Ep 13. Hair Loss Bootcamp | Androgenetic Alopecia, Alopecia Areata, Telogen Effluvium, CCCA, LPP, FFA, Dissecting Cellulitis of the Scalp and MORE!

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Alopecia Boot Camp: Scarring vs Non-Scarring, Key Patterns, Dermoscopy Pearls, and First-Line Management | The Derm Resident

Contact: thedermresident.pod@gmail.com

Hosts Dr. Jonny Hatch and Dr. Deven Curtis present an “alopecia boot camp” framework focused on first distinguishing scarring (cicatricial) from non-scarring alopecia by assessing follicular ostia with dermoscopy, emphasizing that scarring implies permanent loss and requires urgent treatment at the active edge for biopsy and intralesional therapy. They review non-scarring causes including androgenetic alopecia (DHT-driven miniaturization, anisotrichosis; Hamilton-Norwood/Ludwig scales; minoxidil, finasteride/dutasteride, spironolactone in women, PRP and transplant with donor dominance), alopecia areata (CD8 attack, exclamation point hairs, yellow/black dots; ILK and FDA-approved JAK inhibitors baricitinib and ritlecitinib; totalis/universalis/ophiasis), telogen effluvium (delayed shedding after stressors; hair pull test; consider TSH and iron studies/ferritin), traction alopecia (fringe sign; may become scarring), and trichotillomania (broken hairs of varying length). Scarring alopecias covered include LPP/FFA (perifollicular erythema and tubular scale; hydroxychloroquine/doxycycline and steroids), CCCA (central centrifugal pattern; biopsy active border; discuss styling factors and PADI3), and rapid-fire pearls for DLE (follicular plugging), folliculitis decalvans (tufting; clindamycin/rifampin), dissecting cellulitis (boggy nodules/sinus tracts; follicular occlusion tetrad), and acne keloidalis nuchae (posterior scalp/neck plaques; consider laser/excision).

00:00 Alopecia Boot Camp
00:52 Why Hair Loss Is Hard
01:24 Scarring Versus Nonscarring
03:28 Follicular Ostia Clues
05:38 Androgenetic Alopecia Basics
08:05 Treating Pattern Hair Loss
08:34 Minoxidil ICU Story
12:08 Counseling and Transplants
13:44 Alopecia Areata Recognition
17:04 Areata Workup and Treatment
18:30 Telogen Effluvium Shift
20:31 Postpartum Shedding Explained
20:54 Hair Pull Test Basics
21:50 When to Order Labs
23:37 Traction Alopecia Red Flags
26:21 Trichotillomania Patterns
27:42 LPP and FFA Scarring Clues
30:09 Treating LPP and FFA Early
31:33 CCCA Diagnosis and Biopsy
36:04 Rapid Fire Scarring Alopecias
40:19 Clinic Safety Takeaways
41:12 Boot Camp Wrap Up

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