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.
A 22-year-old male is not seeing hair regrowth after using minoxidil and finasteride for a year and additional treatments for three months. Suggestions include improving scalp absorption with sea salt and trying a lipid-based solution, microneedling, and possibly switching to dutasteride if no improvement after 1-2 years.
Dutasteride can lead to increased cholesterol and liver fat. The user is reconsidering its use due to high cholesterol and lipid levels despite a healthy lifestyle.
The conversation discusses the potential benefits of creating a hydrophobic version of finasteride to reduce systemic side effects while maintaining scalp health. It compares this idea to fluridil, which is designed to be hydrophobic and has less systemic absorption.
Minoxidil with alcohol and propylene glycol was more effective than non-alcohol versions, and RU58841 worked best in a non-water-based solution. Oral finasteride showed better results than topical, despite side effects; microneedling and tretinoin worsened hair loss, and PRP was only helpful when younger.