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.
The conversation is about a user considering the use of Ketoconazole 2% shampoo before showing signs of male pattern baldness (MPB) to potentially delay its onset, inspired by a YouTuber who uses the shampoo to reduce scalp DHT levels. The user's interest in this preventative measure stems from a family history of MPB.
The user has been using 5% minoxidil, finasteride, and dutasteride, along with microneedling and ketoconazole, to treat hair loss, showing significant progress over a year. Side effects mentioned include brain fog, watery semen, and facial dryness.
Minoxidil is typically applied once daily, with some users opting for foam to minimize irritation. Users often combine it with finasteride or use oral minoxidil for improved results, while managing scalp irritation with ketoconazole or salicylic acid shampoos.
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.