Androgenetic alopecia is caused by DHT affecting hair growth. Finasteride and minoxidil are used to manage hair loss by blocking DHT and promoting hair growth.
Minoxidil's effectiveness is limited by the need for sulfation and proper transport to hair follicles, with tretinoin potentially enhancing its effects by promoting enzyme activity and keratinocyte differentiation. Tretinoin may improve minoxidil's response by boosting the expression of necessary enzymes and transporters.
Scalp biopsies are crucial for diagnosing hair loss conditions like Diffuse Unpatterned Alopecia (DUPA) and retrograde hair loss, as treatments like finasteride and dutasteride may not be effective if other conditions are present. Combining PPAR-GAMMA agonists with retinoids could improve treatments for conditions like Lichen Planopilaris.
Topical Finasteride doesn't directly reduce 5ar enzyme on scalp and has the same mechanism as oral, needing to go through the liver. Users debate the accuracy of this information and discuss various studies and experiences.