Paradoxical Psoriasis and Alopecia Areata After the Use of Anti-TNF in a Patient With Crohn's Disease

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 user with alopecia totalis, borderline universalis, seeks advice on getting into a Xeljanz trial or appealing insurance for coverage. They experienced significant hair regrowth but are now seeing hair loss again and want to try Xeljanz.

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.

Topical roflumilast is effective for reducing inflammation in various scalp conditions like seborrheic dermatitis, psoriasis, and eczema, but not proven to stop scarring alopecia. Alternatives like apremilast and Vtama are also discussed for their anti-inflammatory benefits.

A user with scalp psoriasis and hair loss is hesitant to use topical minoxidil and finasteride due to concerns about psoriasis and potential side effects. They are considering alternatives like pumpkin seed and saw palmetto.

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.