Increased Malassezia and Cutibacterium in the scalp microbiome are linked to higher sebum production and inflammation in androgenetic alopecia (AGA). Treatments include ciclopirox shampoo, benzoyl peroxide shampoo, clobetasol propionate, calcipotriol, minoxidil, finasteride, and dutasteride.
Topical roflumilast is effective for reducing inflammation in various scalp conditions like seborrheic dermatitis, psoriasis, and eczema, but not proven to stop scarring alopecia. Alternatives like apremilast and Vtama are also discussed for their anti-inflammatory benefits.
Nizoral shampoo effectively reduces scalp itchiness and dandruff, particularly for those using minoxidil, and may promote hair growth despite not being FDA-approved for this purpose. Users report significant improvements in scalp health and reduced itchiness with regular use.
The DHT itch is linked to hair loss and persists despite finasteride use; switching to dutasteride helped alleviate the itch and promoted regrowth. Some users suggest seborrheic dermatitis as a cause and recommend treatments like medicated shampoos, vitamin D, and minoxidil.
Using Nizoral shampoo intermittently and reassessing scalp condition after each bottle, potentially adding in other tools to target seb derm, and alternating between Pura D'Or and Nizoral for a healthy and clean scalp.