Extensive Cicatricial Alopecia in a Patient with Long-Term Trichotillomania

In this conversation, 4990 discussed various treatments for hair loss, including oral minoxidil, PRP, transplan, Jak inhibitors, Dutasteride, Finasteride, Olumiant, Ketoconazole, RU58841, microneedling, baricitinib, and CCCA. They recommended scalp biopsies in unclear cases of DUPA, twice weekly to twice daily shampooing for topical minoxidil users, and two sessions spaced one month apart with follow up at month three to determine the effectiveness of PRP treatment.

Scalp biopsies are crucial for diagnosing hair loss conditions like Diffuse Unpatterned Alopecia (DUPA) and retrograde hair loss, as treatments like finasteride and dutasteride may not be effective if other conditions are present. Combining PPAR-GAMMA agonists with retinoids could improve treatments for conditions like Lichen Planopilaris.

The user is experiencing hair loss and confusion over conflicting medical advice, with treatments including minoxidil, finasteride, and topical corticosteroids. They are unsure about the necessity of a biopsy and the timing of using minoxidil, while also considering the impact of potential androgenetic alopecia and telogen effluvium.

A user is concerned that finasteride isn't working for their hair loss, questioning if it's due to male pattern baldness or low iron levels. They are advised to take finasteride daily and get blood work done.

A user has been treating hair loss with finasteride for two years without success and is experiencing an itchy scalp with seborrhea. Despite low DHT levels, they are still losing hair, suggesting that DHT might not be the main cause of their hair loss, and they are considering other treatments or causes.

Derma rolling, pumpkin seed oil, and daily massages helped regrow weak hairs on the crown. Nizoral shampoo and yoga also contributed to reducing scalp pain and stress.