Growing a cosmetic practice with devices and injectables in dermatology.

Growing a cosmetic dermatology practice is an often complex and arduous task. Many factors must be considered to build and maintain a successful clinical practice. Devices and injectables are both integral components to operating a comprehensive cosmetic dermatology practice. Aesthetic physicians seeking to grow their cosmetic practice in these areas must be aware of the numerous considerations-both more obvious and more subtle-that play a role in the decision-making process, including the local market, patient demand, clinic space, and physician experience and training. This contribution is focused on the factors that should be carefully considered when one is looking to grow a cosmetic dermatology practice with devices and injectables.

Treatment of Hyperpigmented Discoid Lupus Erythematosus With Jessner's Peel: A Case Report.

Discoid lupus erythematosus (DLE) is the most common type of chronic cutaneous lupus erythematosus and is categorized by well-demarcated, often hyper or hypopigmented macules or papules that gradually progress into discoid plaques. Lesions are most commonly found above the neck, particularly on the face, scalp, and ears.1.

Hair Care Professionals as Community Health Partners in Detection and Management of Alopecia: A Pilot Survey Study.

BACKGROUND: Alopecia is one of the most common diagnoses encountered by dermatologists; despite this, patients with hair loss often seek help from hair stylists prior to seeing a physician. OBJECTIVE: The purpose of this pilot survey study was to investigate hair stylists as hair loss community health partners and identify how dermatologists can potentially play a key role in cosmetology education. STUDY-DESIGN: Twenty-four New York City hair stylists completed a novel 23-item survey via email. RESULTS: When encountering hair loss in clients, stylists not formally educated about alopecia reported initially recommending their clients see a dermatologist, while those who were taught on the subject reported first recommending over the counter products as treatment. Hair stylists with alopecia training were equally as likely as those without alopecia training to believe hair styling practices do not contribute to hair loss. CONCLUSION: Our data support the need for integrated dermatologic training in cosmetology schools, particularly in the area of hair loss, with combined support of established hair instructors and dermatologists. Developing a brief curriculum regarding the fundamentals of alopecia etiology, diagnostics and therapeutics could equip hair stylists with useful evidence-based information they can use to help their clientele prevent and detect early stages of hair loss. By doing so, we can increase accessibility to quality hair care in the community and therefore streamline the process of alopecia patients getting the medical care they need. J Drugs Dermatol. 2021;20(8): 908-910. doi:10.36849/JDD.5643.

Commonly Used Over the Counter Therapies for Hair Growth in Skin of Color: An Evidenced-Based Review.

BACKGROUND: Given the immense psychosocial effects of hair loss as well as patient preference for treatment type, it is common for patients to turn to alternative medicine to improve their conditions. However, the commonly used alternative treatments can vary greatly between patients and particularly among skin of color populations. OBJECTIVE: In this work, we performed a scoping review of the evidence behind alternative topical treatments for hair loss used by skin of color patients. Methods & Materials: We conducted a comprehensive search using PubMed to identify relevant studies. RESULTS: Results show a diverse variety of hair growth products used; however, only a few are supported by randomized controlled trials, case reports, pilot studies, and animal studies with some important limitations. CONCLUSION: This information will be exceedingly useful for physicians so they may relay accurate evidence on these haircare practices to their skin of color patients. J Drugs Dermatol. 2021;20(7):726-731. doi:10.36849/JDD.5689.

Impact of Laboratory Work Up and Supplementation on Alopecia Patients: A Single-Center Retrospective Chart Review.

Evaluation of alopecia often includes laboratory testing for ferritin, thyroid stimulating hormone, vitamin D, and zinc as previous studies have found associations between non-scarring alopecia and vitamin deficiencies. These studies are limited by small sample sizes, and subsequent analyses showed conflicting results. This study aims to explore laboratory abnormalities in non-scarring alopecia and examine whether supplementation is associated with increased hair growth. A total of 131 patients completed at least two visits by a hair specialist at NYU’s Faculty Group Practice. They had quantitative hair measurements taken at each visit and laboratory tests performed at the first visit. There were 20 (15.3%) patients with abnormal lab results. The most common vitamin deficiency was ferritin (6.5%). Forty-two (32%) patients received supplementations that specifically addressed their vitamin or hormone deficiency. Multivariate regression analysis showed that supplementation did not significantly impact hair density or diameter (P=0.73; P=0.96, respectively). Baseline hair density and diameter were positively associated with change in hair density and diameter, respectively (standardized coefficient [β] 0.57, P<0.01; β 0.61, P<0.01). The number of prescribed oral medications was negatively associated with change in hair diameter (β -6.60, P=0.04). Limitations of this study include the single-center, retrospective design and the short followup interval. However, our findings suggest that vitamin supplementation may not lead to improved outcomes in non-scarring alopecia, thus limiting the utility of laboratory testing. Additional large-scale prospective studies are needed to improve our management of alopecia. J Drugs Dermatol. 2021;20(7):807-809. doi:10.36849/JDD.5886.

Psychiatric disorders and suicidal behavior in patients with acne prescribed oral antibiotics versus isotretinoin: Analysis of a large commercial insurance claims database.

BACKGROUND: The association between isotretinoin and psychiatric disturbance, including depression and suicidal behavior, is controversial. OBJECTIVE: To investigate whether acne patients prescribed isotretinoin or antibiotics were more likely to have psychiatric disorders and/or engage in suicidal behavior. METHODS: Retrospective cohort study using the IBM MarketScan Research Databases, which contain commercial insurance claims in the United States, to identify acne patients who were prescribed isotretinoin or oral antibiotics between 2011 and 2017 and who were diagnosed with psychiatric disorders or suicidal behavior. RESULTS: A total of 72,555 patients were included in the study. Patients in the general population were 1.47 times more likely to be diagnosed with suicidal ideation or attempt compared to acne patients prescribed isotretinoin (adjusted odds ratio [OR] 1.47; confidence interval [95% CI], 1.27, 1.70; P < .0001). The general population (adjusted OR 0.87; 95% CI, 0.84, 0.89; P < .0001) and acne patients prescribed antibiotics (adjusted OR 0.88; 95% CI, 0.85, 0.91; P < .0001) were less likely to have a psychiatric diagnosis compared to acne patients prescribed isotretinoin. The prevalence of suicidal behavior during isotretinoin treatment was lower (0.10%; P = .082) than in the year prior to isotretinoin treatment (0.22%) and in the year following treatment (0.34%; P = .004). LIMITATIONS: The study excluded individuals with public insurance and those who were uninsured, and the data in the study relied on the accuracy of the medical coding. CONCLUSIONS: Compared to the general population, acne patients prescribed isotretinoin were less likely to engage in suicidal behavior. Further exploration into the slight increase in suicidal behavior seen in isotretinoin patients 1 year after therapy is warranted.

Seasonality of procedures in dermatology: Insights for practice management.

This commentary examines the seasonality of various procedures in dermatology. With the rising demand of cosmetic procedures, it is important for physicians to understand seasonal trends of their services, which can offer insights to better forecast patient demand and optimize practice management. Although it has been anecdotally reported that the popularity of dermatologic procedures may peak during specific times of the year, available data on consumer behavior is limited. Our data fills this gap in the literature by examining the seasonality of dermatologic procedures and discussing the potential reasons for these findings. Physicians can utilize this information to optimize marketing strategies for particular procedures in order to capture greater market share and potentially increase practice revenues.