Evidence Based Hair

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.

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

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.

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.

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.

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

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.

In this episode, we will dive into fascinating recent studies about the side effects of Minoxidil, a widely-known medication for hair loss treatment.

This podcast highlights new research regarding what Dr. Donovan calls "the OMAHA effect" (ORAL MINOXIDIL ALCOHOL HANGOVER ASSOCIATION), the surprising association between oral minoxidil use and exacerbated alcohol hangover symptoms. This phenomenon challenges previous conceptions in the medical field and warrants further investigation into potential implications for patients using oral Minoxidil.

However, though intriguing, the data about the OMAHA effect lacks detailed and quantitative information about the patients involved and their experiences. This calls for more precise and extensive research on the matter. Dr. Donovan emphasizes the need to gather more information before this knowledge can lead to changes in medical practice.

Moving forward, the episode also examines another study analyzing the association between topical Minoxidil and hair discoloration. This study equips you with more concrete data, reporting that about one-fourth of patients using Minoxidil perceive that the treatment has led to their hair graying. Despite the product monograph advising patients to stop minoxidil use when hair discoloration is noticed, the podcast argues that this abrupt termination might not be practical as patients risk losing the new hair growth achieved with Minoxidil when they stop the treatment.

Overall, this discussion underscores how hair graying and discoloration, like hair loss, also significantly impacts individuals' lives. As researchers dedicate more attention to understanding these issues, expect more practical guidelines and breakthroughs in combatting them.

Join Dr. Donovan every week for insightful discussions about ground-breaking studies relevant to hair loss and its treatment. Stay tuned for our next episode where we look into topical Minoxidil use for beard growth.

In this episode, we dive into a thought-provoking study by Sanfilippo and Friedman, "Survey of Dermatology Practitioners' Opinions and Prescribing Habits of Oral Minoxidil for the Treatment of Androgenetic Hair Loss".

The study provides valuable insights into the perceptions of practitioners on oral minoxidil, an increasingly popular option for treating hair loss.

We discuss the results of this survey and compare it with previous studies, shedding light not only on the effectiveness of oral minoxidil but also on the practitioners' comfort level in prescribing it and patients' satisfaction with its results.

The pulse of the global community and the evidence provided by well-conducted studies play a significant role in shaping our understanding of oral minoxidil. There's a critical need for long-term evaluations and more comprehensive studies to establish its effects and side effects over years of use.

Stay tuned for more in-depth discussions as we continue to explore the realm of hair loss treatments.

And don't forget, if you want to immerse yourself in the study of hair loss and acquire advanced clinical and problem-solving skills, consider applying for a training position in the Evidence-Based Hair Fellowship, the world's most comprehensive program for physicians and allied health professionals.

In this episode of the Evidence-Based Hair Podcast hair loss specialist Dr. Jeff Donovan breaks down the findings of a recent study comparing oral minoxidil and topical minoxidil in the treatment of male androgenetic alopecia. Published in JAMA Dermatology, the study challenged popular opinions by revealing similar performance between the two types of minoxidil, putting a spotlight on the importance of robust evidence from randomized controlled trials.

Interestingly, Dr. Donovan examined the historical usage of oral minoxidil, once a blood pressure medication, in treating hair loss and the subsequent need for more rigorous studies to solidify its effectiveness. The episode also covers the surprising conclusion that oral minoxidil did not significantly outperform its topical counterpart, contrary to what the mainstream assumes.

Diving deeper into the debate, Dr. Donovan explored differing perspectives derived from the Pantchprateep et al and Penha et al studies of oral minoxidil. Where the Panchaprateep et al study suggested that all patients saw some improvement, the Penha et al study showed that not all participants experienced the same positive results.

In an in-depth examination of the 'Oral Minoxidil versus Topical Minoxidil for Male Androgenetic Alopecia: A Randomized Clinical Trial', the potential side effects, including minor adverse effects of both treatments were also discussed. While not definitive in recommending one treatment over the other, the episode sparks stimulating discussions around the efficacy of oral minoxidil, its comparison to topical minoxidil, and the potential of randomized controlled trials in determining the optimal treatment for male androgenetic hair loss.

STUDIES REVIEWED IN THIS EPISODE

Penha MA et al. Oral Minoxidil vs Topical Minoxidil for Male Androgenetic Alopecia: A Randomized Clinical Trial. JAMA Dermatol . 2024 Apr 10:e240284. doi: 10.1001/jamadermatol.2024.0284. Online ahead of print

Panchaprateep et al. Efficacy and Safety of Oral Minoxidil 5 mg Once Daily in the Treatment of Male Patients with Androgenetic Alopecia: An Open-Label and Global Photographic Assessment. Dermatol Ther. 2020 Dec;10(6):1345-1357

This episode is dedicated to a fascinating subject – drug-induced alopecia areata. In addition to genetic factors, alopecia areata is also influenced by environmental factors such as infections and medications. In this episode, Dr Donovan highlights two studies: “A Cross-Sectional Analysis of Medications Used by Patients Reporting Alopecia Areata on the FDA Adverse Events Reporting System” by Ravapati et al and “Drug-Induced Alopecia Areata: A Systematic Review” by Ezemma et al. These studies present an intensive exploration of drugs possibly causing alopecia areata.

Studies show that monoclonal antibodies are common culprits, and reports of drug-induced alopecia areata are rising every over time. 

Surprisingly, it has been observed that the onset of drug-induced alopecia areata could be delayed by as much as a year. Also, patients who discontinued the alleged drug stimulating alopecia areata experienced regrowth of hair, while those who didn't, failed unless treated.

Email is [email protected] or visit our website www.donovanhairacademy.com.

Thank you all for joining. See you next week!