Assessing low-dose oral minoxidil efficacy in androgenetic alopecia: a comparative study of AGA and AGA unmasked by telogen effluvium.

Androgenetic alopecia (AGA) significantly impacts patients' psychological well-being, and treatment options have historically been limited. However, the advent of low-dose oral minoxidil (LDOM) has revolutionized AGA management. This study compares the treatment response and safety of LDOM in patients with AGA alone versus those with AGA unmasked by telogen effluvium. Our findings indicate that LDOM is effective and safe for both groups, showing comparable efficacy and safety profiles. These results support the use of LDOM as a reliable treatment option for AGA, potentially improving patient outcomes and quality of life.

Treatment Challenges in Alopecia Areata: Insights From a Case of Baricitinib Therapy Failure.

Alopecia areata (AA) has long been considered a challenging clinical condition, with dermatologists traditionally employing corticosteroids and immunosuppressants in search of effective solutions. The introduction of Janus kinase inhibitors (JAKi), specifically the Food and Drug Administration (FDA) approval of baricitinib, marked a significant breakthrough in the treatment of AA. Clinical trials have shown promising results with baricitinib, and reports of relapse after initial success are scarce. We present a unique case of a 30-year-old male with severe patch-type AA who initially responded well to baricitinib treatment but later experienced a relapse despite continued treatment.

GLP-1 agonists and hair loss: a call for further investigation.

The widespread adoption of glucagon-like peptide-1 (GLP-1) agonists in treating type 2 diabetes mellitus (T2DM) and obesity has sparked investigations into their impact on hair health, an area characterized by diverse conjectures. Some propose potential risks such as disrupted hair growth cycles or premature androgenetic alopecia (AGA), while others suggest benefits linked to improved insulin sensitivity and enhanced scalp blood circulation. However, despite these theoretical underpinnings, clinical evidence linking GLP-1 agonists to hair loss remains sparse. The necessity for vigilant patient monitoring and collaborative efforts cannot be overstressed in comprehensively addressing any potential consequences of GLP-1 agonist therapy on hair health as their use continues to expand.

Combating "dread shed": The impact of overlapping topical and oral minoxidil on temporary hair shedding during oral minoxidil initiation.

Background: Low dose oral minoxidil (LDOM) is a preferred treatment for alopecia due to ease of use and efficacy. While LDOM is typically well tolerated, patients may experience a temporary increase in hair shedding starting treatment, colloquially regarded as "dread shed". One proposed method to combat this is to overlap therapies by maintaining use of topical minoxidil when initiating LDOM. Objective: To evaluate the impact of maintaining topical minoxidil when initiating LDOM on "dread shed". Methods: We performed a retrospective chart review of patients seen at New York University Langone Health Dermatology from January 1, 2008 to August 1, 2023 prescribed LDOM. Results: A total of 115 patients met inclusion criteria, of whom 37 maintained use of topical minoxidil when initiating LDOM. Six patients experienced "dread shed" when initiating LDOM, 2 of whom overlapped therapies. We did not find that overlapping therapies had a significant impact on decreasing rates of "dread shed". Limitations: Limitations include retrospective design, sample size, and subjective patient-reported assessment of hair shedding. Conclusions: A total of 5.2% of patients experienced dread shed, which is lower than previously reported in literature. Maintaining topical minoxidil during LDOM initiation does not significantly impact "dread shed". This remains a significant side effect deserving of further research.

Navigating Diagnostic Uncertainty: Frontal Fibrosing Alopecia Versus Keratosis Pilaris Atrophicans Faciei With Genetic Testing Insights.

Keratosis pilaris atrophicans faciei (KPAF) and frontal fibrosing alopecia (FFA) present diagnostic challenges due to their similar clinical characteristics. Dermatologists often employ overlapping treatment regimens, which may hinder accurate diagnosis and treatment expectations. Genetic testing offers promise for precise diagnosis and tailored treatment strategies, yet its utility in these conditions remains underexplored. This manuscript presents a unique case study of a 36-year-old male with symptoms of both KPAF and FFA, who underwent genetic testing. Despite testing negative for this mutation, the case underscores the potential of genetic testing to enhance diagnostic accuracy and optimize treatment outcomes.