Lupus Erythematosus of the Scalp

A 27-year-old male with diffuse hair loss, including the donor area, did not respond to finasteride, dutasteride, or minoxidil. He suspects his hair loss may be linked to a mild connective tissue disorder, possibly affecting the structural support of hair follicles, rather than being purely hormonal.

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.

Chronic Telogen Effluvium can be managed by avoiding inflammatory foods, exercising, staying hydrated, and using supplements like krill oil, saw palmetto, or licorice root. Minoxidil is discouraged due to its cost and potential for worsening hair loss, while castor oil is recommended to strengthen hair roots and reduce shedding.

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.

Scalp inflammation may contribute to hair thinning, with treatments like ketoconazole shampoo potentially helping by reducing inflammation. Some users report that DHT blockers and other treatments like finasteride, minoxidil, and RU58841 can alleviate symptoms associated with inflammation.

The user has been using finasteride and oral minoxidil for two years without improvement in diffuse thinning and is considering switching to dutasteride and getting a scalp biopsy. Suggestions include treating subclinical hypothyroidism, trying PRP therapy, and checking for autoimmune issues.