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Dutasteride may not be effective for everyone due to underlying issues, suggesting scalp biopsies for further diagnosis. Users discuss using higher doses of dutasteride, topical treatments, minoxidil, and pyrilutamide for hair loss management.

Ultrasound imaging can non-invasively detect active and inactive hair follicles, inflammation, and fibrosis, potentially reducing unnecessary biopsies. It may help assess hair growth potential and diagnose scalp issues, but some users believe in trying treatments regardless of ultrasound results.

Scalp tension from the occipitalis muscle is theorized to contribute to hair loss, but most believe DHT and genetics are the main causes. Treatments like finasteride and minoxidil are considered more effective than addressing scalp tension.

The user has been using oral dutasteride and minoxidil for over a year without regrowth or stability, and hair loss continues. Suggestions include checking for inflammation, considering a scalp biopsy, and trying microneedling, topical anti-androgens, or a hair transplant.

Hair follicles can be dormant and potentially revived with treatments like finasteride and minoxidil, but irreversible loss occurs if certain structures are destroyed. Early intervention is more effective, and additional methods like microneedling may help.