Scalp Atrophy Secondary to Steroid Use in Patients With Scarring Alopecia: Are Topical Steroids Superior to Topical Calcineurin Inhibitors?

The user has been using oral finasteride for 15 months and oral minoxidil for 6 months, and developed alopecia areata, for which a dermatologist prescribed calcipotriol/betamethasone. The treatment is helping, but the user is experiencing another shedding phase and is concerned about the effects of the steroid cream and the cause of hair loss.

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.

The user suspects scarring alopecia and is exploring NSAIDs and turmeric/pepper for inflammation-related hair loss, having experienced burning and thinning with finasteride and testosterone reduction. They are seeking feedback while unable to afford a dermatologist.

The user is experiencing diffuse thinning and receded hairline, using dutasteride, minoxidil, and ketoconazole without regrowth, and was prescribed clobetasol propionate 0.05% with salicylic acid for possible inflammation. Other users caution against using the strong steroid without a serious condition, sharing experiences of adverse effects and alternative treatments for scalp issues.

Topical pirfenidone is highlighted as an effective anti-inflammatory and anti-fibrotic treatment for hair loss, particularly in addressing perifollicular fibrosis, which may enhance the effectiveness of standard treatments like finasteride and minoxidil. The user also uses calcipotriol, MCT oil, ciclopirox shampoo, and benzoyl peroxide shampoo as part of their regimen.

The user has been using topical 5% Minoxidil, 0.1% Finasteride, dermastamping, 2% ketoconazole, and a DHT-blocking shampoo with saw palmetto, caffeine, biotin, and argan oil for hair loss. Despite some baby hair growth on one side, the user is experiencing continued hairline recession and shedding, leading to distress.