A Case of Folliculitis Decalvans With Concomitant Acne Keloidalis Nuchae, Androgenic Alopecia, and Profound Postinflammatory Hyperpigmentation

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 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 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 potential causes of pigmentation around hair follicles, suggesting sebum buildup, autoimmune conditions, or dermatitis. Treatments mentioned include finasteride, dutasteride, and an anti-inflammatory diet, with a recommendation to consult a doctor for a proper diagnosis.

Excess sebum rich in cholesterol and triglycerides can lead to hair loss through inflammation, with treatments like Ciclopirox shampoo, Benzoyl Peroxide shampoo, and Clindamycin gel recommended for managing conditions like seborrheic dermatitis and folliculitis. Pioglitazone is suggested for Lichen Planopilaris, while Omega-3s and reducing processed foods may improve sebum quality, though genetic factors play a significant role.