Painful scalp and diffuse thinning (telogen effluvium) for 8 months- is there ANYTHING out there that could help me?

If you have thinning hair you really need an evaluation to see if it is genetic or from another cause like stress or autoimmune. If it is determined to be genetic there are many options and traditional treatments like rogaine foam and propecia pills can be used. I have great success in my practice using injectable progesterone and prp to the scalp. Postmenopausal women also benefit from spironolactone. A formal biopsy should be performed and for nerve pain lyrica or neurontin started at least in the mean time till biopsy results are obtained.  I suggest seeing a dermatologist with expertise in hair loss. Best, Dr. Emer.

It seems you have seen many doctors and have a treatment regimen.  There really isn't much more "out there" in terms of treatment.  The best course of action is to find a good doctor and stick with the treatment and follow up with the doctor if the treatment does not work.  Chronic pain is very difficult to treat.

This is one of the most challenging areas, by far, in all of hair medicine.  You've been on many of the standard treatments ..... which do help some. Seeing a neurologist, pain specialist or dermatologist specializing in hair medicine could yield further help. Ideally, collaboration between 2 or 3 specialists is the way to go and the way I prefer to assist patients. Yes, treatments which block nerves from sending aberrant signals are likely to be associated with side effects.  This is a profound change in the body to trick nerve signals - not an easy task.In general terms, treatments available include:gabapentinpre-gabalincapsaicin (topical and shampoos)tricycylic antidepressants - Amitriptyline and Nortriptilineother antidepressants (SNRI type)anti-convulsants - carbamazepine, valproic acid, phenytoinanti-anxiety medications - clonazepamcertain analgesicsnerve stimulating devices (including radio frequency neuromodulators)nerve blocksbotox