Hormones: Underestimated Problem in Dermatology. Part I. Diseases Connected with Excessive Androgenization

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.

DUPA and retrograde alopecia may not be solely DHT-based, and a biopsy is crucial for accurate diagnosis and treatment. Treatments mentioned include dutasteride, oral minoxidil, pioglitazone, clobetasol, calcipotriol, ketoconazole, and doxycycline, depending on the specific condition.

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 discusses a new model for understanding androgenetic alopecia (AGA), linking it to dietary and lifestyle factors similar to PCOS, and highlighting the role of DHT, vascular damage, and inflammation. Treatments mentioned include Minoxidil, finasteride, and RU58841.

A user shared their 11-year experience with spironolactone and nearly 5 years with finasteride for hair loss, recently adding oral minoxidil and stopping birth control. Various treatments were discussed, including organic options, checking for underlying health issues, considering dutasteride, and the potential role of progesterone in hair loss.

N-Acetyl-Cysteine (NAC) was found to improve hair parameters in men with early-onset androgenetic alopecia, showing increased terminal hair count and decreased vellus hair count, with good tolerability. NAC, used alone or with minoxidil, may help due to its antioxidant properties, though its effectiveness can vary among individuals.