Faculty Bibliography

Chemotherapy-induced alopecia and radiation-induced alopecia, the thinning or loss of hair due to cytotoxic chemotherapy and radiation therapy, respectively, are distressing adverse effects of cancer treatment. Chemotherapy, targeted therapies, and radiation therapy used in pediatric oncology often lead to alopecia by damaging hair follicles, with varying degrees of severity depending on the specific treatment type, mechanism of action, and damage-response pathway involved. Pediatric chemotherapy-induced alopecia, radiation-induced alopecia, and permanent alopecia, defined as hair regrowth that remains incomplete 6 months or more after treatment, have significant negative impacts on mental health, self-esteem, and social interactions, highlighting the need for further research into supportive care strategies. There are currently no standard interventions for chemotherapy-induced alopecia or radiation-induced alopecia in children, with most recommendations limited to gentle hair care and camouflaging techniques during treatment. Scalp cooling has demonstrated safety and efficacy in reducing chemotherapy-induced alopecia in adults and is currently under investigation in children and adolescents. Topical and low-dose oral minoxidil have been studied in children for other hair loss disorders and may improve hair regrowth after chemotherapy or radiation. Increased awareness and continued research into management strategies for pediatric chemotherapy-induced alopecia and radiation-induced alopecia are necessary to help mitigate its significant negative impact on quality of life.

INTRODUCTION/UNASSIGNED:Although platelet-rich plasma (PRP) is a widely used treatment for androgenetic alopecia (AGA), the impact of patient age on treatment efficacy remains underexplored. METHOD/UNASSIGNED:This retrospective study evaluated PRP outcomes in 57 AGA patients treated at NYU Langone Health, stratified into four age cohorts. Changes in trichometric hair density and width were measured from initial to final follow-up visits. Statistical significance and linear regression testing were determined using ANOVA and Rank-Based ANCOVA, respectively. RESULTS/UNASSIGNED:While overall changes in density and width did not differ significantly across age groups, younger patients trended toward greater density gains. Furthermore, greater baseline hair width was predictive of smaller improvements in width, and significant interactions between age and the number of PRP sessions suggested that older individuals may require a greater number of treatments to attain results comparable to those seen in younger cohorts. Additionally, improvements in hair density were positively associated with the number of adjunctive therapies, as patients who received more concurrent treatments experienced greater gains. PRP was well tolerated across all age groups. CONCLUSION/UNASSIGNED:These findings highlight the potential impact of patient age on PRP efficacy, informing counseling and treatment planning.

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.