Evidence Based Hair

Latest Episodes:

Season 8, Episode 3. Understanding Alopecia Neoplastica: A Deep Dive into Hair Loss from Metastatic Breast Cancer Oct 21, 2024

Show notes

Welcome to another insightful episode of the Evidence-Based Hair Podcast with Dr. Jeff Donovan, a dermatologist and hair loss specialist. As the director of the Donovan Hair Academy, Dr. Donovan is dedicated to educating the public and practitioners about hair loss through comprehensive training programs.

In this episode, Dr. Donovan explores a fascinating study from the Brazilian Annals of Dermatology, focusing on the trichoscopic features of alopecia neoplastica caused by breast cancer metastases. Alopecia neoplastica, a type of hair loss linked to neoplastic processes, can sometimes resemble alopecia areata, but presents with distinct trichoscopic patterns. Dr. Donovan discusses the study's findings on the blood vessel patterns and color variations that are key indicators of this condition.

Join us as we delve into the clinical case of a patient with metastatic breast cancer presenting with alopecia neoplastica. Discover the significance of early detection and how trichoscopy can aid in diagnosing and managing this complex form of hair loss.

Tune in next week as we explore the rare side effect of central serous chorioretinopathy from steroid injections, and continue our journey of empowering clinicians and patients through education.

STUDIES REFERENCED IN THIS EPISODE

Bruno Simão Dos Santos, Eduardo César Diniz Macêdo, Bruna Nascimento Arruda Scabello, Patrícia Porto de Oliveira Grossi, Neusa Yuriko Sakai Valente. Dermoscopy of neoplastic alopecia secondary to cutaneous metastasis from breast carcinoma. An Bras Dermatol. 2024 Sep-Oct;99(5):742-745. doi: 10.1016/j.abd.

Season 8, Episode 2: Exploring Diphencyprone Use for Alopecia Areata During Pregnancy Oct 14, 2024

Show notes

Welcome to the latest episode of the Evidence-Based Hair Podcast, hosted by dermatologist and hair loss specialist, Dr. Jeff Donovan. As the director of the Donovan Hair Academy, Dr. Donovan is committed to educating both the public and hair loss practitioners through comprehensive programs like the Evidence-Based Hair Fellowship (EBHF).

In this episode, Dr. Donovan delves into a compelling case report from JAAD Case Reports that explores the use of diphencyprone (DPCP) for treating alopecia areata during pregnancy. Traditionally contraindicated in pregnancy, DPCP is a topical treatment that induces an allergic reaction on the scalp to promote hair regrowth in patients with alopecia areata. Dr. Donovan discusses a unique case where a patient opted to continue DPCP treatment during her pregnancies, resulting in minimal hair loss without any adverse effects on her pregnancies or babies.

Dr. Donovan emphasizes the significance of this study in contributing to the limited data available on DPCP use during pregnancy. While the findings are promising, he cautions that more research is needed before making broad recommendations for DPCP use during pregnancy.

Join Dr. Donovan next week too as he explores the trichoscopy of alopecia neoplastica from breast cancer in another enlightening episode of the Evidence-Based Hair Podcast. Don't miss this opportunity to expand your knowledge and engage in meaningful discussions about hair loss treatment and research.

STUDIES REFERENCED IN THIS EPISODE:

Desai DD et al. Use of diphenylcyclopropenone for alopecia areata treatment during pregnancy. JAAD Case Rep. 2024 Apr 19:48:88-89.

Berth-Jones et al. Diphencyprone is not detectable in serum or urine following topical application. Acta Derm Venerol 1994; 74: 312-3.

Season 8, Episode 1: Navigating JAK Inhibitors and Pregnancy: Insights and Implications Oct 07, 2024

Show notes

Welcome to the Evidence-Based Hair Podcast, hosted by dermatologist and hair loss specialist Dr. Jeff Donovan. As the director of the Donovan Hair Academy, Dr. Donovan is dedicated to educating both the public and practitioners about hair loss through comprehensive training programs like the Evidence-Based Hair Fellowship.

In this episode, Dr. Donovan delves into the critical topic of JAK inhibitors and their safety during pregnancy. He explores a pivotal study published in Drug Safety that examines pregnancy outcomes in patients treated with Upadacitinib, a JAK inhibitor used for various inflammatory disorders, including alopecia areata.

The episode provides an in-depth analysis of data from clinical trials and post-marketing reports, highlighting the impact of JAK inhibitors on pregnancy outcomes, such as congenital anomalies and live births. Dr. Donovan discusses the importance of understanding the safety of these medications in pregnancy and emphasizes the need for more research in this area.

Listeners will gain valuable insights into the complexities of managing hair loss treatments during pregnancy and the challenges faced by patients and clinicians alike. Dr. Donovan also shares promising findings and case studies involving other JAK inhibitors, offering a comprehensive overview of the current landscape and future directions in this field.

Join us for this informative episode as Dr. Donovan addresses a pressing concern in the world of hair loss and pregnancy, providing expert analysis and guidance for both practitioners and patients.

REFERENCES

Uma Mahadevan et al. Pregnancy Outcomes in Patients Treated with Upadacitinib: Analysis of Data from Clinical Trials and Postmarketing Reports. Drug Saf . 2024 Oct;47(10):1039-1049. doi: 10.1007/s40264-024-01454-0. Epub 2024 Jul 15.

Megan E B Clowse et al. Pregnancy Outcomes in the Tofacitinib Safety Databases for Rheumatoid Arthritis and Psoriasis. Drug Saf . 2016 Aug;39(8):755-62. doi: 10.1007/s40264-016-0431-z.

Mahadevan U et al. Outcomes of Pregnancies With Maternal/Paternal Exposure in the Tofacitinib Safety Databases for Ulcerative Colitis. Inflamm Bowel Dis. 2018 Nov 29;24(12):2494-2500. doi: 10.1093/ibd/izy160.

Season 8 Preview Oct 01, 2024

Show notes

Welcome back to Season 8 of the Evidence-Based Hair Podcast! I'm Dr. Jeff Donovan, a dermatologist and hair loss specialist. Join me each week as I review groundbreaking studies that are transforming our understanding of hair loss and influencing clinical practices.

This season, we'll delve into a variety of compelling topics including hair loss medications during pregnancy, JAK inhibitors like upadacitinib and baricitinib, and the use of terzepatide and metformin. We'll also explore conditions such as alopecia areata, androgenetic hair loss, CCCA, and dissecting cellulitis, and discuss their links to heart disease, thyroid disease, and breast cancer.

Episodes will be released every Monday, and you can also find video presentations on our Donovan Medical YouTube channel. Thank you for your continued interest, and we look forward to another exciting season!

Season 7, Ep 10: Topical JAK Inhibitors: How well do they work for FFA/LPP? Jun 24, 2024

Show notes

Welcome back to the Evidence-Based Hair Podcast! This episode continues our June theme on JAK inhibitors, focusing on their topical use for treating frontal fibrosing alopecia (FFA) and lichen planopilaris (LPP).

We'll delve into a groundbreaking study by Dr. Maryanne Senna and colleagues from Boston, examining the effectiveness and side effects of topical 2% tofacitinib for FFA and LPP. The study's results provide encouraging data, showing that about 31.6% of patients experienced improvement, and 60.5% saw disease stabilization.

Join us as we explore the potential of topical JAK inhibitors in managing scarring alopecia, their practical applications, and the implications for future treatment protocols. Don't miss our insightful discussion on this emerging therapy and how it could transform patient care.

Next month, we'll shift gears to discuss spironolactone and its role in treating androgenetic hair loss in women. Stay tuned!

STUDIES REFERENCED IN THIS EPISODE

Li-Chi Chen, Chino Ogbutor, Kristen J Kelley, Maryanne M Senna. Topical tofacitinib for patients with lichen planopilaris and/or frontal fibrosing alopecia. J Am Acad Dermatol. 2024 Jun;90(6):1260-1262. doi: 10.1016/j.jaad.2024.01.060. Epub 2024 Feb 2.

Yang C.C., Khanna T., Sallee B., Christiano A.M., Bordone L.A.: Tofacitinib for the treatment of lichen planopilaris: a case series. Dermatol Ther 2018; 31:

Moussa A., Bhoyrul B., Asfour L., Kazmi A., Eisman S., Sinclair R.D.: Treatment of lichen planopilaris with baricitinib: a retrospective study. J Am Acad Dermatol 2022; 87: pp. 663-666.

Plante J., Eason C., Snyder A., Elston D.: Tofacitinib in the treatment of lichen planopilaris: a retrospective review. J Am Acad Dermatol 2020; 83: pp. 1487-1489.

Season 7, Episode 9: Exploring Topical JAK Inhibitors for Scarring Alopecia Jun 24, 2024

Show notes

Welcome back to another episode of the Evidence-Based Hair Podcast. This week, we continue our June theme of JAK inhibitors, focusing on the use of topical JAK inhibitors for treating frontal fibrosing alopecia (FFA) and lichen planopilaris (LPP).

In this episode, we delve into a significant study by Dr. Maryanne Senna and colleagues from Boston, exploring the effectiveness and side effects of topical 2% tofacitinib for LPP and FFA. The study, involving 41 patients, provides valuable statistics on improvement and stabilization rates, offering practical insights for clinical application.

We discuss the potential of topical JAK inhibitors, given their less systemic absorption compared to oral forms, and their specific relevance to scarring alopecia where inflammation is closer to the skin's surface. Despite some challenges with compounded topical formulations, the study's promising results highlight a third of patients showing improvement and over 60% achieving disease stabilization.

Join us as we wrap up our June series on JAK inhibitors and prepare for July, where we'll focus on the antiandrogen spironolactone and its use in androgenetic hair loss in women.

Thank you for tuning in, and I look forward to our next discussion on the Evidence-Based Hair Podcast.

STUDY REFERENCED

Season 7, Episode 9: Baricitinib for Pediatric Alopecia Areata: Promising Results and Future Directions Jun 18, 2024

Show notes

Welcome to another episode of the Evidence-Based Hair Podcast. In this episode, Dr. Donovan delves into an insightful study by Zhao and colleagues, published in the Journal of the European Academy of Dermatology and Venereology, titled "Baricitinib Therapy for Pediatric Patients with Severe Alopecia Areata."

This episode continues the June series dedicated to JAK inhibitors. Dr. Donovan highlights the increasing global use of these medications for treating severe alopecia areata, including the recent approvals of baricitinib and ritlicitinib.

The featured study examines the effectiveness and safety of baricitinib in treating children with severe alopecia areata, focusing on a small group of 10 patients aged between under two years to 13 years. The results reveal promising regrowth and mild side effects, underscoring the potential of baricitinib for younger patients.

Dr. Donovan discusses the broader implications of these findings, including the likelihood of future approvals for younger age groups and the importance of long-term safety data. He emphasizes the need for ongoing research and real-world studies to better understand the prolonged effects of JAK inhibitors.

Join Dr. Donovan next week for the final episode of the June series, where he will explore a study on the use of topical tofacitinib for treating lichen planopilaris and frontal fibrosing alopecia.

Season 7, Episode 8: Effectiveness of Generic Tofacitinib in Treating Alopecia Areata Jun 15, 2024

Show notes

Welcome back to another episode of the Evidence-Based Hair Podcast! In this episode, we delve into a fascinating study on the use of generic tofacitinib for treating alopecia areata.

This study, published in the Archives of Dermatologic Research, explores the effectiveness and safety of generic tofacitinib. With the recent availability of this cost-effective alternative in Canada, the study provides valuable insights into whether switching from brand name options (Xeljanz) is a viable choice for patients.

The retrospective study included 20 patients with advanced alopecia areata, and the results were promising. A significant number of patients experienced noticeable improvements in hair regrowth, with low incidence of side effects. This episode discusses the study's findings and the broader implications for treatment options in alopecia areata.

Join me as we explore how this study might change the landscape of hair loss treatment and what it means for patients and practitioners alike. Don't miss next week's episode, where we'll discuss the use of baricitinib in young children.

STUDY REFERENCED

Jian J et al. Effectiveness and safety of generic tofacitinib in alopecia areata: is the generic a cost-effective option? A retrospective study. Arch Dermatol Res. 2024 May 11;316(5):154. doi: 10.1007/s00403-024-02879-4.

Season 7, Episode 7: Infectious Diseases and Vaccinations Among JAK Inhibitor Users Jun 04, 2024

Show notes

In this June series of the podcast, we focus on JAK inhibitors. This episode kicks off with a detailed review of an Italian study published in Expert Opinion in Drug Safety, which examines the incidence and management of infections in patients with alopecia areata treated with JAK inhibitors. Dr. Donovan discusses the findings, emphasizing that about one in three patients on JAK inhibitors may develop infections, highlighting the need for careful monitoring and potential treatment pauses.

Additionally, Dr. Donovan reviews a study from New York in Archives of Dermatologic Research, which reveals low vaccination rates among patients with immune-mediated diseases on biologics and JAK inhibitors. The study underscores the importance of pre-treatment vaccinations to mitigate infection risks.

Join us next week as we explore the efficacy and cost benefits of generic tofacitinib in managing alopecia areata, part of our ongoing series on JAK inhibitors. Stay tuned for more insights and expert analysis on the Evidence-Based Hair Podcast.

STUDIES REFERENCE IN THIS WEEK'S EPISODE

Giacomo Caldarola et al. Infectious events in patients with alopecia areata treated with JAK inhibitors: low burden and minimal impact on persistence in treatment. Expert Opin Drug Saf. 2024 May 8:1-5.

Hren MG and Khattri S. Low rates of vaccination among atopic dermatitis, alopecia areata, psoriasis, and psoriatic arthritis patients on biologics. Arch Dermatol Res. 2024 May 25;316(6):285

Season 7, Episode 6: Topical Minoxidil for Facial Hair Enhancement May 27, 2024

Show notes

In this episode, Dr. Jeff Donovan, a dermatologist and hair loss specialist, examines the effect of topical minoxidil in enhancing beard hair growth in men

Dr. Donovan focuses on a study published in Sage Open Medicine Case Reports titled, "Facial Hair Enhancement with Minoxidil and Off-Label Use". This study highlights the impact of using topical minoxidil for beard hair growth. As a subject frequently questioned by men worldwide, understanding the benefits, side effects, and the result of its use is vital.

A noteworthy part of this study was that it compared the use of topical minoxidil by two identical twins. Only one of the twins applied minoxidil on his face, and as early as the first month, finer, lighter-colored hairs appeared on his beard and mustache. He experienced hair shedding for a few months but still showed overall improvement in hair density and count after using minoxidil for 16 months.

Despite mild side effects such as skin dryness and hypertrichosis on ears and forehead, as well as increased body hair in other areas, the study shows that minoxidil can be an effective strategy for males wishing to enhance their facial hair. The patient in the case report switched to topical minoxidil foam due to dry flakiness caused by the solution, suggesting that the foam might be a preferable choice for some users.

To sum up, this 16-month-long study provides valuable insights on the potential effectiveness of using minoxidil for beard growth. Despite the side effects and need for more long-term data, the results suggest that it is a reasonably safe and potentially helpful approach for those who desire to improve their facial hair density.

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