Successful Treatment of Refractory Folliculitis Decalvans with Secukinumab

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 suspects scarring alopecia and is exploring NSAIDs and turmeric/pepper for inflammation-related hair loss, having experienced burning and thinning with finasteride and testosterone reduction. They are seeking feedback while unable to afford a dermatologist.

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.

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 experienced hair loss since 2019 and tried finasteride, dutasteride, RU58841, and ketoconazole shampoo without success. A scalp biopsy showed scarring and inflammation from folliculitis, indicating chronic inflammation was affecting treatment effectiveness.

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.