Wokeness in Our Practice

March 2025 in “ International Journal of Trichology ”

Ralph M. Trüeb, Natalia Caballero Uribe

hair restoration alopecia management ethnic differences gender-affirming treatments

TLDR Dermatologists should address discrimination and consider ethnic and gender differences in treatments.

The document explores the concept of "wokeness" in medical practice, focusing on the LGBTQI community and dermatology. It emphasizes the need for evidence-based medicine that considers ethnic and gender differences, particularly in conditions like androgenetic alopecia (AGA). The text reviews finasteride's effectiveness for AGA but notes potential sexual side effects, suggesting that factors like hand preference and sexual orientation might predict these effects, though this could lead to discrimination. It also examines gender-affirming hormone therapy's impact on hair growth in transgender individuals and proposes alternatives like low-dose oral minoxidil. The document advocates for increased awareness of discrimination and healthcare accessibility in medical practice.

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Research cited in this study

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research Effect of Gender-Affirming Hormone Therapy on Hair Growth: A Systematic Review of the Literature

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The document concludes that treatments for hair loss in transgender and gender-diverse individuals include topical solutions, oral medications, laser therapy, and hair restoration procedures, with progress assessed after 6-12 months.

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AGA treatments like minoxidil and LLLLT are safe and effective for gender minority patients.

research Discriminating in Favor of or Against Men with Increased Risk of Finasteride-Related Side Effects?

2 citations , August 2016 in “Experimental Dermatology”

Finasteride treats baldness but may cause lasting sexual side effects.

Are Hand Preference And Sexual Orientation Possible Predicting Factors For Finasteride Adverse Effects In Male Androgenic Alopecia?

research Are Hand Preference And Sexual Orientation Possible Predicting Factors For Finasteride Adverse Effects In Male Androgenic Alopecia?

12 citations , March 2016 in “Experimental Dermatology”

Hand preference and sexual orientation may predict finasteride side effects in male hair loss.

research Ethnic Hair Disorders: Diagnosis and Management

17 citations , January 2015 in “Current problems in dermatology”

Understanding and treating hair disorders in different ethnic groups requires knowledge of specific hair care practices and hair characteristics.

research Ethnic Considerations in Hair Restoration Surgery

7 citations , July 2014 in “Facial Plastic Surgery Clinics of North America”

Different ethnic hair traits must be considered for successful hair restoration surgery to achieve natural-looking results.

research Persistent Sexual Side Effects of Finasteride: Could They Be Permanent?

112 citations , July 2012 in “The Journal of Sexual Medicine”

Finasteride may cause long-lasting sexual side effects.

research Evaluation of Efficacy and Safety of Finasteride 1 mg in 3177 Japanese Men with Androgenetic Alopecia

41 citations , October 2011 in “Journal of Dermatology”

Finasteride 1 mg effectively and safely increases hair growth in Japanese men with hair loss.

Adverse Side Effects of 5α-Reductase Inhibitors Therapy: Persistent Diminished Libido, Erectile Dysfunction, and Depression in a Subset of Patients

research Adverse Side Effects of 5α-Reductase Inhibitors Therapy: Persistent Diminished Libido, Erectile Dysfunction, and Depression in a Subset of Patients

223 citations , December 2010 in “The Journal of Sexual Medicine”

Some patients taking finasteride or dutasteride may have ongoing sexual problems and depression even after stopping the medication.

research A New Classification of Pattern Hair Loss That Is Universal for Men and Women: Basic and Specific (BASP) Classification

125 citations , May 2007 in “Journal of The American Academy of Dermatology”

The BASP classification is a detailed and accurate way to categorize hair loss in both men and women.

research Hair and Scalp Disorders in Ethnic Populations

55 citations , October 2003 in “Dermatologic Clinics”

Different hair care practices and conditions affect African American hair and scalp health, requiring specialized knowledge for treatment.

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