Dermoscopic Approach to a Small Round to Oval Hairless Patch on the Scalp

Lichen Planopilaris (LPP) is an autoimmune condition causing permanent hair loss and fibrosis, often misdiagnosed. Treatments include pioglitazone, topical corticosteroids, anti-inflammatory medication, and Jak inhibitors.

The conversation discusses hair loss concerns, specifically traction alopecia and hair loss from acne. It mentions that sleeping on one side is unlikely to cause traction alopecia.

The user is experiencing hair loss with possible causes including chronic telogen effluvium, diffuse alopecia areata, and androgenic alopecia. They have tried treatments like Nizoral shampoo, minoxidil, and finasteride, and are considering a biopsy for further clarity.

A user noticed irregularities on their scalp using a digital microscope and suspects scarring alopecia, despite using minoxidil and finasteride. Other users suggest seborrheic dermatitis as a possible cause and recommend treatments like ketoconazole shampoo, sulfur soap, selenium sulfide shampoo, and apple cider vinegar rinses.

Excess sebum rich in cholesterol and triglycerides can lead to hair loss through inflammation, with treatments like Ciclopirox shampoo, Benzoyl Peroxide shampoo, and Clindamycin gel recommended for managing conditions like seborrheic dermatitis and folliculitis. Pioglitazone is suggested for Lichen Planopilaris, while Omega-3s and reducing processed foods may improve sebum quality, though genetic factors play a significant role.

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.