Hair Loss Awareness Month 2024

This is a live recording from the 2024 Hair Loss Awareness month webinar which took place on August 13 2024. In this recording, Dr Donovan highlights 25 questions that were submitted by webinar participants.

Q1 (starts 04:29). When you start the treatment for AGA with Minoxidil, do you start with formulation containing PG and if there are some issues (like irritation) you switch to formulation without PG ?

Q2 (starts 06:43). Is it reasonable to start minoxidil smaller dosage, like 2 percent one time per day or 5 percent but less amount - like 0.5 ml in order to get less amount of initial hair shedding?

Q3 (starts 09:23).. I have a lot of young female clients who come to consultation with their mothers and mothers are concerned about the hair density  which have changed (they say that in childhood their hair was very good and now they have shedding and the density is less. On trichoscopy it doesn't look like AGA...What is the right explanation?

Q4 (starts 15:15).. How effective is scalp massage for androgenic alopecia or telogen effluvium?   What is the best way to massage the scalp and for how long?

Q5 (starts 17:59).. Is microneedling a good option for androgenic alopecia or telogen effluvium?

Q6 (starts 22:09).. Does inversion help bring blood flow to the scalp and help grow hair?

Q7 (starts 24:30).. I've used topical minoxidil for the last 2 years, and as of 7 months ago, started taking 2.5 mg oral minoxidil as well.  At some point, do I need to stop the topical, or is it okay to continue doing both?

Q8 (starts at 30:45).. We know that we have lower hair density in the temples, but sometimes patients complain that the temples are always shorter, so I wonder, is it right explanation that it could be different anagen phase duration in different regions of the scalp?

Q9 (starts 32:28).. Can you tell from the images if scarring is taking place?

Q10 (starts 44:06).. My question is about the strength/dose of injectable Triamcinolone (Kenalog-10) for scalp. What strength Triamcinolone do you use for LPP?  for FFA? What interval do you recommend? How do you know if injectable steroid is working?


Q11 (starts 55:24).. Do the new JAK inhibitors basically make the other treatments obsolete?

Q12 (starts 1:02:35).. Can you please share if there is any up-to-date data on the importance of avoiding titanium dioxide for someone that has FFA. It is a very difficult ingredient to avoid as it is so many make up and skin care products as well as sunscreen.


Q13 (starts 1:07:00).. Can you please discuss the use of accutane in the treatment of FFA. I have been taking 10mg three x per week. It has helped but I have extremely dry eyes! How long should people take it for? I’ve now reduced to 2x per week to see if my eyes feel better.

Q14 (starts 1:15:54).. Is there any treatment that targets helping to prevent scarring specifically around the ear area?


Q15 (starts 1:20:40).. I have had FFA for at least 14 years and have been on oral Dutasteride several years. I switched to topical (0.05% dutasteride and 5% minoxidil) in April of this year.
Is the oral more effective than topical? I find that I am having hair loss now and my frontal hairline seems to be receding now. Should I go back on oral Dutasteride to help the progression of the disease?

Q16 (starts 1:28:21).. How does Pioglitazone work on a patient with FFA who is already on topical Dutasteride and minoxidil?


Q17 (starts 1:37:42).. Are there any laser recommendations for treatment of Folliculitis Decalvans/FD?


Q18 (starts 1:39:33).. With Folliculitis Decalvans once disease goes into remission, what is the likelihood that it would flare up in the same region of scalp after having scalp reduction?

Q19 (starts at 1:43:55). We see scarring alopecia with Folliculitis Decalvans, my understanding is permanent hair loss and damage to hair follicle, what is the success rate of hair transplant?


Q20 (starts 1:49:02).. I see some of the recommendations for steroid injections for treatment of folliculitis decalvans. Is this administered only to affected areas or do you inject at other sites?


Q21 (starts 1:49:54).. I was recently diagnosed with demodex Blepharitis and have had Folliculitis Decalvans for 10+ years. How often do you see demodicosis mimic FD and how do you treat it?


Q22 (starts at 1:56:30). Do you believe that JAK inhibitors are the most effective treatment for CCCA?

Q23 (starts 1:57:30). Do you believe Ixekizumab can cure LPP?


Q24 (starts at 1:59:00). I most likely have Lichen Planopilaris. My symptoms have improved but are still present. I have extremely dry, curly hair and have struggled to find what hair products, including shampoo and conditioner, I can use that is safe for my condition and won't make my scalp worse. Do you have any recommendations?


Q25 (starts at 2:03:28). What effect will chemotherapy drugs/radiation therapy have on scarring alopecia?  Are there safer chemotherapy drugs than others?