Black Piedra: A Case Report

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 hair regrowth after a health condition, with the appearance of white substance on the scalp. Suggestions include it being sebum or White Piedra, with a recommendation to try Nizoral.

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 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.

OP struggles with scalp flakes causing hair loss and has tried Selsun Blue, Ketoconazole, and ZPT Shampoo without success. Suggestions include using salicylic acid shampoo, shaving the head, using Nizoral, and combining treatments like Minoxidil and finasteride.

A user is experiencing scalp flaking from a finasteride/minoxidil topical solution and considers using salicylic acid shampoo to remove propylene glycol residue. Another user suggests trying a leave-in conditioner to address dryness and flaking.