Pseudo Alopecia Areata Caused by Skull-Caps with Metal Pin Fasteners Used by Orthodox Jews in Israel

A 35-year-old with alopecia areata has tried finasteride, topical and oral minoxidil, and dutasteride without success in stopping hair loss. The dermatologist suggests JAK inhibitors, but they are too costly, leading to uncertainty about the cause of hair loss.

The user has been managing hair loss for over 15 years, using treatments like Minoxidil, Finasteride, and corticosteroids, while experiencing side effects and recurrent Alopecia Areata. They seek advice on progression and potential underlying conditions, questioning if their hair loss is due to an autoimmune issue beyond typical patterns.

The review discusses traditional hair loss treatments like minoxidil and finasteride, and newer options like Low-Level Laser Therapy, microneedling, and platelet-rich plasma for androgenetic alopecia. It highlights the need for more high-quality trials to assess these treatments' effectiveness and standardized protocols for emerging therapies.

The conversation is about a person experiencing treatment-resistant androgenic alopecia despite using high doses of dutasteride and minoxidil, along with other treatments like microneedling and purilutamide. Suggestions include considering a hair transplant, checking medication authenticity, and exploring other treatments like RU58841 or topical estradiol.

Topical finasteride and Minoxidil are the most effective treatments for hair loss, with non-pharmaceutical options like PRP, stem cell therapy, and red light caps offering minimal additional benefits. Users suggest sticking to proven treatments unless cost is not a concern.

The user is experiencing diffuse thinning and inflammation despite using 2.5mg dutasteride daily, ciclopirox, and ketoconazole shampoos. They are considering treatments like hydroxychloroquine and JAK inhibitors due to suspected scarring alopecia and have faced challenges in obtaining a scalp biopsy.