Frontal Fibrosing Alopecia and Cutaneous Comorbidities: A Potential Relationship with Rosacea

A user has been experiencing hair loss for 4 years, with treatments like minoxidil, finasteride, and various supplements proving ineffective. They were diagnosed with fibrosing alopecia in a pattern distribution, a condition that may require a combination of anti-inflammatory and hair growth treatments.

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.

A 27-year-old woman with advanced female pattern hair loss and telogen effluvium is experiencing increased hair shedding after starting oral minoxidil and finasteride. She is seeking advice and reassurance from others who have experienced similar issues, while also considering additional treatments like dermapen and ensuring her nutritional needs are met.

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 25-year-old is experiencing chronic telogen effluvium (TE) and androgenetic alopecia (AGA) after surgery, using finasteride, red light therapy, and supplements, and considering oral minoxidil despite heart concerns. They are unsure whether to start minoxidil before or after an upcoming surgery, which may trigger another hair shed.

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.