Approach to Nail Pitting in Pediatric and Adolescent Patients: A Dermatology Perspective

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 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.

The user discusses their experience with diffuse unpatterned alopecia and acquired progressive hair kinkering, noting improvements with treatments including biotin, pantothenic acid, finasteride, ketoconazole, and zinc pyrithione shampoo. They report thicker, healthier hair and improved scalp condition, attributing success mainly to biotin, pantothenic acid, and finasteride.

Hair loss treatments discussed include microneedling, minoxidil, tretinoin, finasteride, dutasteride, pumpkin seeds, saw palmetto, and scalp massage. The consensus is that finasteride or dutasteride is necessary for significant regrowth, while other methods may only slow hair loss.

Excess sebum rich in cholesterol and triglycerides can lead to hair loss through inflammation, with treatments like Ciclopirox shampoo, Benzoyl Peroxide shampoo, and Clindamycin gel recommended for managing conditions like seborrheic dermatitis and folliculitis. Pioglitazone is suggested for Lichen Planopilaris, while Omega-3s and reducing processed foods may improve sebum quality, though genetic factors play a significant role.

The user has tried various hair loss treatments including topical minoxidil, oral finasteride, oral dutasteride, oral minoxidil, and exosome therapy, but none have been effective. They suspect trichodynia might be preventing these treatments from working.