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The user experienced severe side effects from finasteride, including hormonal imbalances and cognitive issues, leading to a recommendation to stop its use. They plan to follow up with tests to rule out a pituitary tumor and are considering topical treatments as alternatives.

Topical pirfenidone is highlighted as an effective anti-inflammatory and anti-fibrotic treatment for hair loss, particularly in addressing perifollicular fibrosis, which may enhance the effectiveness of standard treatments like finasteride and minoxidil. The user also uses calcipotriol, MCT oil, ciclopirox shampoo, and benzoyl peroxide shampoo as part of their regimen.

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.

Blocking DHT is not a complete solution for hair loss; instead, altering the scalp's response to DHT may be more effective. Topical finasteride and minoxidil are current treatments, but future approaches may involve bioengineering, gene therapy, and inflammation control.

Lichen Planopilaris (LPP) is an autoimmune condition causing permanent hair loss and fibrosis, often misdiagnosed. Treatments include pioglitazone, topical corticosteroids, anti-inflammatory medication, and Jak inhibitors.