Tumor Necrosis Factor-Alpha Inhibitor Associated Psoriasiform Alopecia (Drug-Induced Psoriasiform Alopecia)

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 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.

A user with scalp psoriasis and hair loss is hesitant to use topical minoxidil and finasteride due to concerns about psoriasis and potential side effects. They are considering alternatives like pumpkin seed and saw palmetto.

The user added P5P (vitamin B6) to their shampoo to reduce scalp itch, which improved significantly. They have been using finasteride for hair loss but are exploring additional treatments like topical antiandrogens and prolactin inhibitors.

Topical roflumilast is effective for reducing inflammation in various scalp conditions like seborrheic dermatitis, psoriasis, and eczema, but not proven to stop scarring alopecia. Alternatives like apremilast and Vtama are also discussed for their anti-inflammatory benefits.

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.