Sonal Choudhary, MD, a Dermatopathologist, Dermatologist, and the Director of the Integrative Dermatology and Skincare Clinic at the University of Pittsburgh Medical Center in Pittsburgh, PA, and Apple Bodemer, MD, a Dermatologist at the University of Wisconsin in Madison, WI, continue their discussion on integrative approaches to hair loss. In this episode, they take a deep dive into the use of botanicals and nutraceuticals, including pumpkin seed oil, rosemary oil, and Nutrafol, “the Cadillac” of hair growth supplements. Drs. Choudhary and Bodemer also weigh in on the role that breathwork, hypnotherapy, red light, and an anti-inflammatory diet can play in treating different types of alopecia.

Sonal Choudhary, MD, a Dermatopathologist and Dermatologist, and the Director of the Integrative Dermatology and Skincare Clinic at the University of Pittsburgh Medical Center in Pittsburgh, PA, continues her conversation with Apple Bodemer, MD, a Dermatologist at the University of Wisconsin in Madison, WI, about integrative approaches to hair loss and how they can be used with traditional therapies.

Among the highlights:

Vigorous scalp massage may help treat androgenic alopecia, but it's not a cure-all.

Red-light therapies can be effective, but not all devices are created equally.

Home microneedling with a stamp can also be a useful adjunctive therapy for some types of hair loss.

Platelet-rich plasma injections work best when overall health is optimized.

Host Sonal Choudhary, MD, and Apple Bodemer, MD, a Dermatologist at the University of Wisconsin in Madison, WI, discuss the game-changing role that Janus Kinase (JAK) inhibitors play in treating alopecia areata. The U.S. Food and Drug Administration (FDA) has approved three JAK inhibitors— baricitinib (Olumiant, Eli Lilly & Co.)  , ritlecitinib (Litfulo, Pfizer) , and deuruxolitinib(Leqselvi, Sun Pharma)  —as treatments for alopecia areata.

Key takeaways:

• These medications, while highly effective, can increase risk for infections, but integrative approaches may help keep the immune system optimized.

• People with celiac disease and alopecia areata who follow gluten-free diets may regrow hair.

In this bonus episode of The Blend, host Sonal Choudhary, MD, continues her conversation about alopecia with Apple Bodemer, MD, a Dermatologist at the University of Wisconsin in Madison, WI. The two discuss the important role that dermoscopy can play in making a differential diagnosis for patients with alopecia.

Sonal Choudhary, MD, a Dermatopathologist, Dermatologist, and the Director of the Integrative Dermatology and Skincare Clinic at the University of Pittsburgh Medical Center in Pittsburgh, PA, talks to special guest Apple Bodemer, MD, a Dermatologist at the University of Wisconsin in Madison, WI, about hair loss.

In this episode, Dr. Bodemer shares the bold approach that helped her develop empathy for alopecia patients. The two also discuss the lab tests they routinely order to assess alopecia patients and why, and share how these results can help inform treatment choices.

Sonal Choudhary, MD, a Dermatopathologist, Dermatologist, and Director of the Integrative Dermatology and Skincare Clinic, and Physician Assistant Noel Prevost discuss changes to the iPLEDGE program and share tips on how they counsel patients on isotretinoin regarding potential risks.

Key takeaways:

• The 19-day lock-out period has been removed. Now, patients who miss the 7-day window can immediately get a new pregnancy test to re-qualify for treatment.

• At-home pregnancy tests are now allowed during and after isotretinoin treatment.

• There is no causal link between isotretinoin and inflammatory bowel disease (IBD). If a patient has a history of inflammatory bowel disease, get a letter from their gastroenterologist approving treatment.

• Proceed with caution when prescribing isotretinoin to patients with bipolar disorder.

• Consider getting an approval letter from the treating psychiatrist when prescribing isotretinoin for patients with other mental health conditions.

Dr. Sonal Choudhary, a Dermatopathologist and Dermatologist, and Director of the Integrative Dermatology and Skincare Clinic at the University of Pittsburgh Medical Center, and Noel Prevost, MPAS, PA-C, a Dermatology Physician Assistant at UPMC Falk Dermatology-Oakland, discuss how dairy and sugar can contribute to acne flares.

Key Takeaways:

Skim milk and Greek yogurt may contain high levels of insulin-like growth factor, which can stimulate oil production

Sugars can also aggravate acneAcne may improve even without systemic or topical therapy when patients cut out or limit dairy products in their diet

People with polycystic ovary syndrome may be more sensitive to dairy and sugar – possibly due to high levels of insulin-like growth factor.

Taking a dietary history may help identify factors that are contributing to acne flares

Sonal Choudhary, MD, Dermatopathologist and Dermatologist, and Director of the Integrative Dermatology and Skincare Clinic at the University of Pittsburgh Medical Center in Pittsburgh, PA, and Noel Prevost, MPAS, PA-C, a Dermatology Physician Assistant at UPMC Falk Dermatology-Oakland discuss the role that diet may play in athletes with acne, including an evidence-based discussion on protein powders. They also discuss the use of anabolic steroids and their effects on athlete’s skin.

Key Takeaways:

• Worsening of acne lesions may occur in athletes who consume whey protein powder.

• Plant or paleo-based protein powders may be a skin-friendly option for some athletes with acne.

• Patients can consider sweetening plant-based protein powders with stevia or monk fruit.

• Anabolic steroids can increase risk for acne, including acne fulminans.

• It’s important to discuss anabolic steroid use with athletes who are experiencing acne.