Hidradenitis Suppurativa: Update and Review of Therapeutic Modalities

Topical androgen receptor antagonists may not be necessary if 5-AR inhibitors like finasteride or dutasteride effectively reduce DHT levels. Combining a 5-AR inhibitor with a topical androgen antagonist could potentially enhance treatment, but oral use of androgen antagonists is too risky due to severe side effects.

The user is considering using tretinoin with topical finasteride due to poor absorption and side effects from oral finasteride. They are also contemplating switching to topical dutasteride, while others suggest trying oral minoxidil or lower oral doses.

The user is experiencing chronic folliculitis with scalp sores and is concerned about a receding hairline. They have tried various treatments including antibiotics, Nizoral 2% shampoo, and lifestyle changes, but are seeking further advice.

The user is experiencing diffuse thinning and excessive sebum production, considering Accutane as a potential solution after trying dutasteride and oral minoxidil without success. Other users suggest treatments like Nizoral shampoo, finasteride, beclomethasone dipropionate lotion, and topical androgen receptor inhibitors.

Pyrilutamide's effect on sebum production and scalp inflammation is unclear, with users noting no significant changes. Isotretinoin is mentioned as effective for reducing sebum, while Dutasteride and various shampoos have limited impact on oiliness and seborrheic dermatitis.

The user has been using oral Dutasteride, RU58841, and Minoxidil for three years without success and is considering adding topical Finasteride or Dutasteride to target DHT both locally and systemically. Other users suggest sticking to a consistent treatment plan, exploring different combinations, and considering other factors like potential misdiagnosis or inconsistent medication use.