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Malassezia overgrowth can worsen oily scalp and inflammation, contributing to hair loss. Treatments include antifungal shampoos, C6/C8 MCT oil, low-dose isotretinoin, finasteride, and dutasteride.

The "DHT itch" is real and likely due to inflammation at the hair follicle, exacerbated by increased testosterone or androgens. Treatments mentioned include dutasteride, minoxidil, finasteride, and various topical solutions.

Hard water may contribute to an itchy, dry scalp and hair issues, but it doesn't affect genetic hair loss. Some users suggest using distilled water or a water softener to alleviate symptoms.

The conversation discusses using isotretinoin (Accutane) to reduce scalp oiliness and manage scalp issues like seborrheic dermatitis, inflammation, and chronic itch. A user shares that taking 20mg of Accutane every other day effectively reduces oily hair and skin.

The user experienced hair loss despite using Fin and Min for 12 years and switched to Dutasteride, RU58841, and Keto scalp serum, but shedding and itch persist. They are considering increasing Dutasteride to 2.5mg and questioning the necessity of a scalp biopsy, with mixed opinions on its usefulness.