Today’s report also covers research into vulvar dermatoses according to ethnicity, allergic contact dermatitis of the scalp, and more (1,510 words, 7.3 minutes)
The Women in Dermatology e-newsletter is supported without restriction by Galderma Canada.
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 dermatologists who treat 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 JPRAS Open (Sept. 2024; 41: P311-319) found that lip feminization plays a crucial role in aligning transgender women’s facial aesthetics with their gender identity, significantly enhancing their overall well-being and satisfaction.
Facial feminization includes a range of procedures designed to align transgender women’s facial features with their gender identity. The researchers explored surgical and nonsurgical lip feminization techniques, emphasizing their role in refining lip aesthetics to reflect feminine characteristics and effect perceived femininity better.
For this study, the authors conducted a comprehensive literature search using PubMed, MedLine, and Embase databases, focusing on studies related to lip feminization techniques and outcomes up to April 18, 2024. After reviewing 28 potentially relevant titles, the authors selected 21 articles that met the inclusion criteria. These articles, while limited in terms of direct focus on lip feminization, provided insights into the broader realm of facial feminization, with data from studies involving cisgender patients where applicable.
The authors note that aesthetic facial analysis is essential in attaining harmonious and affirming outcomes in facial feminization. Achieving feminine lip aesthetics involves addressing gender-specific differences in lip dimensions. For instance, women usually have a shorter upper lip height and more pronounced vermilion height than men, while men tend to have thicker upper lips. Lip feminization treatments should address and fix these differences. Factors such as facial proportions, bone structure, skin elasticity, and ethnic considerations should also be carefully assessed to tailor lip feminization plans.
According to the review, surgical techniques for feminizing the upper lip, such as lip lifts and augmentations, play a key role in facial feminization surgeries and enhance facial harmony. A standard procedure is the “bullhorn” technique, which involves removing a portion of skin from the upper lip to improve its shape and increase the visibility of the vermilion, often leaving a barely noticeable scar. Additionally, augmentation methods, including fat grafting, cellular allogenic dermal grafts, and alloplastic implants, provide options for increasing lip volume and improving lip contour.
Nonsurgical approaches also play a significant role in lip feminization. For example, injectables such as hyaluronic acid and botulinum toxin derivatives enhance lip volume and contour. According to the authors, these techniques are beneficial for those seeking less invasive options. Laser hair removal addresses facial hair, including mustache removal, complementing other feminizing treatments, and hormone therapy further influences lip characteristics, contributing to overall facial feminization.
The Takeaway: Lip feminization is a crucial aspect of facial feminization in transgender women. Surgical feminization techniques can significantly enhance the aesthetic appeal of the upper lip and contribute to overall facial harmony. Non-surgical methods, such as injectable fillers, also play a significant role in lip feminization by enhancing lip volume and contour with less invasiveness than surgical options. The effectiveness of lip feminization techniques depends on individualized treatment plans.
Differences in frequency of vulvar dermatoses according to ethnicity
A study in JEADV ClinicalPractice assessed the prevalence of vulvar dermatoses across different ethnic groups at a National Health Service hospital in East London. The researchers found that lichen sclerosus was most common among White patients, while lichen simplex was more frequently diagnosed in Asian and Black patients. Furthermore, the odds of lichen simplex were 20.2 times higher in Asian and 11.71 times higher in Black patients compared to White patients.
For this study, data from 246 patients attending vulvar clinics in East London was analyzed to assess the prevalence of vulvar dermatoses across different ethnic groups. The findings showed the five most common diagnoses varied according to ethnicity, suggesting that genetic predispositions, such as atopic dermatitis, and cultural practices related to genital hygiene may contribute to these differences.
A review published in the International Journal of Women’s Dermatology explored the increasing prevalence of scalp allergic contact dermatitis (ACD) in women. The researchers found that allergens in hair products may trigger scalp ACD in women, can present with atypical symptoms such as itching, hair thinning, and hair loss, and is often misdiagnosed as seborrheic dermatitis.
The authors conducted a literature review across multiple databases to investigate the characteristics of scalp ACD in women, focusing on studies from the last 40 years. They analyzed data on prevalence rates, common allergens, and diagnostic tools. The study found common allergens include paraphenylenediamine from hair dyes, nickel from hair accessories, and preservatives in various hair products. Additionally, the authors note that women are particularly susceptible to scalp ACD due to the frequent use of these potential allergens. Diagnostic tools such as trichoscopy, skin biopsies, and individualized patch testing significantly improve diagnostic accuracy compared to standardized tests. Management typically involves allergen avoidance and topical steroids, with systemic treatments reserved for severe cases.
Dermatologic care of gender-diverse patients in Australia
A study in the Australasian Journal of Dermatology explored the dermatologic needs of transgender and gender-diverse (TGD) individuals in Australia, emphasizing the need for specialized care. The researchers found that gender-affirming treatments for TGD patients can cause various dermatologic issues, including acne, hair loss, dermatitis, and skin dryness.
In this study, the authors highlight the journey of TGD individuals through psychological and pharmacologic treatments for gender dysphoria. They identified that while puberty blockers have minimal dermatologic impact, gender-affirming treatments can cause acne, hair loss, and skin dryness. Additionally, surgical procedures such as vaginoplasty and phalloplasty may lead to complications such as intravaginal hair growth and skin cancer in neovaginas.
Prenatal fish oil supplementation, maternal COX1 Genotype, and childhood atopic dermatitis
A study published in JAMA Dermatology explored the impact of prenatal fish oil supplementation on childhood atopic dermatitis (AD) and its interaction with maternal cyclooxygenase-1 (COX1) genotype. The researchers found that prenatal fish oil supplementation reduced the risk of childhood atopic dermatitis in children of mothers with the TT COX1 genotype. At the same time, it increased the risk in children of mothers with the CC genotype.
In this randomized trial, 736 pregnant women were assigned to either 2.4 g of fish oil or placebo daily from 24 weeks of gestation until one week postpartum. The study, which included data from the Danish Copenhagen Prospective Studies on Asthma in Childhood 2010 cohort, followed mother-child pairs from birth to age 10. By age 10, 635 children had completed follow-up. The results showed that fish oil supplementation reduced the risk of childhood atopic dermatitis in children of mothers with the TT COX1 genotype but increased the risk in children of mothers with the CC genotype. The findings suggest fish oil supplementation should only be provided to pregnant women with the TT genotype.
Prof. Jan Gutermuth, Chair and Principal Investigator of the Department of Dermatology at Universitair Ziekenhuis Brussel, and dermatologist Dr. Evgenia Makrantonaki from Wildeshausen, Germany, discuss the role of hormones and genes in skin aging.
Balancing maternal melanoma and vaginal birth after cesarean delivery
A case report in Cureus described a 22-year-old woman who presented with a dome-shaped mole on her left thigh. At 35 weeks of pregnancy, she desired a vaginal birth, hoping to avoid another cesarean after her first delivery. The patient underwent an uncomplicated induction of labour and delivered a healthy male infant. After the delivery, the mole was surgically excised, and a sentinel lymph node biopsy was performed. Pathology revealed Stage IIIA Spitzoid melanoma without metastasis. A subsequent positron emission tomography scan demonstrated no evidence of recurrent local or distant metastasis. The patient was placed under regular supervision with a physical exam and ultrasonography of the nodal basin every four months. She chose a levonorgestrel-intrauterine device for contraception while her condition was monitored.
Join us at the 10th Annual Skin Spectrum Summit and the Indigenous Skin Spectrum Summit!
Join us on October 5th for the 10th anniversary of the Skin Spectrum Summit, a landmark event for healthcare practitioners committed to advancing dermatologic care for Canada’s diverse population. This year, we celebrate a decade of education and innovation at the Art Gallery of Ontario.
On October 4th, the Indigenous Skin Spectrum Summit returns for its third year. This special session will focus on improving dermatologic care for Indigenous communities and addressing their unique challenges.
Secure your spot today and be part of this essential conversation on diversity and inclusion in dermatology.
“I hear all day, every day from all my patients who have children in their teens, and younger, that they are so fixated on all of these skin care products and TikTok trends and they’ve gone overboard. When you have a 13-step skincare routine that takes 45 minutes a night, that is too much.”
— Dr. Dendy Engelman, a Manhattan-based dermatologist, in an interview with ABC News.
You are receiving this newsletter because you subscribe to Women in Dermatology or another Chronicle journal, have attended a Skin Spectrum Summit live event or webinar, or have previously requested a subscription to one of our newsletters. If you no longer wish to subscribe to this newsletter, please email the subject line “Unsubscribe Women in Dermatology” to health@chronicle.org.
Women in Dermatology is published by Chronicle Companies: 1460 The Queensway, Suite 212, Etobicoke, Ont. M8Z 1S4
