Inflammatory Role of Sex Steroids in Hidradenitis Suppurativa: An Androgenic Phenotype

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.

The conversation discusses hair loss treatments, focusing on the use of topical minoxidil, microneedling, finasteride, and dutasteride, while debating the role of testosterone and DHT in hair loss. It also touches on the potential liver health impacts of these treatments and the genetic sensitivity of hair follicles to androgens.

Androsterone may help with sexual and affective dysfunction from finasteride by replacing disrupted neurosteroids without increasing androgenic side effects. Controlled testing is needed to confirm its effectiveness and safety.

The user received hormone test results showing normal estradiol and testosterone levels, low SHBG, and normal free androgen index. They are considering starting finasteride but are concerned due to being slightly overweight.

A 16-year-old is experiencing hair loss and is using minoxidil, finasteride, and plans to add RU58841, while considering other treatments like MK-677 and microneedling. Concerns are raised about the potential impact of these treatments on puberty and development.