Lichen Planopilaris: Retrospective Study and Stepwise Therapeutic Approach

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 33-year-old male restarted finasteride after stopping it to conceive, noticing hair loss, especially in the crown area. His current routine includes finasteride, minoxidil, ketoconazole, and microneedling, and he plans to continue this treatment for 18 months before making any major changes.

A user with mild psoriasis on the scalp is using finasteride, topical minoxidil, and dermarolling for hair loss but plans to stop minoxidil on the crown due to psoriasis aggravation. Suggestions include switching to a lipid-based minoxidil, using Ketoconazole shampoo, or trying oral minoxidil.

The user is experiencing diffuse thinning and receded hairline, using dutasteride, minoxidil, and ketoconazole without regrowth, and was prescribed clobetasol propionate 0.05% with salicylic acid for possible inflammation. Other users caution against using the strong steroid without a serious condition, sharing experiences of adverse effects and alternative treatments for scalp issues.

The user is undergoing treatment for hair loss using finasteride, Kenalog injections, and Clobetasol, along with vitamin D and collagen supplements. They are considering additional treatments like minoxidil and microneedling, and there is discussion about whether the hair loss is due to stress, alopecia areata, or a scarring condition like lichen planopilaris.

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.