Secondary Cicatricial Scalp Alopecia Caused by Brunsting-Perry Pemphigoid: A Case Report

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.

DUPA and retrograde alopecia may not be solely DHT-based, and a biopsy is crucial for accurate diagnosis and treatment. Treatments mentioned include dutasteride, oral minoxidil, pioglitazone, clobetasol, calcipotriol, ketoconazole, and doxycycline, depending on the specific condition.

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 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.

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 treatments like Dutasteride, RU58841, Minoxidil, Finasteride, Spironolactone, Pyrilutamide, and Ketoconazole for hair loss without success and is considering a scalp biopsy to diagnose another condition. Others suggest consulting a dermatologist and possibly getting a biopsy, as the issue might not be typical male pattern baldness.