Nixing hair loss
Current and future hair and scalp treatments bring hope to diverse population.
P014 – Managing Hair Disorders
9 a.m.-noon | Saturday, Aug. 3
Room 606
There can be satisfaction in managing and treating patients with hair loss and scalp issues. That’s the word from Carolyn Goh, MD, FAAD, who said new and emerging treatments are bringing hope to people who have the conditions.
Dr. Goh, an associate clinical professor of dermatology at the University of California Los Angeles David Geffen School of Medicine, is the director of Saturday’s session, P014 – Managing Hair Disorders. The session features a panel of dermatologists who will address old and new therapies. In particular, the focus will be on treating diverse populations such as children, racial minorities, and gender minorities. The session will also explore the psychosocial ramifications that make hair loss a unique and challenging problem.
Uncovering cultural and religious causes
The session aims to help dermatologists differentiate potential causes of hair loss and scalp disorders in a diverse patient population, formulate a culturally and individually appropriate treatment plan for those populations, and assess the benefits of both new and old therapies.
“The most common causes of hair loss and scalp disorders are androgenetic alopecia (pattern hair loss) and seborrheic dermatitis, but it is important to highlight how these and other types of hair and scalp diseases can manifest in our diverse patients,” Dr. Goh said. “Alopecia areata is also quite common, and there is some evidence to show that it is more common in some populations as compared to others.”
The most discussed new therapies are the Janus kinase (JAK) inhibitors for alopecia areata, she said. Current evidence suggests that topical or oral use for scarring alopecias may be of benefit as well. Similarly, topical minoxidil is still a mainstay in the treatment of most types of hair loss, she said, and its oral counterpart is highly popular.
Consider everything
For the management of seborrheic dermatitis, Dr. Goh said topical roflumilast foam is now FDA approved and is pending approval for the treatment of scalp psoriasis. The 5-alpha reductase inhibitors (finasteride, dutasteride) are also fundamental tools in the treatment of male and female hair loss as well as frontal fibrosing alopecia (though off-label for the latter).
“It is important to ensure we do not miss scarring alopecias, which can be quite debilitating in their symptoms and lead to permanent hair loss,” she said. “Also, there are particular differences in hair types and hair care practices in different populations that can contribute to or exacerbate hair loss and scalp disorders such as traction, hair straightening, or use of head coverings.”
When formulating a culturally and individually appropriate treatment plan for the patient with hair loss and scalp disorders, dermatologists must first understand that a patient's hair type is the first step as well as considering the patient’s cultural practices and history.
“This will play a role in both the etiology of their hair disorder as well as guide us to the best way to work with the patient to treat their condition,” Dr. Goh said. “Many of our topical treatments may cause brittleness of hair that is already fragile — curly hair for example. Ultimately, one’s cultural or religious beliefs may influence the type of treatment that they can accept.”
Dr. Goh will be joined by panelists Prince Adotama, MD, FAAD, Ronda S. Farah, MD, FAAD, Pearl E. Grimes, MD, FAAD, Tiffany Mayo, MD, FAAD, Paradi Mirmirani, MD, FAAD, Melissa Piliang, MD, FAAD, and Michelle B. Tarbox, MD, FAAD.
“Hair loss and scalp disorders can be quite satisfying to manage, and we will provide some tools for success in this session,” Dr. Goh said. “There are innovative treatments and tools that will help us provide better care for our patients, making this an exciting area of dermatology right now.”
