Actinic Keratosis: A Clinician’s Guide to Diagnosis and Treatment

Androgenic alopecia (AGA) might have evolved to reduce prostate cancer risk by increasing UV exposure to the scalp, but this theory is debated. Treatments like minoxidil and finasteride are used for AGA, though the exact causes and evolutionary reasons for hair loss are unclear.

Male-pattern baldness might increase UVB exposure on the scalp, potentially affecting vitamin D and skeletal health. The hypothesis is debated, with some seeing it as a minor benefit in specific contexts.

A user observed orange fluorescence on their nose and hair under a black light, indicating Cutibacterium acnes, which may contribute to hair loss alongside androgenic alopecia. A suggestion was made to use coal tar shampoo to address the issue.

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.

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.

The conversation discusses using tretinoin for hair loss and whether applying SPF on the scalp is necessary if hair covers the treated areas. The user is considering this treatment despite having no completely bald patches.