17-Beta-Hydroxy-Steroid Dehydrogenases in Hair Follicles of Normal and Bald Scalp: A Histochemical Study

The conversation discusses the hypothesis that a lack of the enzyme 3-alpha hydroxysteroid dehydrogenase (3α-HSD) on the scalp may contribute to hair loss by allowing DHT to accumulate. Despite interest in this theory, no recent research has been conducted, and current treatments like finasteride and minoxidil remain the most supported options.

Balding scalps have more androgen receptors, leading to increased TGF-beta, which causes blood vessel loss and hair follicle miniaturization. Blocking androgen signaling and TGF-beta may help prevent hair loss.

17-alpha-estradiol may work for hair loss by inhibiting 5-alpha reductase, similar to finasteride. It might lower testosterone in the scalp, reducing DHT conversion.

The user is experiencing progressive hair thinning despite using finasteride and dutasteride. A biopsy confirmed male pattern baldness, and minoxidil was suggested as an additional treatment.

The user experienced hair loss despite using Fin and Min for 12 years and switched to Dutasteride, RU58841, and Keto scalp serum, but shedding and itch persist. They are considering increasing Dutasteride to 2.5mg and questioning the necessity of a scalp biopsy, with mixed opinions on its usefulness.

The conversation discusses the mechanism of action of alfatradiol (17 alpha estradiol) in treating hair loss. It explores theories that it either inhibits 5 alpha reductase to prevent T->DHT conversion or aromatizes scalp T into 17-alpha-estradiol to save hair.