Nonclassic Congenital Adrenal Hyperplasia

Female (37) experiencing hair loss for 5 years, tried max dose of spiro and oral + topical minox without success. Discovered low cortisol and low DHEA levels, seeking functional medicine practitioner for help.

A male in his early 20s with CCCA (scarring alopecia) started treatment with Finasteride, Fluocinolone, and Doxycycline. Steroid injections were suggested but not yet done.

27-year-old female experiences aggressive hair thinning and hirsutism despite normal testosterone levels. Spironolactone and 2% minoxidil were ineffective; high DHEA sulfate levels may be the cause.

The conversation discusses a new model for understanding androgenetic alopecia (AGA), linking it to dietary and lifestyle factors similar to PCOS, and highlighting the role of DHT, vascular damage, and inflammation. Treatments mentioned include Minoxidil, finasteride, and RU58841.

FCE 28260 (PNU 156765), an under-explored 5α-reductase inhibitor, showcases promising results in research by Giudici et al., outperforming well-known treatments like Finasteride in reducing the conversion of testosterone to DHT. Its superior efficacy, demonstrated through lower IC50 values in both natural and human recombinant enzyme studies, suggests it could offer more effective management of DHT-related conditions. Additionally, its lower molecular weight hints at better potential for topical application, potentially offering advantages in treating conditions such as androgenic alopecia. Despite its potential, it has not advanced in development, possibly due to financial limitations, leaving its therapeutic prospects and side effect profile largely unexplored.

The user has DUPA and suspects autoimmune activity as a cause. They have tried various treatments including finasteride, minoxidil, dutasteride, pyrilutamide, estrogel, hydrocortisone, and clobetasol, and are now seeking a long-term immunosuppressant.