Tamoxifen-Induced Total Alopecia

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.

The user is experiencing hair loss despite using estradiol, bicalutamide, dutasteride, and topical minoxidil. They stopped minoxidil temporarily, which worsened their condition, and are considering oral minoxidil but are concerned about side effects and cost.

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.

DHT may inhibit hair growth by affecting mitochondrial function, leading to hair follicle miniaturization. Treatments like minoxidil and PP405 may promote hair growth by altering metabolic pathways, potentially counteracting DHT's effects.

The conversation is about maintaining hair after stopping finasteride due to side effects like gynecomastia. Alternatives discussed include alfatradiol, topical finasteride, and minoxidil.

Topical tacrolimus is being considered for androgenetic alopecia, though its effectiveness is unproven. Other treatments mentioned include minoxidil, dutasteride, cyclosporine, and teicoplanin, with discussions on blocking the prolactin receptor for hair growth.