The Evaluation and Treatment of Hirsute Women

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.

The conversation discusses the hypothesis that a lack of the enzyme 3-alpha hydroxysteroid dehydrogenase (3α-HSD) on the scalp may contribute to hair loss by allowing DHT to accumulate. Despite interest in this theory, no recent research has been conducted, and current treatments like finasteride and minoxidil remain the most supported options.

OP is using 5% minoxidil and a foligain supplement for hair loss, with blood test results showing high cortisol levels. OP is considering starting finasteride, while another user shares their experience with finasteride and hair loss challenges due to malabsorption issues.

A 30-year-old female with PCOS and male pattern baldness is frustrated with her endocrinologist's recommendation of only Spironolactone and minoxidil, feeling that dutasteride, finasteride, and progesterone would be more effective. Other users suggest various online sources for treatments, warn against self-medicating due to potential risks, and recommend seeking a specialized endocrinologist or considering additional treatments like Inositol, Berberine, and dermaneedling.

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.