Over 1 billion people in the world smoke - which here is defined as the consumption of nicotine-containing tobacco. Smoking is felt to be a risk factor for both the development of AGA and the worsening AGA. The subject, however, remains somewhat controversial. Several studies have examined the relationship between smoking and androgenetic alopecia. To date, there are almost a dozen such studies. Mosley and Gibbs, 1996 The Mosley and Gibbs study of 1996 often gets referenced when it comes to smoking and hair loss studies. This was one of the first reports that meant to address the relationship ..read more

Introduction It is increasingly clear that androgenetic alopecia (i.e. male and female genetic hair loss or “balding) is an inflammatory condition. Even though the scalp typically looks non-inflamed, scalp biopsies show that inflammation is present just a few millimetres beneath the scalp in an area known as the isthmus and infundibulum. Studies have shown that inflammation occurs relatively early in the course of androgenetic alopecia. This inflammation is believed to facilitate the progressive miniaturization of hair follicles. Although the scalp usually looks fairly normal and non-inflamma ..read more

COVID-19 infection can trigger several autoimmune diseases, including rheumatoid arthritis, lupus, and many more. (For further review, see the article “Autoimmune Disease Risk Increased After COVID19 Infection”.) There is growing evidence that COVID-19 infection can trigger AA or flare AA in those who already have the disease. A 2023 study by Lim et al. showed an increase in both alopecia areata and alopecia totalis following COVID infection and a reduced risk in those who were vaccinated A 2023 study by Tesch  et al. et al. showed an increase in both alopecia areata following COVID i ..read more

Topical Minoxidil Inferior to Betamethasone dipropionate in Treatment of Patchy Alopecia Areata I enjoyed reading a study from Pakistan comparing topical betamethasone dipropionate and topical minoxidil in the treatment of patchy alopecia (less than 50% loess). This non-randomized study involved 100 patients—50 received topical betamethasone dipropionate twice daily, and 50 received topical minoxidil twice daily. The study lasted four weeks. The authors showed that topical betamethasone dipropionate was superior to topical minoxidil in helping people regrow hair. 74 % of patients in the betam ..read more

Specific Gut microbiota Alterations Linked to AGA The gut microbiome refers to the array of organisms that live in our bowels. It’s clear that the health of the gut microbiome is extremely important for human overall health. An altered gut microbiome can lead to disease. A recent study sought to identify changes in the microbiome associated with androgenetic alopecia and those felt to help prevent AGA. Risk Factors for AGA included the genus Olsenella, genus Ruminococcaceae UCG-004, and genus Ruminococcaceae UCG-010 Preventive factors for AGA included the family Acidaminococcaceae and genus ..read more

Dupilumab and CTCL: What does it mean for our alopecia areata patients? I’ve been increasingly prescribing dupilumab, the IL4/13 antagonist, in the management of some patients with alopecia areata and atopic dermatitis. Dupilumab is a drug often used for atopic dermatitis but has the potential to help hair growth in a small proportion of patients with alopecia areata. Safety seems reasonably good. Blood tests are not needed for most, and it’s reasonably easy to administer. We’ve talked about the role of dupilumab in alopecia areata in prior articles. But then there’s the lymphoma studies. S ..read more

First Report of FFA Cases in Northern India Several months ago, I had a discussion with a several colleagues. We spoke about FFA and the role of stress, diet, cosmetics, family history, hormones. Basically everything! Not too long into the discussion, a point was made by my colleague: “I don’t think we’re jseeing much FFA in India!” Another made the point that if this is indeed true that there must be important dietary and genetic reasons that need exploration. A new report in the Indian Journal of Dermatology reminds us that while FFA in India might be a little less frequent than some pockets ..read more

When a new drug comes to market, I’m pretty excited. After all, it’s proof of something I fundamentally believe in : good science can create better treatments and help more people lead fuller lives. Whenever a new drug comes to market, I also remember something I learned many years ago: about 5 % of the time, the drug you are cheering about is going to eventually be removed from the market because of the harm it caused someone. Why are drugs removed? Drugs are removed from the market for several reasons. The top 4 reasons seem to be hepatotoxicity, cardiac disorders hypersensitivity and kidn ..read more

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