SF Derm Society Annual Meeting Pearls

Hair Me Out—A Synopsis of Dr. Paradi Mirmirani’s ‘Hair Loss Updates’

Part III: Scarring Alopecia & Environmental Triggers

Authors: Chandler Johnson, Paradi Mirmirani, MD

At the San Francisco Dermatological Society Annual Conference hosted in Half-Moon Bay, California on July 27, 2024, Dr. Paradi Mirmirani, MD led an informative lecture titled “Hair Loss Updates.” Dr. Mirmirani is a dermatologist and world renowned hair loss expert, serving as a scientific advisor for the Cicatricial Alopecia Research Foundation as well as an active member of the North American Hair Research Society and National Alopecia Areata Foundation. In Dr. Mirmirani’s lecture, she discussed three main topics of interest:

  • Alopecia Areata and JAK-inhibitors
  • Hair Loss and Low-Dose Oral Minoxidil
  • Scarring Alopecia and Environmental Triggers

The following writing outlines clinical pearls as well as updates to topics related to hair loss—relevant to dermatologists, patients, and their advocates.

Scarring Alopecia and Environmental Triggers

A trend that is both concerning and thought-provoking is the increase incidence of frontal fibrosing alopecia(FFA) seen within the clinic. Although the development of FFA may be attributed to a genetic predisposition and hormonal factors, Dr. Mirmirani discusses the importance of considering potential provoking environmental factors.

Specifically, she draws upon a report from the World Congress for Hair Research, which evaluated hair follicle cell culture (in vitro) exposed to linalool (a frequently encountered fragrance ingredient). This report indicated that there was a decrease in K15 epithelial stem cells, as well as a loss of markers associated with immune privilege. Though this work was conducted in vitro, rather than in vivo, it still has the potential to guide patient counselling. Dr Mirmirani instructs patients with FFA to avoid any products that contain fragrance, as well as chemical sunscreen. Instead, she instructs patients to look for free-and-clear style products, and to pay special attention to moisturizers and other products that may have hidden ingredients or even sunscreen included in the formulation.

The use of topical JAK-inhibitors may another option for (FFA).

"a report from the World Congress for Hair Research, which evaluated hair follicle cell culture (in vitro) exposed to linalool (a frequently encountered fragrance ingredient)."

A Reference of Organizations:

  • National Alopecia Areata Foundation: https://www.naaf.org/
  • Scarring Alopecia Foundation (SAF): https://scarringalopecia.org/
  • American Hair Research Society: https://americanhairresearchsociety.org/

Key Words: circadian rhythms, bright light exposure, chronic inflammatory skin disorders, metabolic health, sleep quality, immune system function, skin aging, non-invasive therapy

ORCiDs

CEJ, https://orcid.org/0009-0000-5818-8710

PM, https://orcid.org/0000-0001-8627-2995