Advancing the Understanding and Management of Segmental Vitiligo and Co-Existing Pigmentary Disorders

Exosomes combined with fractional picosecond laser treatment were effective in treating androgenetic alopecia and promoting repigmentation in white hair patches. The role of exosomes in hair repigmentation, particularly in conditions like poliosis, is not well-studied.

A 43-year-old male with advanced hair loss is experimenting with alternative treatments, including red light therapy, microneedling, scalp massages, an oil mix, and ketoconazole shampoo, after previously experiencing side effects from finasteride and minoxidil. He noticed some minor changes with red light therapy but remains skeptical about significant improvement.

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.

Microneedling, ketoconazole, and tretinoin are discussed as hair loss treatments, with tretinoin favored for its long-term benefits and potential to turn minoxidil non-responders into responders. Microneedling is recommended for initial use, ketoconazole for dandruff, and tretinoin for continuous use due to its skin benefits.

The user is using a topical spray with finasteride and minoxidil, red light therapy, and ketoconazole shampoo for hair loss, and is considering waiting a year before getting a hair transplant. Other users suggest microneedling, using oral treatments, and investing in a laser helmet for better results.

Dermal incision with verteporfin is being explored as a potential hair loss treatment by dermatologist Melissa Toyos, with promising before-and-after photos shared on social media. The conversation discusses its potential effectiveness compared to other treatments like Minoxidil, Finasteride, and RU58841.