A 19-year-old with rapid hair loss since 16 is considering a hair transplant but refuses to take finasteride or any 5α-Reductase inhibitors. They are currently using minoxidil, tretinoin, and microneedling with a Derminator 2, and only want hair until age 27.
In this conversation, 4990 discussed various treatments for hair loss, including oral minoxidil, PRP, transplan, Jak inhibitors, Dutasteride, Finasteride, Olumiant, Ketoconazole, RU58841, microneedling, baricitinib, and CCCA. They recommended scalp biopsies in unclear cases of DUPA, twice weekly to twice daily shampooing for topical minoxidil users, and two sessions spaced one month apart with follow up at month three to determine the effectiveness of PRP treatment.
The conversation discusses using tretinoin as an additional treatment for hair loss alongside minoxidil, with plans to test its effectiveness by applying it to only one side of the scalp. The user intends to start this experiment after using minoxidil for a year.
Saw palmetto's fatty acids, particularly lauric and linoleic acids, inhibit enzymes linked to hair loss, while sterols like beta-sitosterol are less effective due to poor absorption. The conversation questions which specific compounds in saw palmetto contribute to its anti-androgenic effects.
Ketoconazole shampoo may reduce scalp DHT by around 10% but is not effective enough to stop hair loss on its own. For better results, finasteride, minoxidil, and lifestyle changes are recommended.