Successful Treatment of Alopecia Totalis with Topical Calcipotriol: Serial Case Report and Review of the Literature

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 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.

Topical pirfenidone is highlighted as an effective anti-inflammatory and anti-fibrotic treatment for hair loss, particularly in addressing perifollicular fibrosis, which may enhance the effectiveness of standard treatments like finasteride and minoxidil. The user also uses calcipotriol, MCT oil, ciclopirox shampoo, and benzoyl peroxide shampoo as part of their regimen.

The user started finasteride (1mg) a year ago for hair thinning, experiencing stabilization but not significant regrowth. Suggestions included adding minoxidil, microneedling, and considering a hair transplant for improved results.

Insulin resistance may increase DHT production, contributing to hair loss, and addressing it through diet, nutrients, and natural DHT blockers like saw palmetto and pumpkin seed oil could help reverse hair loss. Some users prefer medications like finasteride for more effective results.