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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.

Hair loss is linked to scalp fibrosis and tension, which result from chronic mechanical stress and androgenic signaling. Treatments include blocking androgens with finasteride, promoting hair growth with topical minoxidil, and improving scalp mobility through exercises.

Finasteride can cause sexual side effects in less than 2% of men, but these often disappear over time, even if the treatment continues. Some users report persistent side effects, while others experience no issues or only temporary ones.

Daily microneedling at 0.25mm before applying minoxidil is debated, with some suggesting weekly microneedling is safer and more effective. Concerns include potential skin damage and systemic absorption, while alternatives like tretinoin are considered safer for enhancing minoxidil absorption.

The user experienced hair thickening and reduced shedding using minoxidil, finasteride, and dutasteride, with a switch from finasteride to dutasteride due to ineffectiveness. They also use a saw palmetto shampoo and take vitamin D3 supplements, while considering potential underlying causes like vitamin deficiencies and hard water buildup.