Damn. Good luck dude
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Im going to keep going on a couple of thoughts here.
This could fit pretty good as well, at least in my case.
My hair loss actually started a few months after stopping Accutane.
Alopecia is the medical word meaning hair loss. Alopecia is diffuse if it affects the scalp in a general distribution. This is in contrast to localised or focal alopecia, which is characterised by patchy hair loss.
Telogen effluvium is the most common cause of diffuse hair shedding [3,5]. A triggering event causes an increased number of anagen hairs to prematurely enter the catagen and then telogen phase. Excessive shedding of telogen hairs occurs a few months after the triggering event [3].
Patients may notice clumps of hair falling out on their hairbrush or while showering [6]. tUp to 30–50% of scalp hair may be lost [1]. The excess hair shedding may produce diffuse thinning, bitemporal recession, or expose a pattern hair loss in those genetically predisposed [3].
How is telogen effluvium diagnosed?
Telogen effluvium is usually diagnosed by its clinical features.
- Hair thinning involves the entire scalp +/- loss of other body hair.
- Examination shows diffuse thinning without focal areas of total alopecia and short hairs of normal thickness.
- A gentle hair pull test reveals an increased number of hairs; most are telogen with a typical epithelial sac.
A trichogram can help confirm the diagnosis; more than 25% telogen hairs in a trichogram strongly suggests telogen effluvium.
Light microscopic examination shows club hair
A scalp biopsy is rarely needed; it is expected to show normal terminal/vellus hair ratio, an increased number of telogen follicles, and little to no inflammation and fibrosis.
Id call this a differential diagnosis compared to Lichen Planopilaris
Vitamin A and hair
There is genetic evidence that the alfa retinoid nuclear receptor forms a dimer with Vitamin D receptor and plays a major role in controlling hair cycling [85]. Retinoids play a crucial role for the anagen initiation, and depletion of vitamin A results in epidermal interfollicular hyperplasia with keratinocyte hyperproliferation and aberrant terminal differentiation, accompanied by an inflammatory reaction of the skin [86].
Vitamin A deficiency causes ichthyosis-like skin changes and is often associated with telogen effluvium and fragility of the hair [87,88].
Iatrogenic retinoid-induced hair loss is frequently observed in clinical practice. It has been shown that retinoids can inhibit hair shaft formation during anagen and induce premature catagen [89]. Telogen effluvium can occur with isotretinoin therapy (mostly in doses over 0.5 mg/kg/24 h)[90]. This generally occurs after 3 to 8 weeks of treatment and stops 6 to 8 weeks after stopping it. However, telogen effluvium is more common with acitretin treatment in doses of 25 mg or more daily [91]. Isotretinoin – associated telogen effluvium may also be attributed to an effect on the biotinidase activity
^you see both deficiency and excess when it comes to hair loss.
Some random story, but the timeline is similar to mine.
Chances of telogen effluvium being permanent?
OK, so I got off of Acutane at the end of September, and I first began taking it at the end of last January. My entire course went pretty fine, aside from the super chapped lips/dry skin and everything, but in early December I noticed that I was shedding a lot of hair. It seemingly came out of nowhere. The shedding may have started earlier, but I had no indication of it until December. I was shedding so much that my hair became noticeably thinner, to the point that I could see my scalp when I was in a room with a lot of light. When I washed my hair and ran my fingers through it, I noticed a lot hairs would get stuck to my fingers. At this point, I wasn’t sure if it was the accutane, the stress of finals, or just male pattern baldness.
I had an appointment with my dermatologist at the beginning of January. She said that the cause of my hair loss was most likely telogen effluvium, due to the fact that my hair could be pulled out with little resistance from all over my head, not just the crown. My hairline also hadn’t receded at all, despite the thinning that had occurred. She acknowledged that accutane does have the potential to cause TE/hair shedding up to 6 months after stopping treatment. She said she couldn’t be sure that TE was the cause, but if it were, the shedding should subside in a couple of months, and new hairs would eventually grow in, meaning that the whole thing would be temporary.
I’ll add this as well, a similar scarring form of hair loss going back to Lichen Planopilaris
First evidence of bacterial biofilms in the anaerobe part of scalp hair follicles: a pilot comparative study in folliculitis decalvans
hey Gunnersup, where did you buy/get tofacitinib from?
Did it help your symptom of hair loss?
what kind of medication will you get for lichen Planopilaris??? I believe i might have this condition.
You can find tofacitinib sources if you browse Alopecia world .com
It hasn’t helped yet but it’s been only 2 months, and tofacitinib takes roughly 4 months to kick in for Lichen Planopilaris. This disease is very difficult to halt, as I found out. My derm put me on clobetasol solution and will prescribe oral meds very soon
Are you trying it too?
Let us know if it does anything. I’m in the process of moving so I have to wait to order it till I get a permanent address.
not sure yet, tofacitinib can be harmful in the long run since it is a immuno suppressant drug.
Are you?
thanks for your reply bro, I have tried clobetasol in the past. Didnt do much for me though.
What kind of other oral meds is he willing to try?
btw is there any scarring/redness or bulbs visible on your scalp?
I was just gonna do it for a week
do you have the meds where did you buy it from?
She said I have no scarring yet, but she didn’t exactly look in every area of my scalp. She will formally prescribe hydroxycholchine in a month. For now, I will keep using the prescription clobetasol and continue taking 15mg tofacitinib. I’m also beginning 30mg zyrtec a day due to how so many people on my LPP facebook group said it helped them
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No, but I saw that world alopecia website has some threads on how to get it, I was gonna do that.
isnt toficitinib very expensive?
do you experience any itching or just the hair loss?
Both. Itching, reddness, Miniturization, scale, extreme hairloss. The whole 9-yards.
I’m going to self medicate Otezla instead of tofacitinib now. Apparently it has better results. I can give you a source for everything if you PM me, I just don’t want outsiders to overrun the limited sources I have
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Otezla shipment arriving in 10 days. Hopefully I can withstand the temporary side effects of the medicaiton. My hairloss should halt within 5 weeks of taking it.
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I’ve come to the conclusion I also have a gluten intolerance. The past three days I’ve had no gluten, and the majority of my scalp itching went away. Also, my face leaned out so much to the point I look way different.
I made this connection based on how my Aunt has Celiac, and she actually took accutane when she was a teenager. I’d bet accutane triggered her celiac, I’m sure of it.
I guess the lesson is that I will cut gluten out of my diet completely now.
Nice find, man. Gluten intolerance may not be the most pleasant experience, but it’s a manageable symptom by being cautious about what you eat.
Goods points about excess and deficiency guitarman01 this maybe why carbohydrate consumption changes itching, vitamin A manipulation.
Some guy took an immunosuppressant and it didn’t do anything for his PFS side effects. Another dead end
There are numerous immuno-suppressants, that does not prove anything by itself, not every immuno-suppressant works for everyone