Ronda S. Farah, MD, FAAD, knows the impact of hair and scalp disorders on patients’ quality of life. Dr. Farah is an associate of professor of dermatology at the University of Minnesota and founder of Alluma Dermatology. For Dr. Farah, quality care begins with a thorough hair and scalp exam. In this Next Steps in Derm video interview, conducted in partnership with the ODAC Dermatology Conference, Dr. Farah shares her plan for examining the hair and scalp, and what dermatology clinicians should look for when making a diagnosis. Learn the signs of frontal fibrosing alopecia and how you can tell if the hair loss is prolonged. Understand how to conduct a hair count to determine treatment effectiveness. Find out the role of clinical photography and what a hair loss visit at Dr. Farah’s practice involves. Plus hear Dr. Farah’s approach for addressing hair loss with a patient who is at her office for another reason.
Further Reading
If you want to read more about diagnosing and treating hair and scalp disorders, check out the following articles published in the Journal of Drugs in Dermatology:
Apremilast in the Treatment of Central Centrifugal Cicatricial Alopecia: An Open-Label Pilot Study
ABSTRACT
Background: Central centrifugal cicatricial alopecia (CCCA) is a scarring alopecia primarily affecting Black women. To date, there are no standardized treatment regimens or approved medications for the treatment of CCCA. This single-center, open-label, clinical study investigated the efficacy of apremilast in the treatment of mild to moderate vertex-predominant CCCA.
Methods: 20 adult female patients of African ancestry with mild to moderate vertex-predominant CCCA were treated in an open-label fashion with apremilast 30 mg orally twice daily for 24 weeks.
Results: 15 of 20 patients completed the study. At week 24, mean change in the physician global assessment of improvement (primary endpoint), investigator global severity score, and central hair loss grade was 0.235 (P=0.04), -0.31 (P=0.01), and -0.46 (P=0.08), respectively. Mean improvements were also seen in patient reported outcomes at week 24 including the patient global assessment of improvement 1.31 (P=0.01), visual analog of hair loss severity 1.85 (P=0.05), numerical rating scales for pruritus -2.31 (P=0.00), burning -0.46 (P=0.36), and pain -0.15 (P=0.61), as well as the dermatology life quality index -2.42 (P=0.09).
Limitations: The sample size was small and underpowered to detect statistically significant changes in most secondary endpoints. Additionally, the COVID-19 pandemic interfered with the conduct of the study protocols.
Conclusion: Apremilast was safe and moderately efficacious for the treatment of CCCA, with patients showing statistically significant improvements in several investigator and patient-reported outcomes. Larger, placebo-controlled studies investigating therapies for CCCA are warranted. Adverse events (AEs) were consistent with the known safety profile of apremilast and may limit the use of this medication in some patients.
Molecular Insights: Immune and Barrier Dysregulation in Seborrheic Dermatitis
ABSTRACT
Seborrheic dermatitis(SD) is a chronic inflammatory skin disease that affects sebaceous areas, typically the face and scalp, with an estimated prevalence of 2% to 5%. It is thought to result from a combination of immune dysregulation, barrier dysfunction, and colonization with Malassezia species. However, its underlying molecular mechanisms have been incompletely defined, limiting the development of new therapies. As a result, treatment options largely include nonspecific topical antifungals and corticosteroids, with roflumilast 0.3% foam as the only US Food and Drug Administration (FDA)-approved treatment in recent years. In a 2025 study published in JAAD, Ungar et al performed non-invasive transcriptomic profiling to characterize gene expression in facial SD. This review summarizes their findings, which provide new insight into SD pathogenesis and support the rationale for emerging immunomodulatory treatments.
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