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Aminexil/Kopexil may help reduce hair loss by addressing perifollicular fibrosis in androgenetic alopecia, but it lacks the extensive clinical backing of finasteride and minoxidil. Some users find it effective, but availability and cost are issues, especially in the US where it's not FDA-approved.

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.

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.

A user lost 60% hair density in 4 months, started finasteride and microneedling, and has greasy, flaky, yellowish scalp. They are awaiting biopsy results, and another user suggested trying ketoconazole shampoo.

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.