treatments like topical dutasteride, RU58841, and Breezula. Concerns about Crohn's disease affecting hair loss and past negative experiences with dutasteride impacting libido are also mentioned.

RU58841 was the only treatment that slowed hair loss and reduced irritation for a DUPA sufferer after trying finasteride, minoxidil, and dutasteride with no success. The user continues using 6mg oral minoxidil, 0.5mg dutasteride, and an 8% RU58841 solution.