Hey, thanks for reading my post, i know this is very specific but i hope that there is somebody out there who has faced similar issues before and can help me.
I have been a long time lurker on the forum and i could really use some help right now. i hope that after my questions got answered, i can fix my medical treatment and get 1-2 good transplants in the next years!
I have aggressive androgenic alopecia where i already lost most of my hair at 21 years of age. also i suffer from folliculitis delcalvans for around 3 years now.
I achieved decent regrowth using 1mg oral finasteride + minoxidil twice daily + nizoral shampoo and I'm currently 9 months into the treatment.
I treat my folliculitis delcalvans with doxyciline 100 or 50 mg, depending on how bad it is + sometimes topical antibiotics + benzolperoxide wash shower gel + medical shampoo
2 months ago I've changed my treatment because i started shedding for around 6 weeks (havent changed minoxidil / nizoral shampoo) :
- oral dutasteride every second day (3-4 times a week)
- I take finasteride when I don't take dutasteride (3-4 times a week)
- topical ru58841 daily
- microneedling at 1.25 mm using derminator 2 weekly
- alfatradiol 0.25 mg / ml topical
I believe my hair is slowly improving with the new treatment and shedding is reduced, but I have some questions:
1. how long should i wait until i can tell if the new treatment works? after 2 months im not really sure.
2. does applying topical alfatradiol make sense in my case?
3. should i change from the not well researched ru58841 to topical dutasteride / topical finasteride or probably use both?
4. is it possible that my hairline / overall shedding gots worse when changing from finasteride to dutasteride?
5. am I shedding because now i take finasteride only 3-4 times a week while i took it 7 times before or doesnt it matter because im on the stronger dutasteride now?
6. do i apply too many different topicals? I'm worried that my scalp cant absorb minox, alfatradiol and ru at once? besides that every few months i take topical antibiotics for 1-2 weeks to treat my folliculitis delvalvans, so total of 4 liquids for my scalp.
7. can it be possible that the microneedling does more harm than good and causes shedding because of my folliculitis delvalvans? i try to only microneedle when there is no visible infection on my scalp, but its not always 100% possible unless i take stronger antibiotics daily.
8. can it be possible that all these hair loss medications dont reach their full potential because i cant get rid of my folliculitis delcalvans?
( explaination: unless i take 100mg doxyciline daily which is not recommended by my doctor i always struggle with the folliculitis delvalvans. doc says i should use it for a few months max or use 50 mg doxyciline for half a year, but with 50 mg i still have pimples and a red scalp. when i stop taking doxyciline usually after 1-2 weeks i usually have a severe folliculitis again and start taking the medication + topical antibiotics. i know its important to treat any infection on my scalp first, so has anyone experience with folliculitis and hair loss and can give me advice? )
9. whenever my folliculitis gets worse i shed up to more than 100 hairs after shower compared to the 100 mg doxy + hair loss medication sometimes i dont shed for months. therefore i consider to take the oral antiobiotics for years so that i can improve my hair quality + dont have a scalp full of pimples + no itching. am i too crazy to consider long term antibiotics?
10. would a hair transplant be possible althought i have folliculitis delcalvans? i could take up to 200mg of doxy for a few weeks before or after the operation so that there is absolutely no hurt scalp / no pimples etc during the operation, but im not sure how healthy or risky is this? could the transplanted hair regrow well if i take the antiobiotics or is there a high risk of still losing all the transplanted hair because of the folliculitis?
11. should i add tretoin to my minoxidil application because i am worried that im not a good responder to minoxidil. not sure if its because my folliculitis or my genetics, but i believe my minoxidil gains are not as good compared to other people here on the forum. is it worth a try or are these too much different medications already?
12. how do i go about finding a hair specialist that can properly assess my case? I have contacted clinics like HLC, Bisanga and ProHairClinic when i started taking medication but because of my young age and the folliculitis, a transplant was not possible. unfortunately they didnt guide me in terms of medication and just said that I should contact them when im 1-2 years older. now i get most of my drugs from online doctors here in germany. my local dermatologist and general practitioner don't really treat hair loss in men, they usually give me finasteride but cant give more advice. please help
13. does changing to oral minoxidil make sense so that i could respond better to it + i dont irritate the scalp because of my folliculitis delvalvans?
14. mesotheraphy / prp possible with folliculitis ?
thanks for reading the whole post, even if you just know how to answer 1 of these questions any help is highly appreciated. if you need any more information please let me know !
