Hi Doc. Have you had any luck with insurance companies covering JAK Inhibitors for Scarring Alopecia?
@guillermorivera63323 күн бұрын
Doctor, do you have any data ona oral minoxidil and prolactil levels ? I never have a sexual side effect ( 26 years none stop with topical minoxidil) but it was really hard to get an orgasm while on oral minoxidil ( 46 years old male , was on 2.5mg oral minoxidil , now back to topical ) . Could ‘t find much information about it . Thanks !
@cindykraft44906 күн бұрын
I have LPP and am using a topical 2% Tofacitinib for the past 18 months. For me, it works better than Clobetesol at addressing itching and I have lots of new re-growth. (I've now weaned off Clobetesol use on my scalp). I still have a mostly full head of hair (my LPP has remained relatively mild, though I've had flares here and there). I didn't even know that I'd had so much shedding in some areas until I started seeing all the re-growth after starting the topical Tofa. I get mine from Skin Medicinals in the U.S. and it's $75 for a bottle that lasts me about 7-10 weeks. I also use topical Minoxidil and LDN but have been using both for years (no change to those protocols since starting the topical Tofa). I used Plaquenil in the past (several years ago) and had great success but had to stop due to side effects. Very pleased with the topical Tofa.
@xxx-fv8jt11 күн бұрын
Hi doc... I'm a male and was prescribed Tofacitinib last week for LPP. It seems to be working cuz I dont feel much itchiness. But my 2 concerns are the burning sensation on the scalp and a bit of hair shedding. The burning has been waning since 1st use, which is a good thing; hopefully it will stop altogether. I think the hair shedding stopped but its concerning since its an in area I had a hair transplant in 7 months ago. The shedding wasn't a lot. But I dont want to risk losing hair from my transplant. I also noticed that the medication may be helping to reduce my flakiness. Would you mind providing your thoughts on all I mentioned please?
@copetillirope17814 күн бұрын
great video . i have acess to the cream brand name opzelura do you think it will be as usefull as the jak used in the study? and sorry to ask but according to you in lpp what has the best potential for regrowth inbetween cyclosporine / oral jak / or otezla ? so far it's the three med i've seen giving regrowthon some patient even on somewhat scarred area. thank you very much
@donovanmedical978014 күн бұрын
Well, of those 3 drugs, cyclosporine has the best long term data but they are all somewhat useful. All these drugs have different safety and cost and therefore need to be reviewed one by one. We don’t have data comparing topical tofa to topical ruxo but likely there a similar. But we just don’t have good data to say anything more than that.
@copetillirope17814 күн бұрын
@@donovanmedical9780 @donovanmedical9780 thank you so much for your answer i was under the impression oral jak were safer than cyclo to use long term . sorry to bother you but would you say than otezla is less powerfull monotherapy in term of results than oral jak or cyclo in your experience?
@copetillirope1788 күн бұрын
Thank you so much doc. I know i'm harassing you under your videos and really appreciate your answer and learning on thos disease. As i'm french is there a way for me to get an opinion on my brows lpp or possible ffa through photos? I will pay whatever the cost is to have an opinion . I sent you a message on your instagram i know it's not how a patient should behave and i apologize but i don't think it's possible for me to reach your secretary on your online website
@guillermorivera633214 күн бұрын
Doc , Hace you ever tried Calcipotriol on Scarring alopecias ? I am havingamazing results in FD with Claritromycin plus bactrim plus topical Calcipotriol for the last 12 monts . On Humira before with same results on 40 mg weekly , but to many side effects . Can’t find much info on Calcipotriol and scarring alopecia. Thanks
@donovanmedical978014 күн бұрын
It can have mild benefits but for most patients with FD the credit would need to go to the clarithromycin/Bactrim. But yes, vitamin D analogues can benefit a variety of neutrophilic and acneiform based lesions - including acne and psoriasis.
@guillermorivera633213 күн бұрын
@@donovanmedical9780 Thanks !
@carson852719 күн бұрын
Doctor, have you seen men with androgenic alopecia who don’t have any family members or relatives with the condtion?
@donovanmedical978018 күн бұрын
Yes, it’s possible. Granted it’s not the typical story but absolutely it can occur. Be sure to see an expert to exclude all the hair and scalp disorders that mimic male balding.
@carson852718 күн бұрын
@@donovanmedical9780 Yes, that is exactly what I plan on doing. I’ve been having diffuse thinning and anisotrichosis all over my scalp, including the sides and back, since late September 2023. Back then, I thought it was telogen effluvium because I had COVID a month prior, but later realized that telogen effluvium should not cause individual hairs to become thinner. More recently, the corners of my hairline have started thinning out more aggressively, so I believe these are early signs of a receding hairline. I’ve been to a couple of dermatologists and have gotten mixed opinions from them, and have been told to wait a bit longer. Even though my hair thinning is not cosmetically visible to others yet, I can definitely feel and see a difference compared to how it was a year ago. If I do have a chronic hair loss condition, it is still in its early stages, which is why it might be hard for an accurate diagnosis right now. I would definitely start medical treatment soon (if that is required) to prevent further loss. If you were still accepting new patients, I would definitely visit you, but completely understand why this is not possible for you at this time. I will be moving to Seattle next month, so Whistler would not be too far away (I visited Whistler last summer and it is beautiful). Anyway, maybe I can see a good alopecia specialist soon and get an accurate diagnosis before my hair gets worse. I look forward to more videos on this channel Doctor, they are very informative.
@carson852718 күн бұрын
Yes, I completely agree that an accurate diagnosis is crucial, especially in early stages of hair loss. The thing is I’ve been having diffuse thinning and anisotrichosis all over my scalp, including the sides and back, since late September 2023. At first, I thought this was telogen effluvium because I had COVID a month prior. However, I realized that telogen effluvium should not cause individual hairs to become thinner. More recently I started noticing more aggressive thinning at the corners of my hairline, which seem like the early signs of a receding hairline. I went to a couple of dermatologists, but have gotten mixed opinions from them and have been told to wait longer to see what happens. If I do have a chronic hair loss condition, it is definitely in its early stages, which is why an accurate diagnosis might be difficult right now. I would start treatment ASAP if it were required, because it is always better to prevent hair loss early on. I would visit you if you were still accepting new patients, but completely understand why this is impossible for you at this time. I will be moving to Seattle next month, so Whistler would not be too far away (I visited Whistler last summer and it was beautiful). Anyway, I hope I can get an accurate diagnosis from an alopecia specialist soon and see where I can proceed from there. I look forward to more videos on this channel Doctor, they are very informative.
@carson852718 күн бұрын
@@donovanmedical9780 Yes, I completely agree that an accurate diagnosis is crucial, especially in early stages of hair loss. The thing is I’ve been having diffuse thinning and anisotrichosis all over my scalp, including the sides and back, since late September 2023. At first, I thought this was telogen effluvium because I had COVID a month prior. However, I realized that telogen effluvium should not cause individual hairs to become thinner. More recently I started noticing more aggressive thinning at the corners of my hairline, which look like the early signs of a receding hairline. I went to a couple of dermatologists, but have gotten mixed opinions from them and have been told to wait longer to see what happens. If I do have a chronic hair loss condition, it is definitely in its early stages, which is why an accurate diagnosis might be difficult right now. I would visit you if you were still accepting new patients, but completely understand this is impossible for you at this time. I will be moving to Seattle next month, so Whistler would not be too far away (I visited Whistler last summer and it was beautiful). Anyway, I hope I can get an accurate diagnosis from an alopecia specialist soon and see where I can proceed from there. I look forward to more videos on this channel Doctor, they are very informative.
@carson852718 күн бұрын
@@donovanmedical9780 Yes, I completely agree that an accurate diagnosis is crucial, especially in early stages of hair loss. The thing is I’ve been having diffuse thinning and anisotrichosis all over my scalp, including the sides and back, since late September 2023. At first, I thought this was telogen effluvium because I had high fever (from the illness that starts with a C that I can’t write in youtube comments) a month prior. However, I realized that telogen effluvium should not cause individual hairs to become thinner. More recently I started noticing more aggressive thinning at the corners of my hairline, which look like the early signs of a receding hairline. I went to a couple of dermatologists, but have gotten mixed opinions from them and have been told to wait longer to see what happens. If I do have a chronic hair loss condition, it is definitely in its early stages, which is why an accurate diagnosis might be difficult right now. I would visit you if you were still accepting new patients, but completely understand this is impossible for you at this time. I will be moving to Seattle next month, so Whistler would not be too far away (I visited Whistler last summer and it was beautiful). Anyway, I hope I can get an accurate diagnosis from an alopecia specialist soon and see where I can proceed from there. I look forward to more videos on this channel Doctor, they are very informative.
@carson852720 күн бұрын
Hi Doctor Donovan, do patients with scarring alopecia show hair miniaturization, or is this something that usually only happens in patients with androgenic alopecia or alopecia areata?
@donovanmedical978019 күн бұрын
Miniaturization can be seen in several different conditions. I’ll attach a helpful link here for you. donovanmedical.com/hair-blog/miniaturization
@carson852719 күн бұрын
@@donovanmedical9780 Thank you Doctor, I’ll take a look at this.
@shwin.23 күн бұрын
I’ve been on the CTP-543 trial for about 2 years now. However, I had AA since I was 10 years old (now 35), and my scalp shows limited to no response. I wish there was another solution.
@donovanmedical978023 күн бұрын
Thanks for sharing. I hear your frustration. The JAK inhibitors are helpful for some - but don't help everyone. For patients with total hair loss (alopecia totalis and universalis), the JAK inhibitors help only a small proportion of patients to completely regrow hair. There will be more options in the future. kzread.info/dash/bejne/iYRrlrSvg7zKYKw.html
@GrayWithMeАй бұрын
One thing to keep in mind is the likelihood of compliance and cost when it comes to oral minoxidil. It’s simply easier and cheaper for most people. Insurance doesn’t cover the topical products (in the U.S.)
@donovanmedical9780Ай бұрын
There are actually four things that we must keep in mind at all times. They are safety, affordability, feasability and effectiveness. Cost is just one issue. Safety of oral minoxidil becomes an issue as the dose goes higher and higher and higher. At typical doses, it's reasonably safe. Long term safety is somewhat unknown. All four parameters need to be kept in mind. For many people, yes oral minoxidil has it's advantages. I agree with that. But a proportion of patients don't tolerate oral minoxidil very well.
@VivP532Ай бұрын
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.
@donovanmedical9780Ай 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!
@sofiawhite9337Ай бұрын
I was diagnosed with with FFA in December of 2022, and started “treatments” with my Dermatologist in January2023. Are there any medical trials or research that someone suffering with this hair disease can get involved? I believe that I had this issue for at least 3-4 yrs before I knew what it was. I spent that time going from Derm to Derm before I found a Derm who properly diagnosed me. It pains me to think that I may have to eventually shave my hair bald.
@calijay9805Ай бұрын
I thought finasteride already took care of this problem for most people.
@donovanmedical9780Ай бұрын
Thank you for your comment. No, finasteride does not help alopecia areata. It is of no benefit for this autoimmune-mediated disease.
@copetillirope178Ай бұрын
what's your thought on topical jak for ffa or lpp ? thanks
@donovanmedical9780Ай бұрын
does not help everyone - but it's a reasonable second line approach. donovanmedical.com/qow-posts/topical-jaks-ffa
@paulsmith2823Ай бұрын
Oral min is overrated do you think 10mg would work better
@donovanmedical9780Ай бұрын
Yes. it works better. Many of these benefits are dose dependent. Side effects are dramatically increased by going up. I rarely ever prescribe such doses. Many men can’t even tolerate 5 mg. 10 mg dramatically increases cardiovascular side effects, hypertrichosis, headaches and other issues. Not a dose I recommend!
@paulsmith2823Ай бұрын
@@donovanmedical9780 I get no sides on 5mg after 2 years, you think I could up titrate the dose up from 5mg with 1mg a day so 6mg then keep working up to a max dose ?
@candygirl-gp2hd2 ай бұрын
Hello dr. Donovan ,how do I deal with this condition where by my hair grows like that of a toddler since I was young upto now in my mid 20s..... kindly help me especially a patch at the back of my head... Otherwise thanks for the information ❤
@donovanmedical97802 ай бұрын
thank you. Please contact my office.
@nurDerHSV8572 ай бұрын
great video
@tinaghim51222 ай бұрын
Hello Dr. I’m 60 years old woman after menopause and taking spironolactone, finasteride and estrogen based syeda birth control pill for spotting as well as HRT treatment. These meds have been somewhat controlling excessive shedding, but I’m still losing a lot of hair after washing my hair with dwindled hair volume. Can I add minoxidil 1.25 mg for hair volume improvement? Please help!!
@jonessaetienne5902 ай бұрын
You know whats crazy, I'm 28 now but I've had this condition since 21, started getting bald patches at 18 that eventually stopped growing back, it's very depressing, I don't like the way I look
@mohammedelqahtani38432 ай бұрын
I'd like to inquire about the Pfizer vaccine's potential link to hair thinning. Since June 2022, I've observed several people (ages 16-53) in my workplace and community who previously had very thick hair. All of them received the Pfizer vaccine and have since experienced hair thinning across their scalp. Is there a possibility that the vaccine triggers increased sensitivity of hair follicles to DHT (dihydrotestosterone)? Alternatively, could the immune response to the vaccine be attacking hair follicles? It's important to note that none of these individuals have progressed to complete baldness, but rather a general thinning throughout their scalp. Telogen effluvium (TE) seems unlikely as the hair loss has persisted for several months.
@copetillirope1782 ай бұрын
Awesome video as always i never miss one . Doctor i have one final question concerning ffa and lpp . I have a case of both localized in my eyebrows so far and really refractory i tried everything so far excepted topical high strenght steroid , hydroxychloroquine and systemic immunosupressant . I wanted to know if in some case topical clobetasol ( i know you wrote in one of your blog post that it was too potent to use near the eyes ) was enough to stop the progression ik some rare case? Another thing i wanted to know was if a short course of oral cyclosporine could shut down the disease forever or if there was always a relapse? ( i consulted with a french professor dr reygane who is specialized in ffa and lpp even if he is definitely not on your level of expertise and he told me the relapse rate was as high as 80% ) . And finally do hcq on his own is able to stop ffa or lpp progression in some case? I'm considering choosing inbetween hcq or cyclosporine but those are really potent medication and i want to make the right choice ( and i saw the that the half life of hcq is really long). I tried all the other gold standard and some silver medication ( dut / isotretinoin / intralesional steroid / pimecrolimus / doxycicline / topical jak / oral min.... ) with no sucess in stopping the disease . Sorry for my long post but i am feeling quite desperate . With all my respect and consideration for your work . Thank you.
@mashleyden3 ай бұрын
I’ve been on the birth control Depo Provera for 5 years and have been experiencing this pattern of balding for the past year. I am in disbelief that my doctors cannot tie hair loss to hormonal changes caused my bc as something to potentially consider.
@mstanzo713 ай бұрын
It would seem that due to it's low side effect profile that finasteride would be the best choice for men and women for all androgenetic hair loss. Would you agree?
@donovanmedical97803 ай бұрын
No, I would not agree with that broad statement. It is taken on a case by cases basis. Finasteride would not be a good option for males with depression, females with depression, males with low libido, females with low libido, males with gynecomastia, females of childbearing age, males under 16-17 years, and many more! Unfortunately the statement would not be broadly supported as written, no.
@mstanzo713 ай бұрын
thank you for the quick response. I am considering the academy when the next cycle starts in 2026@@donovanmedical9780
@mstanzo713 ай бұрын
Thank you for the quick response. I am looking into possibly joining the academy in the 2026 rotation@@donovanmedical9780
@ambrosia19174 ай бұрын
Hi! ILK caused bald spots weeks after injection, should I continue to get another injection? or is this proof of damage?
@HearTruth4 ай бұрын
Do not put your faith in these so called "specialists Medical Professionals" I went 2 x b/c first time Derm just glanced at my head and recommended Minoxidil . I have since researched much and know I have FFA and AUniversalis but 2nd visit ,, no need for biopsy and so another exam fail. Is it such a big deal to take a strand of my hair and put under a microscope? smh. I just use prayer and know God will not allow me to be shorn. also clove oil infusion rosemary coffee etc and for now the minoxidil. Psa 118:8 It is better to trust in the LORD than to put confidence in man.
@Alexeloy14 ай бұрын
Thank you very much, Dr.Donovan for your videos. Recently i've stumbled upon some videos of people saying that oral minoxidil, even in low doses can cause pericardial effusion. What do you think about safety of oral minoxidil?
@donovanmedical97804 ай бұрын
Oh, yes, for sure. Every single think in life has some risk attached. You just need to talk to your doctors about what exactly is the level of risk.Fortunately, the level of risk at low doses is quite low (but not zero). donovanmedical.com/hair-blog/ldom-fluid-retention
@Alexeloy13 ай бұрын
@@donovanmedical9780 Thank you for the answer, i really appreciate it. By the way, i saw a graph at your website that had the minoxidil concentration in blood, like: 5mg is 156.6ng, 2.5mg is 28ng, and what about 1mg? Will it be just around 1/5 of the 28ng?
@tomo-lr6fc4 ай бұрын
this medication is way too expensive for people who can't afford it or poor, once again the people with the money get all the toys
@kennall454 ай бұрын
Thank you so much for sharing! I started losing hair January 2023 due to Emgality. I didn’t know it was Emgality at the time since hair loss is not listed as a side effect. I saw multiple dermatologists, and had lots of bloodwork drawn to find out what it was. I googled “Emgality hair loss” and was able to stumble upon a Reddit thread with hundreds of people saying that they think their migraine meds might be causing hair loss. I think many patients were probably told it was COVID related since the research on this drug surrounding hair loss is so new. It’s good to see to raised awareness around this topic. There are lots of patients searching for answers and spending thousands of dollars in the process. What concerns me about the initial clinical trials, is that the length of the study is thought to be the reason why hair loss wasn’t listed or at incredibly low numbers; although, most of us seem to be losing hair really quickly (3 months in) after taking the drug. I did raise this to the FDA. I believe the subjects in the Germany trial were switched to a different type a few weeks in, but I wish they would have continued down the same path, using the same exact drug over 3 months which seems to replicate the typical case for those experiencing this shedding. I could be misunderstanding the Germany study though, but if that’s right - I wonder if the switch skewed the results a bit. I am on Nurtec and Qulipta now. It’s much better. I’m not losing clumps of hair like before, but the shedding still persists. The really weird thing is that the texture of my hair has completely changed since taking the drug last year, it’s not shiny or healthy looking. It’s very straw like. That has not changed for me, and many other patients I have spoken with. I am not sure if that’s due to still being on some form of these drugs with Nurtec and Qulipta. I just wanted to share all of this in hopes that it might help someone out there. ❤
@lycherbabe5 ай бұрын
If growing well from steroid injections for beard alopecia (1-3 patches). What do you mean by be available from time to time when they lose hair? Does this mean after steroids it will fall out?
@donovanmedical97805 ай бұрын
yes, sometimes. For some ongoing periodic injections are needed. Be sure to review with your physician. Alopecia areata is a lifelong condition for some patients. There can be weeks, months or years between patches of hair loss
@lycherbabe5 ай бұрын
@@donovanmedical9780 Thanks for the reply! The reason I ask is because I have 3 patches on the beard - 2 of which were tennis ball size. They have now grown in 80-90%. However in the remaining gaps, I noticed that I’ll see some hair in it but a few weeks later after I shave the hair it wouldn’t be there (I’m talking about 5-6 hairs) which could just be the darker vellus falling but I worry inflammation is still present in that small area. For the rest of the hairs within the patch, they remain strong and no signs of falling.
@copetillirope1785 ай бұрын
When it comes to eyebrow ffa is the combo of topical steroid / pimecrolimus or tacrolimus able to halt the disease in a portion lf patient ? I tried most first line treatment excepted heavy immunosupresive such ad mtx or cyclo . And sorry to bother but would you think topical spiro or clascoterone could help sibce it's suppose to have anti inflammatory properties. I whish i could getva consultation with you but i live in france . Thanks doctor
@weeteelim37495 ай бұрын
And would oral minoxidil help TE😊
@user-wz1ch9hs1x5 ай бұрын
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.
@inesovayavratch68765 ай бұрын
Tthank you Dr for your efforts. I am also Dr i suffer from TE for 10 months it is after covid 19 infection. Doctors told me that my hair will come back but i m not sure since it seems to be fibrosis it is diffuse it starts on occipital part then all the scalp . Mu temples start to look like patients with fibrosis alopecia what can i do to stop the progress. I have strong pain on my scalp with sensation of burn and when i feel this why i loose more hair then other days please answer me i visited 7 doctors all they said to me is stress, covid and maybe AGA will start to appear but i m sure it is different my middle hair line is not large my hair is thick but i loose it without any regrowth and the scalp is so white.
@shivampatel44616 ай бұрын
i am 21 years old male, i used minoxidil + finasteride solution and lost my hairline in a week of using it. i had mature hairline and i thought i was losing hair , shouldn't have done it . i thought it was shedding period and continued for 6 months with no visible regrowth, its now been 6 months since i stopped minoxidil in that time i had only little regrown on 1 temple. what should i do ? can minoxidil cause FFA ? i had itching from minox in the start as it was one of the side effects of minox.
@shivampatel44616 ай бұрын
can i get FFA with irritation from minoxidil ?
@jess-raeoliver36286 ай бұрын
I have been diagnosed with this condition and it has driven me into a deep depression, I want to take my life. There is no hope.
@hhh-nm3we6 ай бұрын
amazing compilation as always thanks for your extensive work doctor it's highly appreciated from us alopecia suffferers that like to deep dive into research studies. if you don't mind i have a question regarding ffa . i know oral dutasteride is in the gold standard list but what's your take on mesotherapy with dut? and also mesotherapy with minoxidil? ( since OM is supposed to be hlefpull in ffa and also lpp ) i know there are no medical studies regarding those 2 but do you think it could help? thanks and happy new year
@Kyle_Bu6 ай бұрын
Hello Dr. Donovan I'm very interested in featuring you on my channel for an interview, where we can discuss questions from my subscribers. Your website and services have garnered much admiration from us. Additionally, I have a personal inquiry: How is CCCA manifested, and what are the identifiable biological markers in a scalp biopsy? Are general inflammatory signs present, and how do these differ from other inflammatory skin conditions? I concur with your approach that early and aggressive action leads to more favorable outcomes. In my view, factors like DHT and the Androgen receptor's impact on macrophages, as well as their effects on the WNT pathway following DHT-AR complex transcription, are pivotal in suppressing hair follicle growth, suggesting AGA is akin to other skin diseases. I look forward to the possibility of discussing these topics further with you.
@donovanmedical97806 ай бұрын
CCCA affects many black women and sometimes black males too. Patients present with central hair loss and there may or may not be symptoms. The area expands over time without treatment . The biopsy findings resemble lichen planopilaris very very closely if not perfectly in some cases. There is some eccentric thinning of the root sheath and premature separation of the IRS but these are not entirely specific. There may be redness clinically but there does not have to be. The biopsy may highlight mild to moderate inflammation but the inflammation is often much less than typical classical LPP. Be sure to read more on our website donovanmedical.com/hair-blog/ccca-2. As for interviews, simply contact my office and they can arrange. The website donovanmedical.com takes you to them! Happy New Year.
@Kyle_Bu6 ай бұрын
@@donovanmedical9780 thank you for getting back to me Doctor! I'll be sure to set that up.
@lmzkot51756 ай бұрын
Thank you for all your informative videos. I’ve always been a bit confused when choosing between Finesteride and Dutasteride and which is superior in treating AGA. The study you spoke of regarding FPHL and what is most affective listed Finesteride 5mg as the most affective. How does Dutasteride at 0.5mg compare to the dosage of Finasteride 5mg? Should I be increasing my Dutasteride dosage or possibly changing to Finasteride for optimal improvement. I am not of child bearing age. I’ve been on Dutasteride for several years with no improvement.
@donovanmedical97806 ай бұрын
We don’t know how dutasteride compares or it would most certainly have been included in this study. They are probably somewhat similar when comparing finasteride 5 mg once daily and dutasteride 0.5 mg once daily. But good studies are needed. I don’t know enough about your story to say if you should switch or not. A doctor who knows your story and knows how the dutasteride has been working can help solve this. If you are taking suboptimal doses of dutasteride then increasing to optimal doses like 0.5 mg daily would be reasonable for many patients before jumping to finasteride. I doubt that a switch is going to make a huge difference but yes, could make some. Bringing on board another mechanism of treating the hair loss probably makes more sense for most (assuming the dutasteride dose is optimal). Minoxidil, laser and other antiandrogens with different mechanisms (spironolactone, bicalutamide) can all be carefully and thoroughly reviewed with your doctor. All in all, we don’t have great data comparing finasteride and dutasteride yet. While they may be slightly different, it’s unlikely a huge difference for most. Therefore, if one is on an optimal dose (like 0.5 mg daily) and still not getting results, the best plan probably involves looking into adding other treatments rather than time spent on deciding whether to switch to finasteride. If one is not using a proper dose of dutasteride, it may be worth moving forward with a good dose and deciding on next steps in 6-9 months. One must always make sure that there are no other hair loss issues present that themselves require treatment (scarring alopecia, telogen effluvium, etc).
@anthonybewlz3886 ай бұрын
Love all your due diligence, efforts, and knowledge. Much appreciated, Doc! 🙏
@donovanmedical97806 ай бұрын
thank you!
@zhyloNN6 ай бұрын
How can LDOM result in sexual side effects? I think Minoxidil has the potential of different side effects because ultimately how it works (potassium channel opener?) and its effect at a cellular level is not well understood
@underworldjack48776 ай бұрын
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
@donovanmedical97806 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.
@underworldjack48776 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!
@angelar76086 ай бұрын
Any explanation for hair loss after starting ivig (also seems to have more stray grey hairs)?
@donovanmedical97806 ай бұрын
both hair loss and growth have been reported with IVIG. I've seen both alopecia areata and telogen effluvium triggered by IVIG.
@Msh3el527 ай бұрын
What is the hairloss induced of selenium toxicity? Telogen effluvium? And what happens if someone is still toxic on selenium can hairloss be permanent or scarring due to selenium?
@Msh3el527 ай бұрын
Hey Dr , i hope you really answe these two questions i have Two questions about two scenarios, first question ? if i use minoxodil but im one of the minority that minoxodil doesn’t work for me , but i haven’t noticed that its not working, so i kept applying it for a long time lets say a year , btw i was using the topical solution form which contains alcohol, will that minoxodil that isn’t working make my situation worse does it make it like im only applying the alcohol? Second question if i got missdiagnosed with androgenetic alopecia lets say, so i use minoxodil for a while ,since in misdiagnosed minoxodil is not gonna help me can it cause adverse effects can it make my hair thinner , due to its daily application on the scalp thinking i have androgenetic alopecia? My point is Imagine minoxodil doesn’t work for me ,ok? Now imagine if ur applying topical solution minoxodil which only has minoxodil and alcohol, now since minoxodil isn’t working, what happens overtime if ur only applying alcohol? We know alcohol is very bad for hair follicles , but in the situation of minoxodil working i know that alcohol helps with absorption. So what if minoxodil isn’t working for me?
@Snatnander627 ай бұрын
Hey dr if u don’t mind me asking an irrelevant question, what can happen if someone kept over applying minoxodil for a while mistakenly, i was applying more than the recommended dose for a while before knowing i was wrong, could 1 year of overly applying damage the hair follicles?
@mohammedelqahtani38437 ай бұрын
Here is one ☝️ victim of vaccine , I had full hair and beard now my beard has so many small gaps and hair also especially after the third dose furthermore I noticed my nail start to be brittle and vertical lines on it before it was clear and strong
@jmass42074 ай бұрын
How long have you been dealing with it? Any improvements as time goes on? The hair across my whole body got wiped out and I’m getting steady but still very sparse regrowth.
@mohammedelqahtani38434 ай бұрын
@@jmass4207 since September 2021 my third dose after i took by 2 months its all started, well am trying to pinball the main cause my IGE is tripled since 2019 test but it within the normal range and my TSH also tripled since but also in the normal range if i found any treatment or breakthrough i will share it , I hope all the best for you
@williefufu29853 ай бұрын
My hair started falling out after this most recent vaccine, last week for my job in healthcare.
@ahmedalhashimi161813 күн бұрын
سلام اخ محمد، ممكن تراسلني عندي استفسار بخصوص هذا الموضوع
@shilpaasija60677 ай бұрын
Is there any study about the remission of AA for those whose cause was Covid 19 vaccine
@donovanmedical97806 ай бұрын
yes, it's described in this podcast.
@tishafay7 ай бұрын
It probably should work for traction Alopecia as well ( that's what I have) but after doing some reading and looking at the website, the side effects aren't worth the risk. This medicine could potentially cause illnesses and even result in death.
@donovanmedical97807 ай бұрын
there is no good evidence that Jak3/Tec activation in lymphocytes plays a critical role in traction nor is there evidence that blocking the pathway would have much in the way of benefit. Inhibitors of this nature would be relatively contraindicated. Evidence based approaches can be reviewed with a dermatologist including cessation of mechanical forces that contribute to traction as well as treatments such as triamcinolone acetonide, topical and oral minoxidil and PRP.
@MariaPerez-iy5pg7 ай бұрын
@Dovan medican Does the drug ritlecitinib in its metabolism give rise to active or inactive metabolites?
@bernicecarr9827 ай бұрын
Thanks for providing this evidence-based forcast. This provides me with pertinent information to share with my dermatologist.
Пікірлер
Hi Doc. Have you had any luck with insurance companies covering JAK Inhibitors for Scarring Alopecia?
Doctor, do you have any data ona oral minoxidil and prolactil levels ? I never have a sexual side effect ( 26 years none stop with topical minoxidil) but it was really hard to get an orgasm while on oral minoxidil ( 46 years old male , was on 2.5mg oral minoxidil , now back to topical ) . Could ‘t find much information about it . Thanks !
I have LPP and am using a topical 2% Tofacitinib for the past 18 months. For me, it works better than Clobetesol at addressing itching and I have lots of new re-growth. (I've now weaned off Clobetesol use on my scalp). I still have a mostly full head of hair (my LPP has remained relatively mild, though I've had flares here and there). I didn't even know that I'd had so much shedding in some areas until I started seeing all the re-growth after starting the topical Tofa. I get mine from Skin Medicinals in the U.S. and it's $75 for a bottle that lasts me about 7-10 weeks. I also use topical Minoxidil and LDN but have been using both for years (no change to those protocols since starting the topical Tofa). I used Plaquenil in the past (several years ago) and had great success but had to stop due to side effects. Very pleased with the topical Tofa.
Hi doc... I'm a male and was prescribed Tofacitinib last week for LPP. It seems to be working cuz I dont feel much itchiness. But my 2 concerns are the burning sensation on the scalp and a bit of hair shedding. The burning has been waning since 1st use, which is a good thing; hopefully it will stop altogether. I think the hair shedding stopped but its concerning since its an in area I had a hair transplant in 7 months ago. The shedding wasn't a lot. But I dont want to risk losing hair from my transplant. I also noticed that the medication may be helping to reduce my flakiness. Would you mind providing your thoughts on all I mentioned please?
great video . i have acess to the cream brand name opzelura do you think it will be as usefull as the jak used in the study? and sorry to ask but according to you in lpp what has the best potential for regrowth inbetween cyclosporine / oral jak / or otezla ? so far it's the three med i've seen giving regrowthon some patient even on somewhat scarred area. thank you very much
Well, of those 3 drugs, cyclosporine has the best long term data but they are all somewhat useful. All these drugs have different safety and cost and therefore need to be reviewed one by one. We don’t have data comparing topical tofa to topical ruxo but likely there a similar. But we just don’t have good data to say anything more than that.
@@donovanmedical9780 @donovanmedical9780 thank you so much for your answer i was under the impression oral jak were safer than cyclo to use long term . sorry to bother you but would you say than otezla is less powerfull monotherapy in term of results than oral jak or cyclo in your experience?
Thank you so much doc. I know i'm harassing you under your videos and really appreciate your answer and learning on thos disease. As i'm french is there a way for me to get an opinion on my brows lpp or possible ffa through photos? I will pay whatever the cost is to have an opinion . I sent you a message on your instagram i know it's not how a patient should behave and i apologize but i don't think it's possible for me to reach your secretary on your online website
Doc , Hace you ever tried Calcipotriol on Scarring alopecias ? I am havingamazing results in FD with Claritromycin plus bactrim plus topical Calcipotriol for the last 12 monts . On Humira before with same results on 40 mg weekly , but to many side effects . Can’t find much info on Calcipotriol and scarring alopecia. Thanks
It can have mild benefits but for most patients with FD the credit would need to go to the clarithromycin/Bactrim. But yes, vitamin D analogues can benefit a variety of neutrophilic and acneiform based lesions - including acne and psoriasis.
@@donovanmedical9780 Thanks !
Doctor, have you seen men with androgenic alopecia who don’t have any family members or relatives with the condtion?
Yes, it’s possible. Granted it’s not the typical story but absolutely it can occur. Be sure to see an expert to exclude all the hair and scalp disorders that mimic male balding.
@@donovanmedical9780 Yes, that is exactly what I plan on doing. I’ve been having diffuse thinning and anisotrichosis all over my scalp, including the sides and back, since late September 2023. Back then, I thought it was telogen effluvium because I had COVID a month prior, but later realized that telogen effluvium should not cause individual hairs to become thinner. More recently, the corners of my hairline have started thinning out more aggressively, so I believe these are early signs of a receding hairline. I’ve been to a couple of dermatologists and have gotten mixed opinions from them, and have been told to wait a bit longer. Even though my hair thinning is not cosmetically visible to others yet, I can definitely feel and see a difference compared to how it was a year ago. If I do have a chronic hair loss condition, it is still in its early stages, which is why it might be hard for an accurate diagnosis right now. I would definitely start medical treatment soon (if that is required) to prevent further loss. If you were still accepting new patients, I would definitely visit you, but completely understand why this is not possible for you at this time. I will be moving to Seattle next month, so Whistler would not be too far away (I visited Whistler last summer and it is beautiful). Anyway, maybe I can see a good alopecia specialist soon and get an accurate diagnosis before my hair gets worse. I look forward to more videos on this channel Doctor, they are very informative.
Yes, I completely agree that an accurate diagnosis is crucial, especially in early stages of hair loss. The thing is I’ve been having diffuse thinning and anisotrichosis all over my scalp, including the sides and back, since late September 2023. At first, I thought this was telogen effluvium because I had COVID a month prior. However, I realized that telogen effluvium should not cause individual hairs to become thinner. More recently I started noticing more aggressive thinning at the corners of my hairline, which seem like the early signs of a receding hairline. I went to a couple of dermatologists, but have gotten mixed opinions from them and have been told to wait longer to see what happens. If I do have a chronic hair loss condition, it is definitely in its early stages, which is why an accurate diagnosis might be difficult right now. I would start treatment ASAP if it were required, because it is always better to prevent hair loss early on. I would visit you if you were still accepting new patients, but completely understand why this is impossible for you at this time. I will be moving to Seattle next month, so Whistler would not be too far away (I visited Whistler last summer and it was beautiful). Anyway, I hope I can get an accurate diagnosis from an alopecia specialist soon and see where I can proceed from there. I look forward to more videos on this channel Doctor, they are very informative.
@@donovanmedical9780 Yes, I completely agree that an accurate diagnosis is crucial, especially in early stages of hair loss. The thing is I’ve been having diffuse thinning and anisotrichosis all over my scalp, including the sides and back, since late September 2023. At first, I thought this was telogen effluvium because I had COVID a month prior. However, I realized that telogen effluvium should not cause individual hairs to become thinner. More recently I started noticing more aggressive thinning at the corners of my hairline, which look like the early signs of a receding hairline. I went to a couple of dermatologists, but have gotten mixed opinions from them and have been told to wait longer to see what happens. If I do have a chronic hair loss condition, it is definitely in its early stages, which is why an accurate diagnosis might be difficult right now. I would visit you if you were still accepting new patients, but completely understand this is impossible for you at this time. I will be moving to Seattle next month, so Whistler would not be too far away (I visited Whistler last summer and it was beautiful). Anyway, I hope I can get an accurate diagnosis from an alopecia specialist soon and see where I can proceed from there. I look forward to more videos on this channel Doctor, they are very informative.
@@donovanmedical9780 Yes, I completely agree that an accurate diagnosis is crucial, especially in early stages of hair loss. The thing is I’ve been having diffuse thinning and anisotrichosis all over my scalp, including the sides and back, since late September 2023. At first, I thought this was telogen effluvium because I had high fever (from the illness that starts with a C that I can’t write in youtube comments) a month prior. However, I realized that telogen effluvium should not cause individual hairs to become thinner. More recently I started noticing more aggressive thinning at the corners of my hairline, which look like the early signs of a receding hairline. I went to a couple of dermatologists, but have gotten mixed opinions from them and have been told to wait longer to see what happens. If I do have a chronic hair loss condition, it is definitely in its early stages, which is why an accurate diagnosis might be difficult right now. I would visit you if you were still accepting new patients, but completely understand this is impossible for you at this time. I will be moving to Seattle next month, so Whistler would not be too far away (I visited Whistler last summer and it was beautiful). Anyway, I hope I can get an accurate diagnosis from an alopecia specialist soon and see where I can proceed from there. I look forward to more videos on this channel Doctor, they are very informative.
Hi Doctor Donovan, do patients with scarring alopecia show hair miniaturization, or is this something that usually only happens in patients with androgenic alopecia or alopecia areata?
Miniaturization can be seen in several different conditions. I’ll attach a helpful link here for you. donovanmedical.com/hair-blog/miniaturization
@@donovanmedical9780 Thank you Doctor, I’ll take a look at this.
I’ve been on the CTP-543 trial for about 2 years now. However, I had AA since I was 10 years old (now 35), and my scalp shows limited to no response. I wish there was another solution.
Thanks for sharing. I hear your frustration. The JAK inhibitors are helpful for some - but don't help everyone. For patients with total hair loss (alopecia totalis and universalis), the JAK inhibitors help only a small proportion of patients to completely regrow hair. There will be more options in the future. kzread.info/dash/bejne/iYRrlrSvg7zKYKw.html
One thing to keep in mind is the likelihood of compliance and cost when it comes to oral minoxidil. It’s simply easier and cheaper for most people. Insurance doesn’t cover the topical products (in the U.S.)
There are actually four things that we must keep in mind at all times. They are safety, affordability, feasability and effectiveness. Cost is just one issue. Safety of oral minoxidil becomes an issue as the dose goes higher and higher and higher. At typical doses, it's reasonably safe. Long term safety is somewhat unknown. All four parameters need to be kept in mind. For many people, yes oral minoxidil has it's advantages. I agree with that. But a proportion of patients don't tolerate oral minoxidil very well.
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.
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!
I was diagnosed with with FFA in December of 2022, and started “treatments” with my Dermatologist in January2023. Are there any medical trials or research that someone suffering with this hair disease can get involved? I believe that I had this issue for at least 3-4 yrs before I knew what it was. I spent that time going from Derm to Derm before I found a Derm who properly diagnosed me. It pains me to think that I may have to eventually shave my hair bald.
I thought finasteride already took care of this problem for most people.
Thank you for your comment. No, finasteride does not help alopecia areata. It is of no benefit for this autoimmune-mediated disease.
what's your thought on topical jak for ffa or lpp ? thanks
does not help everyone - but it's a reasonable second line approach. donovanmedical.com/qow-posts/topical-jaks-ffa
Oral min is overrated do you think 10mg would work better
Yes. it works better. Many of these benefits are dose dependent. Side effects are dramatically increased by going up. I rarely ever prescribe such doses. Many men can’t even tolerate 5 mg. 10 mg dramatically increases cardiovascular side effects, hypertrichosis, headaches and other issues. Not a dose I recommend!
@@donovanmedical9780 I get no sides on 5mg after 2 years, you think I could up titrate the dose up from 5mg with 1mg a day so 6mg then keep working up to a max dose ?
Hello dr. Donovan ,how do I deal with this condition where by my hair grows like that of a toddler since I was young upto now in my mid 20s..... kindly help me especially a patch at the back of my head... Otherwise thanks for the information ❤
thank you. Please contact my office.
great video
Hello Dr. I’m 60 years old woman after menopause and taking spironolactone, finasteride and estrogen based syeda birth control pill for spotting as well as HRT treatment. These meds have been somewhat controlling excessive shedding, but I’m still losing a lot of hair after washing my hair with dwindled hair volume. Can I add minoxidil 1.25 mg for hair volume improvement? Please help!!
You know whats crazy, I'm 28 now but I've had this condition since 21, started getting bald patches at 18 that eventually stopped growing back, it's very depressing, I don't like the way I look
I'd like to inquire about the Pfizer vaccine's potential link to hair thinning. Since June 2022, I've observed several people (ages 16-53) in my workplace and community who previously had very thick hair. All of them received the Pfizer vaccine and have since experienced hair thinning across their scalp. Is there a possibility that the vaccine triggers increased sensitivity of hair follicles to DHT (dihydrotestosterone)? Alternatively, could the immune response to the vaccine be attacking hair follicles? It's important to note that none of these individuals have progressed to complete baldness, but rather a general thinning throughout their scalp. Telogen effluvium (TE) seems unlikely as the hair loss has persisted for several months.
Awesome video as always i never miss one . Doctor i have one final question concerning ffa and lpp . I have a case of both localized in my eyebrows so far and really refractory i tried everything so far excepted topical high strenght steroid , hydroxychloroquine and systemic immunosupressant . I wanted to know if in some case topical clobetasol ( i know you wrote in one of your blog post that it was too potent to use near the eyes ) was enough to stop the progression ik some rare case? Another thing i wanted to know was if a short course of oral cyclosporine could shut down the disease forever or if there was always a relapse? ( i consulted with a french professor dr reygane who is specialized in ffa and lpp even if he is definitely not on your level of expertise and he told me the relapse rate was as high as 80% ) . And finally do hcq on his own is able to stop ffa or lpp progression in some case? I'm considering choosing inbetween hcq or cyclosporine but those are really potent medication and i want to make the right choice ( and i saw the that the half life of hcq is really long). I tried all the other gold standard and some silver medication ( dut / isotretinoin / intralesional steroid / pimecrolimus / doxycicline / topical jak / oral min.... ) with no sucess in stopping the disease . Sorry for my long post but i am feeling quite desperate . With all my respect and consideration for your work . Thank you.
I’ve been on the birth control Depo Provera for 5 years and have been experiencing this pattern of balding for the past year. I am in disbelief that my doctors cannot tie hair loss to hormonal changes caused my bc as something to potentially consider.
It would seem that due to it's low side effect profile that finasteride would be the best choice for men and women for all androgenetic hair loss. Would you agree?
No, I would not agree with that broad statement. It is taken on a case by cases basis. Finasteride would not be a good option for males with depression, females with depression, males with low libido, females with low libido, males with gynecomastia, females of childbearing age, males under 16-17 years, and many more! Unfortunately the statement would not be broadly supported as written, no.
thank you for the quick response. I am considering the academy when the next cycle starts in 2026@@donovanmedical9780
Thank you for the quick response. I am looking into possibly joining the academy in the 2026 rotation@@donovanmedical9780
Hi! ILK caused bald spots weeks after injection, should I continue to get another injection? or is this proof of damage?
Do not put your faith in these so called "specialists Medical Professionals" I went 2 x b/c first time Derm just glanced at my head and recommended Minoxidil . I have since researched much and know I have FFA and AUniversalis but 2nd visit ,, no need for biopsy and so another exam fail. Is it such a big deal to take a strand of my hair and put under a microscope? smh. I just use prayer and know God will not allow me to be shorn. also clove oil infusion rosemary coffee etc and for now the minoxidil. Psa 118:8 It is better to trust in the LORD than to put confidence in man.
Thank you very much, Dr.Donovan for your videos. Recently i've stumbled upon some videos of people saying that oral minoxidil, even in low doses can cause pericardial effusion. What do you think about safety of oral minoxidil?
Oh, yes, for sure. Every single think in life has some risk attached. You just need to talk to your doctors about what exactly is the level of risk.Fortunately, the level of risk at low doses is quite low (but not zero). donovanmedical.com/hair-blog/ldom-fluid-retention
@@donovanmedical9780 Thank you for the answer, i really appreciate it. By the way, i saw a graph at your website that had the minoxidil concentration in blood, like: 5mg is 156.6ng, 2.5mg is 28ng, and what about 1mg? Will it be just around 1/5 of the 28ng?
this medication is way too expensive for people who can't afford it or poor, once again the people with the money get all the toys
Thank you so much for sharing! I started losing hair January 2023 due to Emgality. I didn’t know it was Emgality at the time since hair loss is not listed as a side effect. I saw multiple dermatologists, and had lots of bloodwork drawn to find out what it was. I googled “Emgality hair loss” and was able to stumble upon a Reddit thread with hundreds of people saying that they think their migraine meds might be causing hair loss. I think many patients were probably told it was COVID related since the research on this drug surrounding hair loss is so new. It’s good to see to raised awareness around this topic. There are lots of patients searching for answers and spending thousands of dollars in the process. What concerns me about the initial clinical trials, is that the length of the study is thought to be the reason why hair loss wasn’t listed or at incredibly low numbers; although, most of us seem to be losing hair really quickly (3 months in) after taking the drug. I did raise this to the FDA. I believe the subjects in the Germany trial were switched to a different type a few weeks in, but I wish they would have continued down the same path, using the same exact drug over 3 months which seems to replicate the typical case for those experiencing this shedding. I could be misunderstanding the Germany study though, but if that’s right - I wonder if the switch skewed the results a bit. I am on Nurtec and Qulipta now. It’s much better. I’m not losing clumps of hair like before, but the shedding still persists. The really weird thing is that the texture of my hair has completely changed since taking the drug last year, it’s not shiny or healthy looking. It’s very straw like. That has not changed for me, and many other patients I have spoken with. I am not sure if that’s due to still being on some form of these drugs with Nurtec and Qulipta. I just wanted to share all of this in hopes that it might help someone out there. ❤
If growing well from steroid injections for beard alopecia (1-3 patches). What do you mean by be available from time to time when they lose hair? Does this mean after steroids it will fall out?
yes, sometimes. For some ongoing periodic injections are needed. Be sure to review with your physician. Alopecia areata is a lifelong condition for some patients. There can be weeks, months or years between patches of hair loss
@@donovanmedical9780 Thanks for the reply! The reason I ask is because I have 3 patches on the beard - 2 of which were tennis ball size. They have now grown in 80-90%. However in the remaining gaps, I noticed that I’ll see some hair in it but a few weeks later after I shave the hair it wouldn’t be there (I’m talking about 5-6 hairs) which could just be the darker vellus falling but I worry inflammation is still present in that small area. For the rest of the hairs within the patch, they remain strong and no signs of falling.
When it comes to eyebrow ffa is the combo of topical steroid / pimecrolimus or tacrolimus able to halt the disease in a portion lf patient ? I tried most first line treatment excepted heavy immunosupresive such ad mtx or cyclo . And sorry to bother but would you think topical spiro or clascoterone could help sibce it's suppose to have anti inflammatory properties. I whish i could getva consultation with you but i live in france . Thanks doctor
And would oral minoxidil help TE😊
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.
Tthank you Dr for your efforts. I am also Dr i suffer from TE for 10 months it is after covid 19 infection. Doctors told me that my hair will come back but i m not sure since it seems to be fibrosis it is diffuse it starts on occipital part then all the scalp . Mu temples start to look like patients with fibrosis alopecia what can i do to stop the progress. I have strong pain on my scalp with sensation of burn and when i feel this why i loose more hair then other days please answer me i visited 7 doctors all they said to me is stress, covid and maybe AGA will start to appear but i m sure it is different my middle hair line is not large my hair is thick but i loose it without any regrowth and the scalp is so white.
i am 21 years old male, i used minoxidil + finasteride solution and lost my hairline in a week of using it. i had mature hairline and i thought i was losing hair , shouldn't have done it . i thought it was shedding period and continued for 6 months with no visible regrowth, its now been 6 months since i stopped minoxidil in that time i had only little regrown on 1 temple. what should i do ? can minoxidil cause FFA ? i had itching from minox in the start as it was one of the side effects of minox.
can i get FFA with irritation from minoxidil ?
I have been diagnosed with this condition and it has driven me into a deep depression, I want to take my life. There is no hope.
amazing compilation as always thanks for your extensive work doctor it's highly appreciated from us alopecia suffferers that like to deep dive into research studies. if you don't mind i have a question regarding ffa . i know oral dutasteride is in the gold standard list but what's your take on mesotherapy with dut? and also mesotherapy with minoxidil? ( since OM is supposed to be hlefpull in ffa and also lpp ) i know there are no medical studies regarding those 2 but do you think it could help? thanks and happy new year
Hello Dr. Donovan I'm very interested in featuring you on my channel for an interview, where we can discuss questions from my subscribers. Your website and services have garnered much admiration from us. Additionally, I have a personal inquiry: How is CCCA manifested, and what are the identifiable biological markers in a scalp biopsy? Are general inflammatory signs present, and how do these differ from other inflammatory skin conditions? I concur with your approach that early and aggressive action leads to more favorable outcomes. In my view, factors like DHT and the Androgen receptor's impact on macrophages, as well as their effects on the WNT pathway following DHT-AR complex transcription, are pivotal in suppressing hair follicle growth, suggesting AGA is akin to other skin diseases. I look forward to the possibility of discussing these topics further with you.
CCCA affects many black women and sometimes black males too. Patients present with central hair loss and there may or may not be symptoms. The area expands over time without treatment . The biopsy findings resemble lichen planopilaris very very closely if not perfectly in some cases. There is some eccentric thinning of the root sheath and premature separation of the IRS but these are not entirely specific. There may be redness clinically but there does not have to be. The biopsy may highlight mild to moderate inflammation but the inflammation is often much less than typical classical LPP. Be sure to read more on our website donovanmedical.com/hair-blog/ccca-2. As for interviews, simply contact my office and they can arrange. The website donovanmedical.com takes you to them! Happy New Year.
@@donovanmedical9780 thank you for getting back to me Doctor! I'll be sure to set that up.
Thank you for all your informative videos. I’ve always been a bit confused when choosing between Finesteride and Dutasteride and which is superior in treating AGA. The study you spoke of regarding FPHL and what is most affective listed Finesteride 5mg as the most affective. How does Dutasteride at 0.5mg compare to the dosage of Finasteride 5mg? Should I be increasing my Dutasteride dosage or possibly changing to Finasteride for optimal improvement. I am not of child bearing age. I’ve been on Dutasteride for several years with no improvement.
We don’t know how dutasteride compares or it would most certainly have been included in this study. They are probably somewhat similar when comparing finasteride 5 mg once daily and dutasteride 0.5 mg once daily. But good studies are needed. I don’t know enough about your story to say if you should switch or not. A doctor who knows your story and knows how the dutasteride has been working can help solve this. If you are taking suboptimal doses of dutasteride then increasing to optimal doses like 0.5 mg daily would be reasonable for many patients before jumping to finasteride. I doubt that a switch is going to make a huge difference but yes, could make some. Bringing on board another mechanism of treating the hair loss probably makes more sense for most (assuming the dutasteride dose is optimal). Minoxidil, laser and other antiandrogens with different mechanisms (spironolactone, bicalutamide) can all be carefully and thoroughly reviewed with your doctor. All in all, we don’t have great data comparing finasteride and dutasteride yet. While they may be slightly different, it’s unlikely a huge difference for most. Therefore, if one is on an optimal dose (like 0.5 mg daily) and still not getting results, the best plan probably involves looking into adding other treatments rather than time spent on deciding whether to switch to finasteride. If one is not using a proper dose of dutasteride, it may be worth moving forward with a good dose and deciding on next steps in 6-9 months. One must always make sure that there are no other hair loss issues present that themselves require treatment (scarring alopecia, telogen effluvium, etc).
Love all your due diligence, efforts, and knowledge. Much appreciated, Doc! 🙏
thank you!
How can LDOM result in sexual side effects? I think Minoxidil has the potential of different side effects because ultimately how it works (potassium channel opener?) and its effect at a cellular level is not well understood
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
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.
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!
Any explanation for hair loss after starting ivig (also seems to have more stray grey hairs)?
both hair loss and growth have been reported with IVIG. I've seen both alopecia areata and telogen effluvium triggered by IVIG.
What is the hairloss induced of selenium toxicity? Telogen effluvium? And what happens if someone is still toxic on selenium can hairloss be permanent or scarring due to selenium?
Hey Dr , i hope you really answe these two questions i have Two questions about two scenarios, first question ? if i use minoxodil but im one of the minority that minoxodil doesn’t work for me , but i haven’t noticed that its not working, so i kept applying it for a long time lets say a year , btw i was using the topical solution form which contains alcohol, will that minoxodil that isn’t working make my situation worse does it make it like im only applying the alcohol? Second question if i got missdiagnosed with androgenetic alopecia lets say, so i use minoxodil for a while ,since in misdiagnosed minoxodil is not gonna help me can it cause adverse effects can it make my hair thinner , due to its daily application on the scalp thinking i have androgenetic alopecia? My point is Imagine minoxodil doesn’t work for me ,ok? Now imagine if ur applying topical solution minoxodil which only has minoxodil and alcohol, now since minoxodil isn’t working, what happens overtime if ur only applying alcohol? We know alcohol is very bad for hair follicles , but in the situation of minoxodil working i know that alcohol helps with absorption. So what if minoxodil isn’t working for me?
Hey dr if u don’t mind me asking an irrelevant question, what can happen if someone kept over applying minoxodil for a while mistakenly, i was applying more than the recommended dose for a while before knowing i was wrong, could 1 year of overly applying damage the hair follicles?
Here is one ☝️ victim of vaccine , I had full hair and beard now my beard has so many small gaps and hair also especially after the third dose furthermore I noticed my nail start to be brittle and vertical lines on it before it was clear and strong
How long have you been dealing with it? Any improvements as time goes on? The hair across my whole body got wiped out and I’m getting steady but still very sparse regrowth.
@@jmass4207 since September 2021 my third dose after i took by 2 months its all started, well am trying to pinball the main cause my IGE is tripled since 2019 test but it within the normal range and my TSH also tripled since but also in the normal range if i found any treatment or breakthrough i will share it , I hope all the best for you
My hair started falling out after this most recent vaccine, last week for my job in healthcare.
سلام اخ محمد، ممكن تراسلني عندي استفسار بخصوص هذا الموضوع
Is there any study about the remission of AA for those whose cause was Covid 19 vaccine
yes, it's described in this podcast.
It probably should work for traction Alopecia as well ( that's what I have) but after doing some reading and looking at the website, the side effects aren't worth the risk. This medicine could potentially cause illnesses and even result in death.
there is no good evidence that Jak3/Tec activation in lymphocytes plays a critical role in traction nor is there evidence that blocking the pathway would have much in the way of benefit. Inhibitors of this nature would be relatively contraindicated. Evidence based approaches can be reviewed with a dermatologist including cessation of mechanical forces that contribute to traction as well as treatments such as triamcinolone acetonide, topical and oral minoxidil and PRP.
@Dovan medican Does the drug ritlecitinib in its metabolism give rise to active or inactive metabolites?
Thanks for providing this evidence-based forcast. This provides me with pertinent information to share with my dermatologist.
you're so very welcome.