Considerations and recommendations on camouflage in alopecia in Black women
Today’s report also covers research into the surgical treatment of early-stage vulvar squamous cell carcinoma, skin manifestations in adults with gender dysphoria, and more (1,150 words, 5.5 minutes)
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Good morning, and welcome to the Women in Dermatology e-newsletter from Chronicle Companies. We’re pleased to have you join us. This biweekly bulletin will update you on new findings regarding dermatologic issues that affect women and the female dermatologists who care for them. We welcome your feedback and opinions, so let us know if you have any comments, observations, or suggestions. You can email them to us at health@chronicle.org
A study published in the International Journal of Women’s Dermatology (Oct. 2023; 9(3):e111) outlined the significance of hair camouflage techniques for Black women with alopecia and provided insights and recommendations about several techniques. According to the study’s abstract, Black women are more prone to develop alopecia and often use hair camouflage to minimize visible hair loss.
According to the study, hair camouflage—such as wigs, extensions, topical hair fibres, and micro pigmentation—is often used to mask hair loss, boost self-confidence, and reduce social stigma. However, some techniques that use adhesives, chemicals, and high tension can exacerbate alopecia. The authors emphasize that hair camouflage practices should always prioritize the protection of natural hair.
The authors also provide insights and recommendations about popular hair camouflage practices. For example, they write that while wigs are highly customizable and suitable for extensive hair loss, they can be expensive and may cause hair breakage if not worn properly. They recommend users wear a silk cap to reduce friction between the prosthetic and hair and apply ointments on the scalp to maintain moisture.
For hair extensions, the researchers note that while they are versatile and effective for patchy alopecia, they can induce traction alopecia and are not recommended for inflammatory hair loss or active alopecia areata. Extensions are also often made of synthetic materials, which can cause irritant contact dermatitis. Their recommendations for this technique are to opt for low-tension sew-in prosthetics, avoid extensions longer than shoulder length to reduce tension and choose extensions made with natural hair if possible.
For topical hair fibres, the study found that they are easy to apply, affordable, and instantly give the appearance of thicker hair. The risks are minimal, mostly related to appearance and wearability. The study suggests more permanent options for end-stage hair loss such as fixed cranial prostheses, scalp micropigmentation, microblading, and hair transplants. It also emphasizes the importance of empathy and honest communication with patients when hair regrowth may not be an option.
Bottom line
Understanding the historical, cultural, and medical aspects of hair camouflage is essential when treating Black women with alopecia. Camouflage techniques should be discussed with patients to find the most suitable approach. Open communication is essential, especially when hair regrowth might not be possible.
Effects of a postbiotic saccharomyces and lactobacillus ferment complex on the scalp microbiome of women with sensitive scalp syndrome
A study published in the Clinical, Cosmetic and Investigational Dermatology assessed the effects of topical postbiotic Himalaya-derived Saccharomyces and Lactobacillus ferment complex (SLFC) on the bacterial and fungal scalp microbiome of a group of Chinese women with sensitive scalp syndrome. The researchers found a significant increase in the abundance of Staphylococcus, Lawsonella, and Fusarium in the scalp microbiome after 28 days of SLFC treatment. At the same time, the amount of Cutibacterium and Malassezia significantly decreased. The women reported complete symptom relief after 28 days of applying SLFC twice daily.
Surgical treatment of early-stage vulvar squamous cell carcinomas
Research published in the International Journal of Women’s Dermatology explored the treatment options for early-stage vulvar squamous cell carcinoma (vSCC), focusing on guiding dermatologic surgeons. The researchers found that early vSCC can be effectively treated with Mohs micrographic surgery. They also noted that lymph node dissection can be recommended for vSCC, depending on the stage and location of the tumour.
The authors conducted a systematic review using PubMed and Google Scholar. The study included 18 articles, with 13 addressing surgical treatment of early-stage vulvar carcinomas.
Factors associated with health-related quality of life in women with systemic lupus erythematosus and permanent skin damage
A study in Advances in Rheumatology examined how permanent skin damage affects the quality of life in women with systemic lupus erythematosus (SLE). The researchers found that women with SLE who had permanent skin damage experienced low health-related quality of life in many aspects, inducing physical well-being, self-image, mood, and mental health.
The authors assessed the participants’ quality of life using the Systemic Lupus Erythematosus Quality of Life (SLEQOL) and Dermatology Life Quality Index (DLQI) questionnaires, with higher scores indicating worse quality of life. The study included 56 women with SLE, permanent facial skin damage, and low disease activity. The results showed that lower education was linked to worse SLEQOL scores. Higher DLQI and SLEQOL scores were associated with low self-esteem, depression, and anxiety.
Skin manifestations in adults with gender dysphoria under hormonal treatment
A study published in the Journal of the Endocrine Society assessed the impact of hormonal treatments on the skin of adult patients with gender dysphoria. The researchers found that the main skin manifestations in all patients were acne and androgenetic alopecia. Another common skin issue in transgender men was acanthosis nigricans, while transgender women were more prone to seborrheic dermatitis and melasma.
For this cross-sectional study, the authors analyzed data from 85 adult patients with gender dysphoria who received hormonal treatment at the San José Hospital of Bogotá from 2015 to 2021. Most of the study’s participants were young transgender men.
Houston-based dermatologist Dr. Andrea Suarez, known as Dr. Dray, shares tips for people with sensitive skin and rosacea.
A case of facial pyoderma gangrenosum associated with fallopian tube carcinosarcoma
A case study published in Clinical Case Reports described a 61-year-old woman who presented with a painful necrotic facial ulcer, which had been persistent for one year. Despite several biopsies and tests, no specific diagnosis had been established. The patient had also undergone multiple rounds of antibiotics with no improvement. After a comprehensive evaluation, the patient was diagnosed with pyoderma gangrenosum. She was also diagnosed with an underlying fallopian tube carcinosarcoma. Her treatment involved corticosteroids, cyclophosphamide, and surgery. The ulcer healed completely, with no recurrence during the 18 months of follow-up.
“I'm in my 40s now and suffer from adult female hormonal acne, so anti-aging and balancing skincare products that prevent breakouts and wrinkles are key! I believe in a topical and systemic approach to healing the skin so I am careful in both my skincare selection, as well as dietary and active lifestyle choices. I also use oral supplementations to support healthy skin and shift towards anti-inflammatory tendencies.”
— Dr. Melanie D. Palm, a dermatologist based in San Diego, in an interview with Real Simple magazine.
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