I started Contrave which has Naltrexone and my FFA became inactive after that. My hairdresser noted it first and then my dermatologist confirmed it. Hope it stays quiet, but I think it is the Naltrexone in the Contrave.

@donovanmedical9780

Ай бұрын

This i great to hear and thanks for sharing. Keep taking photos and compare what things look like in 4-6 months too. It sure sounds encouraging!

You are number one doctor ❤

@donovanmedical9780

9 ай бұрын

thank you for your kind comment.

Thank you very much dr. Donovan.

@donovanmedical9780

9 ай бұрын

thanks for stopping by!😊

An incredibly informative and helpful presentation. Thank you for investing your time with as well as your concern for patients.

@donovanmedical9780

9 ай бұрын

thank you so much. I am happy to know it was helpful.

Hi! ILK caused bald spots weeks after injection, should I continue to get another injection? or is this proof of damage?

Thank you so much for the information! I have LLP and recently moved so I need to find a new dermatologist. My past dermatologist took a scalp biopsy, and I am using a Betamethasone cream and a soothing lotion in the worst areas. I had a few small steroid shots in my scalp which helped me so much. I have iron deficiency anemia and have to get regular iron infusions and 6 other auto-immune skin problems. My main concern now is finding a dermatologist who is familiar with LLP, psoriasis, nodular prurigo and others. Do you have any ideas on how I can find a great dermatologist? I am in Round Rock, Texas.

Great video!! Very informative, thank you for always being so thorough. At the 1:46:40 slide, you show doxycycline as a first line treatment but it is also shown in the 3rd line (at low doses of 40mg). I have been taking 100mg daily (50 mg twice a day) for about 9 months now and things seem to have stabilized. Im confused at your slide and why it is both in the 1st and 3rd line of treatment. And what would you consider the suggested dose of doxycycline in the 1st treatment if 40mg is suggested in the 3rd line of treament. Now that my hairloss has stabilized, im afraid of cutting back on the dose and frewuency. Thank you

@donovanmedical9780

7 ай бұрын

Doxycycline at standard doses (100 mg -200 mg) is first line and lower doses are third line (40 mg subantimicrobial). These are very different. Be sure to review all these fine details with your doctors.

@underworldjack4877

7 ай бұрын

Thank you for the reply. To clarify, the 40mg is a different type of doxycycline used in conjunction with the 100mg (doxycycline hyc) that I currently take? I got my biopsy and confirmation of FFA while traveling internationally last year and unfortunately I have no dermatologists in my area that are knowledgeable about FFA so I am having to do much of the research myself for my current dermatologist (thankfully I found your channel a year ago!). I wish you did virtual consultations, but I appreciate all the info you provide here on your channel!

Hi @Donovan Medical I was wondering whether perifollicular tubular scaling is found in non scary type hairloss? I was told i have Chronic telogen effluvim (diffuse loss going on 4 yrs now) and i looked with a microscope and I have redness in the follicle around each hair, perifollicular scale around each hair with tubular scale going up the hair in the front and top of my head and white scale over parts of my scalp aslo (can't be seen with the naked eye.) i am scared now i have a scarring alopecia at play...

@donovanmedical9780

9 ай бұрын

Perifollicular and perifollicular tubular scaling is found in both scarring and non-scarring. That would be a huge mistake to assume one has scarring alopecia based on this. See an expert with a lot of experience in trichoscopy and the diagnosis of hair loss in general.

Hello Dr Donovan I have been loosing my eyebrow hairs diffusely for the past few months and my hairline has also been slowly receding. I am just 23. I am just scared that it might be FFA as I also kind of notice like lonely hairs. My dermatologist looked at my eyebrows under the trichoscope and told I have exclamation point hairs, Is it a feature of FFA? She concluded that I have stress related hairloss and she is doing prp on my eyebrows. She also suggested that cuteragenesis laser somehow will promote growth in the hairline area. I am doing all of these and still losing hair and eyebrows as usual. And also doctor is there any relation between a high CRP level to hairloss? I would be so grateful if you could reply

@donovanmedical9780

9 ай бұрын

Thanks for the question. The information presented here would represent just 2-3 % of the information that I would need so it’s not possible to say what the diagnosis is. We need the diagnosis before we decide on treatment. A few things are not clear. Exclamation mark hairs are not seen in FFA and stress induced hair loss would likely be more of a telogen effluvium and effect hair loss diffusely. Obviously with the word exclamation mark hair, one is forced into thinking about alopecia areata but one exclamation mark hair does not really have so much meaning - especially in the setting of diffuse eyebrow loss. The same is true with “kinda seeing lonely hairs.” Telogen effluvium and seborrheic dermatitis and irritant dermatitis do remain quite high on the list with this story. With high CRP levels, we need to first know how high. Mildly elevated CRP is one thing but skyrocketing CRP is very different. Infections need to be ruled out as do inflammatory conditions inside the body. Blood tests are going to be helpful including repeating the CRP. I would need to know more about your story to decide what other blood tests are useful and which are not useful but these include ferritin, TSH, CBC, ESR, AST, ALT, creatinine, zinc, ANA, urinalysis, CK. These are not the full list and again a good history is key. In my clinic PRP is not first line for anything so there are differences in how we approach treatment. It still may help so be sure to keep amazing photos to figure out if it does anything at all. I would focus here on getting a confident diagnosis as step 1. If it’s still a mystery then starting minoxidil and pimecrolimus cream on the brows would be a consideration for patients with similar stories. The minoxidil goes on first and pimecrolimus goes on right over top. The pimecrolimus addresses seborrheic dermatitis and any inflammatory issues and the minoxidil helps stimulates growth. If not effective then a decision can be made on use of topical steroids, steroid injections or bimatoprost (Latisse). All this must be supervised by a knowledgeable dermatologist. Side effects would need to be reviewed by each patient with their doctors. Photos should be taken every 1-2 months of the eyebrows and hairline. I do not use the stated laser in my practice. Thanks again for the question. It’s a really good one and I would nee to know more. The key point is we need to do as much detective work as possible to get a diagnosis before starting into treatment.

@ashnabasheer1022

8 ай бұрын

I do not see any improvement in terms of new hair growth on my eyebrows and also in the case of my hair,I have some true anagen hairs falling off when I brush my hair. Not much but I recently noticed a few and I saw in one of your lectures that the only time true anagen hairs are extracted are in the case of a scarring alopecia. I am clearly freaking out.

@donovanmedical9780

8 ай бұрын

​@@ashnabasheer1022 Be sure to see a dermatologist, please. Most patients who think they are seeing anagen hairs are not seeing anagen hairs. I would say that for every 100 patients I meet who think they are seeing anagen hairs, 1 is correct and 99 are incorrect. Most patients who think they are seeing anagen hairs are seeing telogen hairs that are surrounded by scale. A dermatologist can help sort this out. If you have any kind of inflammatory disease of the scalp it can look very confusing. Patients with seborrheic dermatitis, psoriasis, contact dermatitis can all have telogen hairs that look like anagen hairs. So be sure to leave it up to an expert to help you decide if you are losing anagen hairs. You can always save some of your hairs and bring them into your appointment with your doctor. They can look under the microscope and help you determine whether you are losing anagen or telogen hairs.

Any explanation for hair loss after starting ivig (also seems to have more stray grey hairs)?

@donovanmedical9780

7 ай бұрын

both hair loss and growth have been reported with IVIG. I've seen both alopecia areata and telogen effluvium triggered by IVIG.

Thank you for this webinar. I also have a few questions. I have FFA. 1. I wondered if Topical Redensyl would be better than Minoxidil since it targets the hair follicle cells more directly. 2. Can I use Redensyl and Minoxidil together? 3. I started to use 5% Topical Minoxidil a week ago and only apply it in the mornings, but do I need to apply it in the evenings as well? Thank you for all your information.

@donovanmedical9780

9 ай бұрын

thanks for the question. At present there is no good published evidence at all for the use of Redensyl. So it’s not know if it would significantly help, or have no effect or potentially worsen FFA. The key to FFA treatment is to stop the immune mediated attack on hair follicles. You can review in the video what are considered first and second line agents. Minoxidil and other growth promoters can be considered once there is evidence that the patient is gaining back control over the autoimmune attack on the follicle. 5 alpha reductase inhibitors, isotretinoin, calcineurin inhibitors, and possibly other agents like topical steroids and/or steroids injections are first line. There is some (albeit weak) evidence for topical minoxidil in FFA- although likely it does something. It is not a first line agent. There is no evidence at the present time for Redensyl in the management of FFA.

@aureliasieberhagen9340

9 ай бұрын

Thanks for your reply. I am on 1mg Finasteride a day, but my hair is still falling out especially above my ears now. It's horrible! I was on 5mg Finasteride a day, but my doctor has reduced it now to 1mg a day since I started using Minoxidel as well. But he is not a hair specialist, and it is therefore I listen to your podcast to get wiser on the subject. @@donovanmedical9780