Comparison of Intra-Lesional Methotrexate and Intra-Lesional Triamcinolone Acetonide in the Treatment of Localized Alopecia Areata

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 is undergoing treatment for hair loss using finasteride, Kenalog injections, and Clobetasol, along with vitamin D and collagen supplements. They are considering additional treatments like minoxidil and microneedling, and there is discussion about whether the hair loss is due to stress, alopecia areata, or a scarring condition like lichen planopilaris.

Microneedling, ketoconazole, and tretinoin are discussed as hair loss treatments, with tretinoin favored for its long-term benefits and potential to turn minoxidil non-responders into responders. Microneedling is recommended for initial use, ketoconazole for dandruff, and tretinoin for continuous use due to its skin benefits.

The user stopped oral treatments due to side effects and switched to a regimen of topical minoxidil, tretinoin, azelaic acid, and dermaneedling, with recent addition of topical finasteride. They are questioning the long-term effectiveness of non-hormonal methods and considering hair transplantation.

The conversation discusses the effectiveness of topical tretinoin as a monotherapy for hair loss, with users suggesting it may not be as effective as minoxidil or finasteride. The original poster is considering other options like a phenol peel and is concerned about the risks of derma rolling.

The conversation discusses the need for a localized 5-alpha reductase inhibitor that only affects the scalp without systemic side effects, similar to pyrilutamide's approach. Current treatments like topical liposomal finasteride and dutasteride are mentioned, but concerns about their systemic effects and lack of research are highlighted.