Losing Sight of the Diagnosis: A Case Report of Neuromyelitis Optica Spectrum Disease and Systemic Lupus Erythematosus-Neuroautoimmunity in Focus, Correlation or Coincidence?

A 27-year-old male with AGA and diffused thinning has been using oral Minoxidil, Finasteride, Vitamin D, B12, Iron, and Ketoconazole shampoo. Despite a hair transplant and improved blood levels, he continues to experience hair loss and suspects a possible misdiagnosis of Alopecia Areata Incognita.

Lichen Planopilaris (LPP) is an autoimmune condition causing permanent hair loss and fibrosis, often misdiagnosed. Treatments include pioglitazone, topical corticosteroids, anti-inflammatory medication, and Jak inhibitors.

Hair loss treatments discussed include Propecia, Rogaine, Nizoral shampoo, and dermarolling. Users shared experiences and results, with some noticing improvements in hair growth and maintenance.

Finasteride can cause sexual side effects in less than 2% of men, but these often disappear over time, even if the treatment continues. Some users report persistent side effects, while others experience no issues or only temporary ones.

The conversation is about the role of testosterone in hair loss and the effectiveness of different treatments. The conclusion is that DHT is the main culprit for hair loss, and finasteride has been proven to work long-term in maintaining and regrowing hair. Testosterone may have a minor effect, but it is not the primary cause of hair loss.

Switching from oral to topical dutasteride may reduce side effects like anxiety and depression while maintaining hair health. Combining it with minoxidil, Nizoral, and dermarolling could be effective for hair preservation.