Scalp Dermatology for the Hair Restoration Surgeon

A 22-year-old male experiencing diffuse thinning and frizzy hair has been using finasteride for nine months and is seeking advice on improving hair quality. Suggestions include using conditioners, biotin, rosemary oil, and addressing scalp conditions like seborrheic dermatitis or psoriasis, while finasteride may help reverse miniaturization and improve hair health.

Scalp biopsies are crucial for diagnosing hair loss conditions like Diffuse Unpatterned Alopecia (DUPA) and retrograde hair loss, as treatments like finasteride and dutasteride may not be effective if other conditions are present. Combining PPAR-GAMMA agonists with retinoids could improve treatments for conditions like Lichen Planopilaris.

A user experienced significant hair shedding and thinning 10 months post-hair transplant despite using minoxidil and topical finasteride. They are considering switching to oral finasteride or dutasteride and are also dealing with scalp conditions like seborrheic dermatitis.

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.

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.

The conversation discusses potential causes of pigmentation around hair follicles, suggesting sebum buildup, autoimmune conditions, or dermatitis. Treatments mentioned include finasteride, dutasteride, and an anti-inflammatory diet, with a recommendation to consult a doctor for a proper diagnosis.