Don’t be at a (hair) loss

Hair loss can be emotionally difficult, in addition to dealing with the physical effects. Dermatologists will present cases that address tips and techniques to diagnose, manage, and counsel hair loss patients in today’s session “Diagnosis and Management of the Hair Loss Patient: Pearls and Pitfalls” (F012). Digest these quick pearls, then catch the whole forum from 3:30 to 5:30 p.m. in Regency Ballroom C.

Oma Nenna Agbai, MD
The assessment and management of hair loss in patients of color may be especially challenging for many dermatologists. For example, while cicatricial alopecias such as central centrifugal cicatricial alopecia and folliculitis keloidalis are often diagnosed in patients of color, histopathological confirmation of the diagnosis can identify mimickers of some cicatricial alopecias, such as early traction alopecia and cutaneous sarcoidosis. Furthermore, when diagnosed early, the progression of disease for cicatricial alopecias can be slowed, and in some cases partially reversed.

Paradi Mirmirani, MD
It can be difficult to navigate the emotional territory of a patient who is experiencing shock, fear, grief, or a loss of self-identity as a result of hair loss. A thorough and systematic evaluation by the physician can give the patient the confidence and trust necessary to accept a diagnosis and treatment recommendations. Some critical elements of this evaluation include: educating yourself on different care and styling techniques; examining the scalp even when the diagnosis may be obvious from across the room; sharing the reasoning for your diagnosis or the need for further testing; and setting expectations and addressing concerns about the future, when possible. Remember that strong emotions go hand in hand with hair loss. Often a nonverbal or non-judgmental acknowledgement of these emotions is all that is needed — reach for the tissue box and hand one over. The response is almost always one of gratitude.

Jerry Shapiro, MD
Hair loss is one of the most challenging and time-consuming disorders that dermatologists have to deal with. It is crucial to perform an efficient [medical] history, scalp examination, as well as trichoscopy and laboratory tests. Scarring hair loss is a trichologic emergency, and hairs will be lost permanently if the condition is not treated in a timely manner. Follicular rescue is the aim of therapy in cicatricial alopecias. Alopecia areata has novel forms of therapy that are very efficacious and must be discussed with the patient. Androgenetic hair loss has a palette of choices from topical, surgical, and intralesional options. The landscape of treatment for hair loss has changed a lot in the past decade.

 

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