Quality of life and patient experience in Black women with alopecia
Today’s report also covers research into increasing roles and visibility for women in dermatology, ABNOM clinical features and post-laser melasma, and more (1,436 words, 7 minutes)
Good morning, and welcome to the Women in Dermatology 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 in the International Journal of Women’s Dermatology (June 2025; 11(2):e e203) assessed the quality of life and patient experience of Black women with alopecia. The researchers found that alopecia significantly affects the emotional well-being and quality of life of Black women, causing considerable psychological distress. They also found that alopecia increases financial burden, as many patients spend substantial amounts on treatments that often do not improve their condition. In contrast, those who received biopsies reported greater trust in their care and improved treatment outcomes.
For this study, the authors conducted a phone survey between June and September 2021 among 100 Black women who had received an alopecia diagnosis at a single academic centre between 2015 and 2020. The primary tool used was the modified English version of the Hairdex Questionnaire, a validated instrument assessing alopecia-related quality of life across five domains: functioning, symptoms, self-confidence, stigmatization, and emotions. In addition, the researchers developed 21 supplemental questions to gain a deeper understanding of how patients discovered their hair loss, its impact on their daily lives, and their perceptions of interactions with healthcare providers.
The results showed that 72% of the participants had scarring alopecia while 28% had nonscarring types. Central centrifugal cicatricial alopecia was the most frequently reported diagnosis, affecting 35% of respondents. The Hairdex Questionnaire found that hair loss had the greatest impact on the emotional well-being of participants, indicating a substantial emotional toll. It also found that symptoms and self-confidence were notably affected while functioning and feelings of stigmatization had a lesser impact.
The additional questions created by the research team showed that 58.2% of patients increased financial spending to conceal or treat their alopecia, and 55.1% felt they spent a lot of money on ineffective treatments. To manage their hair loss, 44.9% of respondents reported wearing wigs, 45.9% used head coverings such as hats or bandanas, and 64.3% adopted specific hairstyles to hide their hair loss. The authors note that these findings suggest the economic and social impact of alopecia is significant for many Black women.
The survey also found 60.4% of participants delayed seeking professional care for more than three months after first noticing hair loss. Furthermore, only 16 patients underwent scalp biopsies and those who did generally reported better outcomes. They were more likely to experience symptom improvement, feel satisfied with their treatment, and trust their dermatologist’s ability to manage their hair type. However, despite biopsy, less than half of the patients experienced complete resolution of their symptoms or were completely satisfied with their treatment outcome.
The Takeaway: The study emphasizes the significant emotional and financial burdens that alopecia places on Black women, as well as the challenges they face in finding effective treatments. It found that many Black women delay professional care and rely on wigs, head coverings, or hairstyles that conceal hair loss. It also found that while scalp biopsies improve patient satisfaction, few achieve full resolution, highlighting ongoing gaps in care.
The impact of the removal of unsatisfactory eyebrow permanent cosmetic pigmentation on quality of life
A study in the Journal of Cosmetic Dermatology assessed the impact of removing unsatisfactory eyebrow permanent makeup on the quality of life in women with Fitzpatrick skin types I to III. The researchers found that removing unsatisfactory permanent makeup significantly improved patients’ quality of life, especially in terms of physical health and psychological well-being.
For this study, the authors assessed 75 Caucasian women with Fitzpatrick skin types I to III using the World Health Organization’s Quality of Life Brief Form questionnaire before and after the removal of permanent makeup. The results showed that the most frequent cause of dissatisfaction with permanent eyebrow makeup was colour, followed by colour and shape, intensity or saturation, and shape alone. Quality of life scores significantly improved between baseline and after removal.
Increasing roles and visibility for women in dermatology
A review published in the Indian Dermatology Online Journal analyzed gender disparities in dermatology leadership and academic roles, highlighting the ongoing under-representation of women in leadership despite near gender parity among practitioners. The researchers found that women in dermatology remain under-represented in leadership and academic roles due to systemic gender bias, limited mentorship, and reduced professional visibility.
The authors reviewed relevant literature on gender disparity in dermatology leadership, academic positions, and professional societies globally. They found that despite a high proportion of women in dermatology, significant gender disparities persist in leadership roles, academic promotions, publication opportunities, and professional visibility. They emphasized the importance of mentorship programs, flexible work policies, and increased institutional support to improve women’s representation and advancement in dermatology.
The psychosocial impacts of ocular ailments and facial dermatoses in women
A systematic review published in Psychology, Health & Medicine examined the psychosocial effects of ocular and facial conditions on women. It assessed the effectiveness of interventions designed to improve psychological well-being and quality of life. The researchers found that interventions significantly improved self-esteem and body image, reduced anxiety and depression, and enhanced overall quality of life in women with ocular and facial conditions.
For this study, the authors included 24 peer-reviewed articles published between 1990 and 2023, sourced from multiple medical databases using PRISMA guidelines. They used forest plots to visualize the data and applied both fixed- and random-effects models for the meta-analysis. The results showed significant improvements in self-esteem, body image, and overall quality of life, along with reductions in anxiety and depression levels following the interventions. The study emphasizes the need for comprehensive care that addresses the multidimensional needs of affected women.
The association between ABNOM clinical features and post Q-switched laser melasma
Research in Lasers in Surgery and Medicine evaluated risk factors for post-laser melasma induction and exacerbation in Chinese women treated for acquired bilateral nevus of Ota-like macules (ABNOM). The researchers found that risk factors for post-laser melasma in ABNOM patients changed over time, with lesion features replacing age and skin type as key predictors of the condition.
The authors retrospectively analyzed 2,675 female patients across two treatment eras: 2010–2013 (1,064 nm-only lasers) and 2020–2023 (multi-wavelength lasers). The results showed that older age, Fitzpatrick skin type IV, and patch lesions predicted melasma in the earlier era, while large or dark lesions were protective. In the more recent era, large or dark lesions have become risk factors, while age and skin type have lost significance. Furthermore, despite an increase in patients with pre-existing melasma in the more recent era, exacerbation rates decreased to 50.1% from 87.6%, likely due to improved subclinical detection and treatment protocols. Additionally, multi-wavelength protocols have been shown to reduce melasma exacerbation rates.
VIDEO: Beyond the White Coat: The Realities of Dermatology, How to Build a Career You Love
Texas-based dermatologist Dr. Ellen Turner shares her journey into dermatology, offering insights on overcoming challenges and finding success as a woman in medicine. Dr. Turner emphasizes the role of mentorship in shaping careers, particularly for aspiring medical professionals, and highlights the importance of having support in an industry where women are often underrepresented.
A case of facial follicular porokeratosis simulating discoid lupus erythematosus in an African American woman
A case study in the Journal of the American Academy of Dermatology described an African American woman in her 30s who presented with a longstanding lesion on her right cheek. The lesion had been present for five years without symptoms. It was previously diagnosed as discoid lupus erythematosus, and she was treated with hydroxychloroquine. Serology was negative for autoimmune markers, and complement levels were also normal. On a clinical exam, the lesion appeared as an atrophic patch with central hypopigmentation and a brown, raised border. A punch biopsy revealed histologic features consistent with follicular porokeratosis, including parakeratosis and dyskeratotic cells surrounded by vacuolated epithelial cells. Based on these findings, the diagnosis was changed to porokeratosis, and hydroxychloroquine was discontinued. The patient began treatment with 2% topical lovastatin twice daily.
“Basal cell carcinoma is the most common [type of skin cancer]. Squamous cell is the second most common, and both are treatable. Melanoma is the most dangerous—it’s pigmented and spreads fast, so early detection is crucial.”
— Dr. Rachel Murray, a Chattanooga, Tenn.-based dermatologist in an interview with WDEF.com.
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