Anti-TNF-Alpha Induced Psoriasiform Eruptions with Severe Scalp Involvement and Alopecia: Report of Five Cases and Review of the Literature

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.

Topical roflumilast is effective for reducing inflammation in various scalp conditions like seborrheic dermatitis, psoriasis, and eczema, but not proven to stop scarring alopecia. Alternatives like apremilast and Vtama are also discussed for their anti-inflammatory benefits.

Topical pirfenidone is highlighted as an effective anti-inflammatory and anti-fibrotic treatment for hair loss, particularly in addressing perifollicular fibrosis, which may enhance the effectiveness of standard treatments like finasteride and minoxidil. The user also uses calcipotriol, MCT oil, ciclopirox shampoo, and benzoyl peroxide shampoo as part of their regimen.

The user suspects scarring alopecia and is exploring NSAIDs and turmeric/pepper for inflammation-related hair loss, having experienced burning and thinning with finasteride and testosterone reduction. They are seeking feedback while unable to afford a dermatologist.

The conversation discusses treatments for scalp inflammation, suggesting options like scalp massage, changing shampoos, using aloe vera, Tgel, nizoral shampoo, topical cetirizine, and consulting a dermatologist. Finasteride was mentioned as helpful for reducing inflammation, but with side effects.

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.