Answer to April 2014 Photo Quiz: Diagnosis and Treatment of Kerion

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.

Foligain foam caused severe scalp irritation and flakiness, unlike Rogaine foam. The user plans to consult a dermatologist for treatment options.

A user with mild psoriasis on the scalp is using finasteride, topical minoxidil, and dermarolling for hair loss but plans to stop minoxidil on the crown due to psoriasis aggravation. Suggestions include switching to a lipid-based minoxidil, using Ketoconazole shampoo, or trying oral minoxidil.

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 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.

A user with scalp psoriasis and hair loss is hesitant to use topical minoxidil and finasteride due to concerns about psoriasis and potential side effects. They are considering alternatives like pumpkin seed and saw palmetto.