Review of Systemic Methotrexate Therapy in Pediatric Dermatoses

Minoxidil may not be effective due to low sulfotransferase activity, and the user considers adding tretinoin to the regimen. They are unsure about the timing and combination with microneedling.

Tazarotene may outperform tretinoin for hairline treatment with minoxidil, but lacks evidence. Tretinoin is recommended for the scalp, while tazarotene can be used on the face.

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 conversation discusses the effectiveness of topical tretinoin as a monotherapy for hair loss, with users suggesting it may not be as effective as minoxidil or finasteride. The original poster is considering other options like a phenol peel and is concerned about the risks of derma rolling.

Tazarotene may be more effective than tretinoin when combined with topical minoxidil for hair loss due to its selective binding to RAR-beta and gamma, though it can cause irritation. Tazarotene's potency can lead to indirect inflammatory reactions despite potentially causing less irritation than tretinoin.

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.