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1.  Assessment of a Diagnostic Predictive Probability Model Provided by a Multispectral Digital Skin Lesion Analysis Device for Melanoma and Other High-risk Pigmented Lesions and its Impact on Biopsy Decisions 
Objective: Risk prediction models for primary malignant melanoma thus far have relied on qualitative patient information. The authors propose a quantitative diagnostic predictive probability model using Multispectral Digital Skin Lesion Analysis for melanoma and other high-risk pigmented lesions and evaluate its effectiveness optimizing biopsy decisions by dermatologists. Design: Data from 1,632 pigmented lesions analyzed by a Multispectral Digital Skin Lesion Analysis device were used to perform a logistic regression analysis. This new quantitative melanoma or melanoma/atypical melanocytic hyperplasia/high-grade dysplastic nevus probability model was then evaluated to determine its impact on dermatologist decisions to biopsy pigmented lesions clinically suggestive of melanoma. Participants were given an electronic keypad and answered “yes” or “no” if they would biopsy each of 12 pigmented lesions when presented first with patient history, clinical images, and dermoscopic images and again when subsequently shown Multispectral Digital Skin Lesion Analysis data. Setting/participants: Study of 191 dermatologists at a medical conference. Measurements: Sensitivity, specificity, biopsy accuracy, overall biopsy rate, and percentage dermatologists biopsying all five melanomas. Results: Dermatologists were significantly more sensitive, specific, and accurate while decreasing overall biopsy rates with Multispectral Digital Skin Lesion Analysis probability information. Conclusion: Integration of Multispectral Digital Skin Lesion Analysis probability information in the biopsy evaluation and selection process of pigmented lesions has the potential to improve melanoma sensitivity of dermatologists without the concomitant costs associated with additional biopsies being performed.
PMCID: PMC4285445  PMID: 25584133
2.  Tolerability and Pharmacokinetics of Ingenol Mebutate 0.05% Gel Applied to Treatment Areas up to 100cm2 on the Forearm(s) of Patients with Actinic Keratosis 
Objective: To determine safety, tolerability, and systemic absorption of ingenol mebutate 0.05% gel applied for two consecutive days to treatment areas up to 100cm2 on the forearm(s) of patients with actinic keratosis. Design and setting: Two studies are reported: a Phase 1, multicenter, open-label, dose-area escalation cohort study ( and a Phase 2, double-blind, vehicle-controlled pharmacokinetic study (http://clinical Participants: The Phase 1 study included male patients (n=65), mean age 68.1 years; the Phase 2 study included both male and female patients (n=16), mean age 63.3 years. Measurements: In the Phase 1 study, patients assigned to escalating dose-area cohorts were evaluated for local skin responses, adverse events, and any other relevant safety data. In the pharmacokinetic study, blood samples were collected pre-dose and for up to 24 hours after administration on Day 2, and analyzed for ingenol mebutate and its primary metabolites. In both studies, safety assessments were performed on Days 2, 3, 8, 15, 29, and 57 (study end). Results: In the Phase 1 study, most adverse events were mild, and all treatment-related adverse events resolved before the end of the study. The 100cm2 treatment area showed a small increase in the overall intensity of mean composite local skin response scores. There was no quantifiable systemic exposure to ingenol mebutate or its primary metabolites. Conclusion: Ingenol mebutate 0.05% gel has a good safety profile when applied to treatment areas up to 100cm2 with acceptable tolerability and local skin responses. There is no systemic absorption following application to areas of 100cm2.
PMCID: PMC4285446  PMID: 25584134
3.  Efficacy, Safety, and Out-of-pocket Costs are the Most Important Factors to Patients in Choosing a Psoriasis Therapy 
Objective: To determine which factors (i.e., cost, efficacy, safety, and method of delivery) influence choice of psoriasis treatment by patients and how patients obtain information regarding treatment options. Design: Anonymous survey. Setting: Specialty Psoriasis Clinic at an academic dermatology department over a six-month period. Participants: Convenience sample of 40 psoriasis patients. Measurements: Participant demographics, psoriasis treatment history, sources of information about treatment options, factors influencing treatment choices, and knowledge of treatment costs. Results: The mean (±SD) patient age and duration of psoriasis was 50 (±17) and 19 (±17) years, respectively. Factors influencing patient’s choice of psoriasis treatment were, in order of importance: efficacy (90% very important), safety/side effects (65%), patient’s own cost (53%), then total treatment cost (46%), frequency of use (37%), and method of medication delivery (i.e., topical, oral, or injection; 17%). Eighty percent of patients reported not knowing the total cost of any psoriasis treatments. The patient’s dermatologist was identified as both the most important (90%) and the most influential (75%) source of information for selecting psoriasis treatments, with the internet being the second most important source. Conclusion: Patients, in large measure, are unaware of the costs for different psoriasis treatments. Efficacy, safety, and out-of-pocket costs are the most important factors to patients in deciding on a psoriasis treatment.
PMCID: PMC4285447  PMID: 25584135
4.  Radiation-induced Breast Telangiectasias Treated with the Pulsed Dye Laser 
Background and objectives: Radiation dermatitis is a frequent sequela of adjuvant radiation therapy for breast cancer. Clinical manifestations include prominent telangiectasias that may be physically disfiguring and psychologically distressing for the patient. The objective of this study was to review cases of breast cancer patients with radiation-induced breast telangiectasias treated with the pulsed dye laser and assess clinical efficacy. The patient’s perception of treatment was also reviewed. Study design: A retrospective chart review of patients treated for radiation-induced telangiectasias was conducted at the Dermatology Division of Memorial Sloan-Kettering Cancer Center. Materials and methods: Pre- and post-clinical photos were used to assess clearance by two independent raters. Patient’s comments were assessed from visit notes and the treating physicians for the impact of treatment on the patient’s overall well-being. Results: All patients (n=11) experienced clinical improvement in the radiation-induced telangiectasias. The mean number of treatments was 4.3 (2–9) with an average fluence of 4.2J/cm2 (585nm platform) and 7.8J/cm2 (595nm) (4–8 J/cm2) used. The mean percent clearance was 72.7 percent (50–90%). Adverse effects were not encountered including those with breast implants or flap reconstruction. Patients reported an improvement in their well-being, including an improved sense of confidence. Limitations: Limitations include the small sample size, nonstandardized digital images, and nonsystematic collection of patient-reported outcomes. Conclusion: The pulsed dye laser is an efficacious treatment for radiation-induced breast telangiectasias. Multiple treatments are required for greater than 50-percent clearance and conservative treatment parameters are advised. Patients also reported an improved quality of life.
PMCID: PMC4285448  PMID: 25584136
5.  Autologous Therapies in Dermatology 
Autologous therapy is a therapeutic intervention that uses an individual’s cells or tissues, which are processed outside the body, and reintroduced into the donor. This emerging field presently represents a mere tip of the iceberg with much knowledge and applications yet to be discovered. It, being free from risks of hypersensitivity reactions and transmission of infectious agents, has been explored in various fields, such as plastic surgery, orthopedics, and dermatology. This review article focuses on various forms of autologous therapies used in dermatology along with their applications and mechanisms of action.
PMCID: PMC4285449  PMID: 25584137
6.  A Review of Epidermal Maturation Arrest: A Unique Entity or Another Description of Persistent Granulation Tissue? 
Objective: To conduct a review of reported cases of epidermal maturation arrest and to compare their clinical and histological descriptions with that of persistent granulation tissue with a focus on diagnostic methods and response to treatment. Methods: The authors performed a literature search within Pubmed, Embase, Google Scholar, and Web of Science for all reported cases of epidermal maturation arrest under the terms “epidermal maturation arrest,” “epidermal arrest,” “epidermal maturation,” and “re-epithelialization maturation arrest.” They reviewed the clinical and histological presentation of hypergranulation tissue as well as the evidence for the most widely used treatments. Results: There is only one case series and one case report of epidermal maturation arrest, and the former gives the most detailed clinical and histological description including response to treatment. The clinical description, histological findings, and response to treatment of all cases are comparable to that of persistent granulation tissue and there is no histological or cytological data provided to support that epidermal maturation arrest exists as a distinct entity. Conclusion: Among the cases of epidermal maturation arrest reported in the literature, there is insufficient evidence that keratinocytes acquired a state of arrest in their migration. Rather, the described cases appear to have been complicated by persistent granulation tissue, a well-known aberration in wound healing.
PMCID: PMC4285450  PMID: 25584138
7.  Persistent Sexual Dysfunction and Depression in Finasteride Users for Male Pattern Hair Loss 
The use of finasteride for the treatment of male pattern hair loss has recently been the focus of media and internet attention for potential irreversible sexual dysfunction and severe depression. The purpose of this study was to perform a critical review of the recent studies reporting prolonged sexual dysfunction and depression with the use of finasteride for the treatment of male pattern hair loss. A literature search was performed using PubMed to review the literature pertaining to any potential adverse effects with the use of finasteride and its treatment of male pattern hair loss. The authors conclude that the reports of potential irreversible sexual dysfunction and severe depression do raise concerns about the safety of finasteride; however, these studies are wrought with significant bias. Therefore, larger, randomized, double blind, controlled trials are warranted to further ascertain the true potential risks or confirm long-term safety profile of finasteride use.
PMCID: PMC4285451  PMID: 25584139
10.  Treatment of Onychomycosis with Efinaconazole 10% Topical Solution and Quality of Life 
Objective: To evaluate the benefits of efinaconazole topical solution, 10% on quality of life in onychomycosis patients. Methods: An analysis of 1,655 patients, aged 18 to 70 years, randomized to receive efinaconazole topical solution, 10%, or vehicle from two identical multicenter, double-blind, vehicle-controlled, 48-week studies evaluating safety and efficacy. The primary endpoint was complete cure rate (0% clinical involvement of target toenail, and both negative potassium hydroxide examination and fungal culture); clinical improvement defined as ≤ 10-percent improvement in nail involvement both at Week 52. Quality of life was assessed using a validated OnyCOE-t™ questionnaire. Improvement in quality of life was compared in those patients clinically and not clinically improved. Results: Efinaconazole topical solution, 10%, was significantly more effective than vehicle irrespective of QoL domain. Greatest improvement in mean score was seen in those domains with the lowest baseline scores. All mean scores in the group considered to have clinically improved with efinaconazole exceeded 80.0 at Week 52. Mean treatment satisfaction scores with efinaconazole in those patients who were clinically improved increased from 79.9 (Week 24) to 89.2 (Week 52), compared to a corresponding drop in those patients considered not improved from 65.3 to 58.0. The correlation between change in percent affected nail and change in mean domain scores was significant with efinaconazole for all domains. Limitations: A period of 52 weeks may be too brief to evaluate improvement in quality of life in onychomycosis patients. Some of the questions in the OnyCOE-t questionnaire may be more relevant than others to the study population and the onychomycosis population as a whole. Conclusion: Once-daily efinaconazole topical solution, 10%, provided statistically greater improvement in all aspects of quality of life compared to vehicle. Improvement was most marked in those patients considered clinically improved and correlated with a change in percent affected nail.
PMCID: PMC4255695  PMID: 25489379
11.  A Novel Triple Medicine Combination Injection for the Resolution of Keloids and Hypertrophic Scars 
Keloids and hypertrophic scars remain one of the more difficult treatment concerns for clinicians. A variety of therapies have been used in the past with moderate success. On occasion, combination therapy has been used to treat these lesion, in an attempt to lessen the symptoms of pain and pruritus that often accompanies keloids and hypertrophic scars, as well as treating the actual lesions themselves. A novel triple combination injection process is introduced here in an attempt to further reduce the signs and symptoms of these lesions. The combination includes 5-fluoruracil, triamcinolone acetonide, and hyaluronidase. All three work in concert to treat keloids and hypertrophic scars, and this is the first work at looking at these medicines given together, at the same time, in a series of recalcitrant keloids and hypertrophic scars. The positive results warrant further investigation and hope for those with keloids and hypertrophic scars.
PMCID: PMC4255696  PMID: 25489380
12.  Clinical Efficacy of Short Contact Topical 5-Fluorouracil in the Treatment of Keratoacanthomas 
Objective: To determine the efficacy of treating patients with a recent onset, biopsy-proven keratoacanthoma with short-contact topical 5% 5-fluorouracil cream twice daily until resolution. Design: Chart review of 10 patients who applied 5% 5-fluorouracil for the treatment of biopsy-proven keratoacanthoma. Setting: Outpatient clinic of a board-certified dermatologist. Participants: The study population was 90-percent women (9/10), 10-percent men (1/10) and ranged in ages from 52 to 92 years old with a mean age of 74.4. Measurements: Patients were followed for weekly visits for the duration of their treatment and at varying, less-frequent intervals after resolution of the lesion clinically. Photographs were taken at each visit. Results: The authors performed a retrospective analysis of 10 patients with biopsy-confirmed keratoacanthomas treated with topical 5-fluorouracil. One patient elected to have Mohs surgery after one week of topical 5-fluorouracil due to personal concern and cosmetic appearance and did not complain of any side effects due to the drug. Of the nine patients that remained on topical 5-fluorouracil, all patients had complete resolution of the lesion within six weeks. The range in the number of weeks to resolution was four to six weeks. Two patients required a one- to two-week drug holiday secondary to erythema, which resolved without any further complication or patient discomfort. All nine patients who continued therapy reported satisfaction with the results and showed excellent compliance with treatment. Conclusion: Short-contact topical 5% 5-fluorouracil appears to provide excellent cosmetic results and is well-tolerated by patients. This should be an initial consideration for the treatment of keratoacanthomas and does not preclude future surgical intervention if deemed necessary.
PMCID: PMC4255697  PMID: 25489381
13.  Is Decreased Ultraviolet Exposure During Childhood the Cause of the Increased Prevalence of Atopic Dermatitis? 
There is a recent accumulation of data suggesting that decreased exposure to ultraviolet light in childhood could be a major factor contributing to the increasing rates of atopic dermatitis in children and adolescents. It would be worthwhile to study the relationship between vigilant sun protective behaviors in children and the incidence of atopic dermatitis.
PMCID: PMC4255698  PMID: 25489382
14.  Psoriatic Plaques “Koebnerizing” to Areas of Acanthosis Nigricans in an Obese Female 
Recent evidence suggests that the activation of several growth factor receptors (EGFR, IGFR1, and FGFRs) is a possible cause of acanthosis nigricans, a skin disorder characterized by velvety thin plaques in skin folds and often seen in patients with insulin resistance. The authors report a 14-year-old obese (body mass index = 38.5kg/m2) girl with a history of polycystic ovarian syndrome and pre-diabetes who presented with psoriatic plaques in her scalp and, subsequently, in areas mostly confined to where she had characteristic lesions of acanthosis nigricans. The authors propose that this as-of-yet unreported observation may represent a preferential koebnerization phenomenon where the abnormal keratinocyte proliferation in acanthosis nigricans may serve as the epidermal “micro-trauma” necessary to incite the prototypical isomorphic response seen in psoriasis.
PMCID: PMC4255699  PMID: 25489383
17.  Improvement of Tear Trough by Monophasic Hyaluronic Acid and Calcium Hydroxylapatite 
Tear trough deformities are a sign of facial aging. The anatomical base is well understood. In many patients, minimal invasive surgical procedures are useful to improve appearance. Here, the authors describe the use of monophasic hyaluronic acid dermal filler and calcium hydroxylapatite injection for correction. Forty female patients with a mean age of 50 years have been treated. On average, an improvement of one class of Hidman’s severity score could be achieved by single treatment. Mean duration of the effect was 10.1 months for hyaluronic acid and 12.8 months for calcium hydroxylapatite. Adverse effects were mild and temporary. Patients satisfaction was high (95%).
PMCID: PMC4217290  PMID: 25371770
18.  Actinic Keratosis 
Actinic keratosis is widely considered a field disease that is rarely limited to a single clinically apparent lesion. Field-directed therapies, such as ingenol mebutate, imiquimod, and photodynamic therapy, aim to treat not only clinically visible lesions, but also subclinical disease that is thought to exist along the same continuum as actinic keratosis and squamous cell carcinoma. These field treatments have shown efficacy compared to placebo as well as in long-term follow-up studies when compared to lesion-directed cryotherapy alone. Field therapy in combination with lesion-directed treatment will allow the practitioner to further optimize efficacy as well as patient preference and convenience. As the incidence of nonmelanoma skin cancer continues to rise, these treatment modalities provide new options to halt the progression of actinic keratosis, and thereby reduce the incidence of nonmelanoma skin cancer and its burden on our healthcare system.
PMCID: PMC4217291  PMID: 25371768
19.  A Randomized, Double-blind, Vehicle-controlled Trial of Luliconazole Cream 1% in the Treatment of Interdigital Tinea Pedis 
Objective: To evaluate the efficacy and safety of luliconazole cream 1% applied once daily for 14 days in patients with interdigital tinea pedis. Design: Multicenter, randomized, double-blind, parallel-group, vehicle-controlled study. Setting: Private dermatology clinics and clinical research centers in the United States and Central America. Participants: Three hundred twenty-two male and female patients ≥12 years of age diagnosed with interdigital tinea pedis. Measurements: Complete clearance (i.e., clinical and mycological cure), effective treatment, and fungal culture and susceptibility. Results: At study Day 42, complete clearance was obtained by a larger percentage (14.0% [15/107] vs. 2.8% [3/107]; p<0.001) of patients treated with luliconazole cream 1% compared with vehicle. Also at Day 42, more luliconazole-treated patients compared with vehicle-treated patients obtained effective treatment (32.7% vs. 15.0%), clinical cure (15.0% vs. 3.7%), and mycologic cure (56.1% vs. 27.1%). Erythema, scaling, and pruritus scores were lower for the luliconazole cream 1% group compared with vehicle on Day 14, Day 28, and Day 42. For all species and the same isolates, the MIC50/90 for luliconazole cream 1% was 6- to 12-fold lower than for other agents tested. No patients discontinued treatment because of a treatment-emergent adverse event. Conclusion: Luliconazole cream 1% was safe and well-tolerated and demonstrated significantly greater efficacy than vehicle cream in patients with interdigital tinea pedis.
PMCID: PMC4217292  PMID: 25371767
20.  Skin Substitutes 
In a relatively short timespan, a wealth of new skin substitutes made of synthetic and biologically derived materials have arisen for the purpose of wound healing of various etiologies. This review article focuses on providing an overview of skin substitutes including their indications, contraindications, benefits, and limitations. The result of this overview was an appreciation of the vast array of options available for clinicians, many of which did not exist a short time ago. Yet, despite the rapid expansion this field has undergone, no ideal skin substitute is currently available. More research in the field of skin substitutes and wound healing is required not only for the development of new products made of increasingly complex biomolecular material, but also to compare the existing skin substitutes.
PMCID: PMC4217293  PMID: 25371771
21.  Evaluation of the Efficacy and Safety of a Lidocaine and Tetracaine (7%/7%) Cream for Induction of Local Dermal Anesthesia for Facial Soft Tissue Augmentation with Hyaluronic Acid 
Injection of dermal fillers for soft tissue augmentation is a minimally invasive cosmetic procedure with growing popularity. However, patients often express concern about pain with such procedures. A topical anesthetic cream formulated with lidocaine/tetracaine 7%7% was approved by the United States Food and Drug Administration in 2006 and recently reintroduced to the market for use during superficial dermatological procedures. A Phase 3 study was conducted to assess the efficacy and safety of lidocaine/tetracaine 7%7% cream versus placebo cream when used to induce local dermal anesthesia during injections with hyaluronic acid. Mean visual analog scale scores significantly favored lidocaine/tetracaine 7%7% cream. A significant percent of subjects also indicated that lidocaine/tetracaine 7%7% cream provided adequate pain relief and that they would use lidocaine/tetracaine 7%7% cream again. Investigators also rated lidocaine/tetracaine 7%7% cream significantly better than placebo cream for providing adequate pain relief and on the assessment of pain scale. Lidocaine/tetracaine 7%7% cream was safe and well tolerated with most subjects reporting no erythema, edema, or blanching. No related adverse events were reported with lidocaine/tetracaine 7%7% cream; one related adverse event of erythema was reported with placebo cream. The results of this study indicate that lidocaine/tetracaine 7%7% cream is efficacious and safe at providing pain relief for soft tissue augmentation with hyaluronic acid.
PMCID: PMC4217294  PMID: 25371769
22.  The 100 Most Cited Psoriasis Articles in Clinical Dermatologic Journals, 1970 to 2012 
Background: Citation analysis is an effective way to gauge the impact of an article on the scientific community. Objective: The purpose of this study was to perform a citation analysis of 24 clinical dermatologic journals from 1970 to 2012, limited to the topic of psoriasis. Methods: The authors conducted a search of “psoriasis” in the Science Citation Index from 1970 to 2012, including articles that have received 100 or more citations. The top 100 most cited articles were further analyzed for country, institution, and study type. Results: Fifty of the top 100 most cited articles were from the United States and 81 of them were original articles. The majority of the top 100 classics were from dermatology programs in the United States, but institutions in the United Kingdom and Germany also made notable contributions. Citation classics in psoriasis were highly published from 1985 to 1989 and 2000 to 2004. Limitations: Limitations included potential neglect of a clinical dermatologic journal and the limited search term of “psoriasis.” Conclusion: The great majority of citation classics were published in the premier dermatologic journals. The top-ranking dermatology programs in the United States produced the majority of the top 100 classics in psoriasis. The high number of citation classics from 1985 to 1989 correlates to the discovery of the immune-mediated pathogenesis of psoriasis at that time. The 21st century brought forth the monumental development of biologic agents in psoriasis therapy, reflected by the high number of citation classics from 2000 to 2004.
PMCID: PMC4217295  PMID: 25371766
23.  Trends in the Use of Neurotoxins and Dermal Fillers by US Physicians 
Background: Demand for minimally invasive cosmetic procedures have led to an increased market of available products for facial rejuvenation. Objective: To characterize trends in the usage of aesthetic products, specifically the use of botulinum toxins and dermal fillers, by United States physicians. Methods: Data from the National Ambulatory Medical Care Survey was analyzed from 1993 to 2010 to evaluate the use of dermal fillers and neurotoxins in the United States outpatient setting. The types of physician specialties administering these products and their preferences in products were characterized. Results: There were an estimated 100,000 annual cosmetic visits at which a dermal filler was administered from 1993 to 2010. From 2002 to 2010, there were 140,000 annual cosmetic visits for a dermal filler and 440,000 visits for a neurotoxin. While collagen was the most common filler used over the entire study period, its use declined eight percent annually. Hyaluronic acid fillers were preferred from 2002 to 2010, followed by calcium hydroxylapatite filler, representing 50 percent and 16.1 percent of visits, respectively. The leading neurotoxin was onabotulinumtoxin A, used at 87.1 percent of visits. Dermatologists were the leading specialty for the cosmetic use of both dermal fillers and neurotoxins. Conclusion: Providers’ preference for cosmetic products appears to be influenced by their familiarity with them, with products that first came to market, such as the neurotoxin onabotulinumtoxin A and the hyaluronic acid fillers being used most frequently from 2002 to 2010.
PMCID: PMC4174914  PMID: 25276271
24.  The Effect of Multiple Sequential Light Sources to Activate Aminolevulinic Acid in the Treatment of Actinic Keratoses: A Retrospective Study 
There is a lack of research regarding the sequential use of multiple light sources for topical 5-aminolevulinic acid activation in photodynamic therapy for actinic keratosis. This study evaluated 5-aminolevulinic acid-photodynamic therapy for actinic keratosis using blue light combined with red light, pulsed dye laser, and/or intense pulsed light in a retrospective fashion. Field-directed 5-aminolevulinic acid-photodynamic therapy was performed with blue light only, blue light + pulsed dye laser, blue light + intense pulsed light, blue light + pulsed dye laser + intense pulsed light, or blue light + red light + pulsed dye laser + intense pulsed light for nonhyperkeratotic actinic keratoses of face, scalp, or upper trunk. Blue light + intense pulsed light + pulsed dye laser produced greater patient-reported improvement in actinic keratoses than blue light or blue light + intense pulsed light and greater subject-reported improvement in overall skin quality than blue light + intense pulsed light. The addition of red light led to no further benefit in either outcome measure. Photodynamic therapy with multiple, sequential laser and light sources led to greater patient-graded improvement in actinic keratoses than that with a single light source (blue light), without significant differences in post-treatment adverse events. However, the small, widely disparate number of patients between groups and follow-up times between patients, as well as retrospective assessments based on subjective patient recall, severely limit the significance of these findings. Nevertheless, the results raise interesting questions regarding the use of multiple light and laser sources for photodynamic therapy of actinic keratoses and warrant further research with a prospective, randomized, controlled study.
PMCID: PMC4174915  PMID: 25276272
25.  African American Women, Hair Care, and Health Barriers 
Objectives: The objective of this study was to elucidate the prevalence of hair loss among African American women; explore the psychosocial impact of hair grooming difficulties; and examine both perceptions related to physician encounters in this group and the relationship between hair grooming, physical activity, and weight maintenance. Design: An anonymous retrospective and qualitative survey, the Hair Care Assessment Survey, is an 18-question novel survey instrument designed at the Henry Ford Hospital Department of Dermatology Multicultural Dermatology Center. Setting: The Hair Care Assessment Survey was distributed at church-related functions at predominantly African American metropolitan Detroit churches. Participants: Two hundred African American women from metropolitan Detroit, Michigan, aged 21 to 83. Measurements: The Hair Care Assessment Survey collected data relating to hair loss and hair care, psychosocial experiences relating to hair loss, and hair care as it relates to exercise and body weight management. Data was collected on doctor-patient hair-related medical visits and experiences with commercially available ethnic hair care products. Results: More than 50 percent reported excessive hair loss. Twenty-eight percent had visited a physician to discuss hair issues, but only 32 percent felt their physician understood African American hair. Forty-five percent reported avoiding exercise because of hair concerns, and 22 percent felt that their hair impeded maintaining healthy body weight. Conclusion: Hair loss affects a compelling number of African American women, and a significant number express dissatisfaction in hair-related physician encounters. Additionally, hair styling problems present a serious impediment to physical activity and weight management among this already high-risk population.
PMCID: PMC4174916  PMID: 25276273

Results 1-25 (442)