Faculty Bibliography

Monitoring both subjective and objective responses to alopecia treatment is critical for assessing patient perception and therapeutic efficacy. Platelet-rich plasma (PRP) therapy is a widely used treatment for alopecia, particularly androgenetic alopecia (AGA), yet the correlation between patient-reported outcomes and trichometric measurements remains poorly defined. This retrospective study analyzed data from 56 alopecia patients treated with PRP at NYU Langone Health between November 2017 and March 2025. Patients were categorized as "improved," "stable," or "worse" based on self-assessments, and changes in hair density and width were evaluated over the course of PRP treatment. Spearman's rank correlation and Kruskal-Wallis Rank Sum Tests were used for statistical analysis. Results showed that patient-reported outcomes correlated significantly with changes in hair density (p = 0.0006), but not hair width (p = 0.2688). The greatest increase in hair density was observed in the "improved" group (+ 18.9 hairs/cm²), with a more modest gain in the "stable" group (+ 7.6 hairs/cm²), while the "worse" group experienced a decrease (- 19.7 hairs/cm²). Differences in density across all three groups were statistically significant (p = 0.0012), whereas width changes were not (p = 0.5009). Subgroup analysis of AGA patients yielded similar findings. These results suggest that patient perception aligns more closely with density changes than width changes. Combining subjective assessments with objective measurements enhances clinical decision-making, expectation management, and holistic evaluation of PRP treatment efficacy in alopecia patients.

BACKGROUND:Topical minoxidil, approved for the treatment of androgenetic alopecia, also has efficacy in many other hair loss disorders, its use limited due to the need for at least daily application. Oral minoxidil, in doses below those likely to lower blood pressure (so called "low dose oral minoxidil") has increasingly been used off label to treat a variety of hair loss conditions but without any standard recommended best practices. OBJECTIVES/OBJECTIVE:To provide a review of how experts in hair loss use the available literature on topical and low dose oral minoxidil to educate and treat safely and effectively patients with hair loss METHODS: Dermatologists with expertise in hair disorders met by teleconference and email to review the literature and share their direct experience with topical and oral minoxidil. RESULTS:Provision of basic knowledge of the key aspects of the use of topical or oral minoxidil to insure safe and effective use of either in treating hair loss.

BACKGROUND:Eyebrow and eyelash (EB/EL) involvement is an important consideration in the assessment of alopecia areata (AA) severity. OBJECTIVES/OBJECTIVE:We report integrated results from BRAVE-AA1 (NCT03570749) and BRAVE-AA2 (NCT03899259) characterising EB/EL involvement at baseline in patients with AA and response to baricitinib treatment. METHODS:BRAVE-AA1 and BRAVE-AA2 were randomised, double-blind, placebo-controlled trials conducted at 169 centres in 10 countries. Patients were randomised to placebo, baricitinib 2 mg, or baricitinib 4 mg. Pooled data from patients continually treated with baricitinib through Week 52 were included. Outcomes were assessed using the Clinician-Reported Outcome (ClinRO) measure for EB/EL and Severity of Alopecia Tool (SALT) score for scalp. RESULTS:At baseline, patients with more severe EB/EL involvement had more severe scalp hair loss, with mean SALT scores ranging from 70.6 to 96.0 for patients with no gaps to complete absence of hair, respectively, at EB/EL sites. EB/EL response rates [ClinRO (0,1) with ≥1-point improvement] at Week 36 were significantly higher in patients treated with both baricitinib 2 mg (28.2%, odds ratio [OR]=3.27, 25.1% OR=2.95) and baricitinib 4 mg (44.3% OR=6.84, 46.4% OR=8.21) as compared with placebo (12.6%, 12.4%). There was high concordance between EB response and EL response, with approximately 80% of patients who achieved hair regrowth at one site, achieving regrowth at the other with baricitinib 4 mg. Among scalp responders (SALT score <20 at Week 52), 78.5% and 82.6% achieved an EB and EL response, respectively, and 71.1% of patients achieved a response in both EB and EL with baricitinib 4 mg. Among scalp nonresponders (SALT score >20 at Week 52), 46.7% and 48.7% achieved EB and EL responses, respectively, and 35.4% achieved responses in both EB and EL. Similar trends but lower response rates were observed with baricitinib 2 mg. CONCLUSIONS:Baseline severity of EB/EL involvement parallels that of the scalp. Baricitinib was efficacious in achieving holistic response across all three hair-bearing sites in a majority of Week 52 scalp responders. These data detail the benefits of baricitinib across important hair-bearing sites involved in AA and highlight that individual patient treatment success should account for the totality of the clinical presentation. TRIAL REGISTRATION NUMBER/BACKGROUND:BRAVE-AA1, ClinicalTrials.gov number, NCT03570749, start date, September 24, 2018; BRAVE-AA2, ClinicalTrials.gov number, NCT03899259, start date, July 8, 2019.