William Lewis, MD, discussed the importance of photo-documentation, referral indicators, efficacy of various treatments, and other topics.
At the American College of Physicians Internal Medicine Meeting 2025, April 3-5, 2025, in New Orleans, William Lewis, MD, instructor, department of dermatology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, presented on the management of nonspecific hair loss, emphasizing the importance of careful assessment and patient communication.
Dr Lewis opened his presentation by underscoring the fact that alopecia presents several challenges in a busy primary care clinic. Patients often experience significant emotional distress regarding their hair loss, which can complicate management. Responses to treatment may be slow, making it difficult to reassure patients about their progress. In some cases, referrals to dermatological specialists may be necessary for effective management, and addressing alopecia often requires comprehensive counseling and lengthy discussions to help patients navigate their concerns.
Key Insights on Management:
Treatment Modalities
Dr Lewis also discussed both FDA-approved and off-label treatment options, with topical minoxidil and oral finasteride being highlighted for androgenetic alopecia. He also covered emerging nonpharmaceutical treatments, such as low-level light therapy and platelet-rich plasma injections, which are gaining traction as viable options for hair regrowth. In discussing laboratory testing, physicians were advised to consider a panel of evaluations, including iron studies, vitamin D levels, TSH, and hormonal assessments in patients demonstrating virilizing signs, particularly in women.
References:
1. Pathoulas JT, Flanagan KE, Walker CJ, et al. Evaluation of standardized scalp photography on patient perception of hair loss severity, anxiety, and treatment. J Am Acad Dermatol. 2021;85:1640-1641. doi:10.1016/j.jaad.2020.12.059
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