Scalp Dermatology for the Hair Restoration Surgeon

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.

The "DHT itch" is real and likely due to inflammation at the hair follicle, exacerbated by increased testosterone or androgens. Treatments mentioned include dutasteride, minoxidil, finasteride, and various topical solutions.

Finasteride and dutasteride can improve skin texture and reduce acne by lowering DHT but do not reverse aging. They may enhance skin and hair health for some, but can also cause side effects like dry skin and sexual dysfunction.

Ketoconazole shampoo is primarily for scalp health and reducing inflammation, not hair regrowth. Combining ketoconazole with finasteride can yield similar results to using minoxidil and finasteride together.

A user on dutasteride and oral minoxidil for two years has experienced worsening hair loss and an itchy scalp. Suggestions include increasing medication doses, trying other treatments like RU58841, getting a scalp biopsy, and addressing potential inflammation through diet and topical treatments.