Tolerability and Adherence Problems in Patients on a Stable Dose of Methotrexate: Results of a Multicenter Survey

A 20-year-old male has been experiencing hair loss since age 15-16 and is using oral minoxidil, dutasteride, and ketoconazole shampoo, with previous use of oral finasteride and topical minoxidil. He has stabilized hair loss but seeks to rule out inflammatory or immune-related causes, considering a scalp biopsy, and is supplementing with vitamin D3, B12, and iron.

Anti-inflammatories like curcumin, quercetin, and vitamin E may help with hair loss when used alongside treatments like finasteride and dutasteride. Ketoconazole is also noted for reducing scalp inflammation and improving scalp health.

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.

Scalp inflammation may contribute to hair thinning, with treatments like ketoconazole shampoo potentially helping by reducing inflammation. Some users report that DHT blockers and other treatments like finasteride, minoxidil, and RU58841 can alleviate symptoms associated with inflammation.

The user is experiencing diffuse thinning and receded hairline, using dutasteride, minoxidil, and ketoconazole without regrowth, and was prescribed clobetasol propionate 0.05% with salicylic acid for possible inflammation. Other users caution against using the strong steroid without a serious condition, sharing experiences of adverse effects and alternative treatments for scalp issues.

Topical roflumilast is effective for reducing inflammation in various scalp conditions like seborrheic dermatitis, psoriasis, and eczema, but not proven to stop scarring alopecia. Alternatives like apremilast and Vtama are also discussed for their anti-inflammatory benefits.