An Updated Clinico-Investigative Approach to Diagnosis of Cutaneous Hyperandrogenism in Relation to Adult Female Acne, Female Pattern Alopecia, and Hirsutism: A Primer for Dermatologists

A 20-year-old female with PCOS is experiencing hair loss and excessive facial hair. She is using ketoconazole and caffeine shampoos, microneedling, and considering anti-androgens like finasteride, but is cautious about minoxidil due to facial hair concerns.

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.

A female with PCOS and androgenetic alopecia is starting treatment with oral Minoxidil, topical Minoxidil 5% with finasteride, and plans to add mesotherapy. She previously tried anti-androgenic contraceptive pills but couldn't tolerate them and is using Myo Inositol for weight management.

The conversation discusses the link between seborrheic dermatitis, acne, and male pattern baldness, suggesting that DHT may cause both skin conditions and hair loss. Treatments mentioned include RU58841, finasteride, dutasteride, minoxidil, Nizoral shampoo, and other topical anti-androgens.

A woman with androgenic hair loss, likely due to PCOS, is seeking topical treatments as oral medications are not an option. Suggested treatments include topical finasteride, spironolactone, and clascoterone, with spironolactone and clascoterone being safer options due to lower systemic absorption risk.

Clascoterone, a topical anti-androgen, shows promise for treating female pattern hair loss without systemic side effects, offering a potential alternative to minoxidil. It could also benefit men who experience side effects from finasteride.