Severe Alopecia Complicating Systemic Sclerosis

The user is undergoing treatment for hair loss using finasteride, Kenalog injections, and Clobetasol, along with vitamin D and collagen supplements. They are considering additional treatments like minoxidil and microneedling, and there is discussion about whether the hair loss is due to stress, alopecia areata, or a scarring condition like lichen planopilaris.

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.

The user has been using oral finasteride for 15 months and oral minoxidil for 6 months, and developed alopecia areata, for which a dermatologist prescribed calcipotriol/betamethasone. The treatment is helping, but the user is experiencing another shedding phase and is concerned about the effects of the steroid cream and the cause of hair loss.

Minoxidil's effectiveness varies due to differences in sulfotransferase enzyme levels in the scalp, affecting people with conditions like ASD, liver disease, and androgenic alopecia. Treatments like topical tretinoin, microneedling, and using minoxidil sulfate instead of regular minoxidil can improve results for those with low enzyme levels.

A user with mild psoriasis on the scalp is using finasteride, topical minoxidil, and dermarolling for hair loss but plans to stop minoxidil on the crown due to psoriasis aggravation. Suggestions include switching to a lipid-based minoxidil, using Ketoconazole shampoo, or trying oral minoxidil.

An 18-year-old woman experiencing hair loss due to stress, possible PCOS, and low vitamin D is concerned about starting 5% minoxidil foam, prescribed by her doctor, due to potential facial hair growth. She is also using a topical steroid for scalp sensitivity and pain.