Updated Treatment for Acne: Targeted Therapy Based on Pathogenesis

Increased Malassezia and Cutibacterium in the scalp microbiome are linked to higher sebum production and inflammation in androgenetic alopecia (AGA). Treatments include ciclopirox shampoo, benzoyl peroxide shampoo, clobetasol propionate, calcipotriol, minoxidil, finasteride, and dutasteride.

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.

Dihydrotestosterone (DHT) impacts various skin conditions, including Androgenetic alopecia and seborrheic dermatitis, by causing overactivity in sebaceous glands. Topical medications Tacrolimus and Clobetasol can reduce these inflammatory conditions, and treatments like RU58841, Minoxidil, and Finasteride may also be beneficial.

The user is experiencing diffuse thinning and excessive sebum production, considering Accutane as a potential solution after trying dutasteride and oral minoxidil without success. Other users suggest treatments like Nizoral shampoo, finasteride, beclomethasone dipropionate lotion, and topical androgen receptor inhibitors.

An 18-year-old experiencing hair loss and seborrheic dermatitis has tried finasteride, dutasteride, and various shampoos without success. They are considering anti-androgens like RU58841 and KX-826 for oil control and dandruff reduction.

Sulfur soap may help with hair thickening and reducing scalp inflammation, but it can cause dryness. Nizoral, containing ketoconazole, is noted for its potential to reduce seborrheic dermatitis but may also cause scalp dryness and hair loss.