An Occupational Perspective of the Lived Experience of Individuals with Alopecia Areata: A Scoping Review

A 26-year-old is experiencing hair thinning and has received conflicting diagnoses of androgenetic alopecia and telogen effluvium. They are considering treatments like dutasteride, oral and topical minoxidil, and are unsure whether to start treatment or pursue further diagnosis like a scalp biopsy.

Increased Malassezia and Cutibacterium in the scalp microbiome are linked to higher sebum production and inflammation in androgenetic alopecia (AGA). Treatments include ciclopirox shampoo, benzoyl peroxide shampoo, clobetasol propionate, calcipotriol, minoxidil, finasteride, and dutasteride.

Switching from finasteride to dutasteride may be more effective for hair regrowth due to dutasteride's stronger enzyme inhibition, but combining both drugs could enhance results. Some users report better outcomes with dutasteride, while others recommend a gradual transition to prevent potential hair loss.

Finasteride may affect neurosteroids, impacting mood and sexual function, with varied user experiences. Some report side effects like depression and sexual dysfunction, while others find it effective for hair retention or prefer alternatives like Dutasteride or topical treatments.

Finasteride, dutasteride, and minoxidil can help prevent or slow hair loss for many, though results vary. The dermatologist's claim that no medication works is incorrect, as these treatments are effective for some individuals.

The conversation is about using finasteride and testosterone replacement therapy (TRT) for hair loss and their role in gender-affirming care. It debates whether these treatments are considered hormone replacement therapy (HRT) and their implications for both cisgender and transgender individuals.