Today’s report also covers research into the association between acetaminophen and vitiligo, maternal dietary patterns and the risk of infantile eczema, and more (1,239 words, 6 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
For many, wearing religious headwear like turbans, hijabs, and wigs is culturally and spiritually significant. However, a recent study published in the International Journal of Women’s Dermatology (Oct. 2023; 9(3):p e107) suggests that these head coverings can cause tension on the scalp and hair, leading to a higher risk of developing traction alopecia.
The authors note that the type of headwear one uses can have an impact on hair health. Muslim women who wear hijabs may experience traction alopecia due to the tight and consistent wrapping of the hijab around their head and hair, resulting in continuous pulling on the hair roots. To prevent this, it is recommended to choose hijab fabrics that are less likely to slip and to wear a cap underneath to protect the scalp.
The study also mentions that Orthodox Jewish women usually wear wigs called sheitels. The attachment and styling of these wigs can create tension on the scalp, promoting tight hair styling techniques such as buns and braids, which can contribute to alopecia. The authors recommend Orthodox Jewish women wear hairstyles that don’t create as much tension underneath the sheitels.
Another risk group is Sikh men, who traditionally wear turbans and may experience turban alopecia. The study notes that a tight turban wrapping around a bun on the head may lead to tension-related hair loss. The primary recommendation for Sikh men is to refrain from wearing the turban when it’s not mandated, such as during sleep. Low ponytails and braids can also reduce scalp tension.
Finally, it is essential for dermatologists and other healthcare professionals to be culturally sensitive. For instance, Muslim and Orthodox Jewish women may not want to show their hair to male physicians, and it is important for these patients to have the choice of being treated by a female practitioner. In the case of Sikh men, it is not permissible for hair to be cut, so physicians should not recommend haircuts as a solution to hair loss.
Bottom line
Religious headwear holds cultural and spiritual importance but can also increase the risk of traction alopecia. Dermatologists should know these risks when treating patients from different religious backgrounds. Dermatologists can effectively address and prevent headwear-associated alopecia by providing culturally competent care.
Evaluation of quality of life among Turkish women with hirsutism
A study published in Northern Clinics of Istanbul explored the impact of hirsutism on the quality of life for Turkish women, and the researchers found that hirsutism is associated with impaired quality of life in this group.
The authors evaluated 40 women diagnosed with hirsutism for this study using the Dermatology Life Quality Index (DLQI) assessment. The women’s results were compared to a control group of 18 without hirsutism. The study found that hirsutism significantly affected the quality of life in Turkish women, independently of hirsutism severity.
Association between acetaminophen use and vitiligo
Research published in the Australasian Journal of Dermatology found that regular acetaminophen use may be associated with a higher vitiligo risk in women.
For this study, the authors examined the risk of vitiligo with regular acetaminophen use in women using the Nurses’ Health Study (NHS) and men using the Health Professionals Follow-up Study (HPFS). In the NHS, 161 vitiligo cases were identified, and 183 were identified in the HPFS. Regular acetaminophen use was linked to an increased vitiligo risk in the NHS but not the HPFS.
Maternal dietary patterns during pregnancy and the risk of infantile eczema during the first year of life
A study in BMC Public Health assessed the impact of dietary patterns during pregnancy on infantile eczema. The researchers found that children of mothers who maintained a high protein diet during pregnancy had a higher risk of developing infantile eczema during the first year of life.
The study involved 495 mother-child pairs from Shenyang, China. Maternal dietary intake during pregnancy was assessed through a food frequency questionnaire, and infantile eczema data was collected using a structured questionnaire. The results showed that as maternal protein intake during pregnancy increased, the risk of infantile eczema within 12 months also increased. However, there were no similar associations with Western or plant-based diets during pregnancy.
Systemic anti-inflammatory treatment of atopic dermatitis during conception, pregnancy, and breastfeeding
In a study published in the Journal of the European Academy of Dermatology and Venereology, experts sought consensus on managing atopic dermatitis (AD) with systemic treatment in reproductive-aged women. The experts concluded that cyclosporine A was the preferred long-term systemic treatment for AD in women before conception, during pregnancy, and while breastfeeding. There was no consensus on second-choice systemic therapies during pregnancy.
For this study, 21 participants, including 16 dermatologists, two obstetricians, and three patients, engaged in a two-round Delphi process. The study achieved complete consensus on 32 statements, partial consensus on four statements, and no consensus on four. The study also highlighted the importance of patient and clinician education on appropriate AD treatments during pregnancy and breastfeeding.
Houston-based dermatologist Dr. Andrea Suarez, known as “Dr. Dray,” talks about collagen peptides for skin, hair, and nails.
A case of diagnosis and management of vulvar Darier disease
A case study published in Case Reports in Women’s Health described a 37-year-old woman who presented with an itchy rash on the vulva, perineum, and groin that had been present for over three months. She had experienced similar symptoms since age 24 but typically resolved without treatment. The affected area was more extensive than before, and she also reported vulvar pain. A physical examination revealed thick, itchy bumps on her vulva, perineum, forehead, and armpits. She also presented crusty areas on her upper chest and glutes. The patient was referred to the dermatology department and was diagnosed with Darier disease. She was prescribed 25 mg/day of acitretin, which significantly improved her lesions. At her one-year follow-up, the patient remained symptom-free.
“There’s a lot of really interesting research further cementing the role of antioxidants as one of the major components that should be included in a skin-care routine, vitamin C being one of the most potent and well-studied antioxidants. Its most potent form would be L-ascorbic acid, and we know that clinical studies show that it can promote collagen production, it can provide defence against damaging free radicals.”
— Dr. Geeta Yadav, a dermatologist based in Toronto, in an interview with The Globe and Mail.
Registration is open for the 9th annual 2023 Skin Spectrum Summit conference.
This year’s edition of the landmark medical educational congress dedicated to providing better dermatologic care for Canada’s diverse population will be held on Oct. 21, 2023, at the University of Toronto’s Chestnut Conference Centre in Toronto.
Now in its 9th year, the conference provides education on treating patients across all six Fitzpatrick skin types, emphasizing care for Types IV–VI.
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