Introduction Alopecia areata (AA) has been associated with adverse pregnancy outcomes, but its relationship with infertility remains poorly characterized. Given the prevalence and psychosocial impact of infertility and the reproductive implications of systemic AA therapies, we examined for potential associations between AA and infertility. Methods A retrospective cohort study was conducted using the TriNetX research network, querying for female patients aged 18-45 years with AA and matched controls. Reproductive outcomes <10-years of diagnosis were compared between cohorts, excluding patients with pre-existing outcomes. AA patients were additionally compared with matched infertile controls. Sex hormone levels were analyzed using t-tests. Results A total of 31,404 AA patients and 31,404 matched controls were included. AA was associated with increased risk of infertility (RR=1.21, 95%CI:1.09-1.35) and decreased likelihood of pregnancy (RR=0.78, 95%CI:0.73-0.82) and IVF utilization (RR=0.71, 95%CI:0.52-0.99). Compared with infertile controls, AA patients had significantly lower IVF use (0.17% vs. 5.04%) and pregnancy rates (6.50% vs. 19.45%) (both p<0.0001). AA patients had lower testosterone and DHEAS levels (both p<0.0001), though within reference ranges. Conclusion AA was associated with increased infertility risk and reduced reproductive outcomes, suggesting broader reproductive implications beyond infertility alone. Multidisciplinary counseling and prospective studies incorporating reproductive intentions are warranted.

Introduction: Prostaglandin D2 (PGD2) is elevated in the bald scalp of men with androgenetic alopecia (AGA) and inhibits hair growth. Cetirizine, an H1-antihistamine, reduces PGD2 production and has anti-inflammatory effects, making it a potential therapeutic candidate. Methods: Ten men aged 18–60 years with Norwood-Hamilton grade III vertex to V AGA applied 1 mL of 1% cetirizine in propylene glycol/butylene glycol daily for 16 weeks. Exclusion criteria included recent use of minoxidil, finasteride, or other antiandrogenic therapies. Hair counts in a 1 cm2 tattoo-marked vertex area and blinded photographic assessments were evaluated at baseline and week 16. Results: Nine participants completed the study. Mean hair count increased from 139.6 (SE 13.9) to 163.4 (SE 15.5), a statistically significant change (p = 0.009). Blinded global photographs showed a +2 improvement in 1 patient, +1 in two, and no change in six. Trichoscopic counts improved in all patients. No adverse events occurred. Conclusion: Despite limitations, this report provides additional real-world data supporting cetirizine as a potential therapy in AGA. Larger randomized controlled studies with longer follow-up are needed to establish efficacy, durability, and mechanism of action.

Introduction: Social media is widely used by adolescents and hair products are frequently promoted on these platforms. However, little is known about marketing strategies or potential dermatologic risks. Methods: We analyzed the first 100 TikTok and 50 Instagram posts using the hashtags “#teenhaircare,” “#tweenhaircare,” and “#hairtok” (10/05/2025–10/15/2025). Eligible posts were English language, ≤2 years old, and promoted hair products or routines intended for adolescents (aged 9–18). Posts were coded for promoter type, marketing strategy, product category, claims, hair type, and ingredients. Results: Influencers comprised 44.7% of creators, and brands accounted for 19.3%. Common marketing strategies included colorful packaging (50.7%) and “natural/clean” labeling (27.3%). Key claims included “shiny hair” (34%) and “damage repair” (26.7%). Most products (82%) contained allergens/irritants such as fragrance, sulfates, silicones, or parabens. Only 2.6% of posts were created by dermatologists and only 6% targeted afro-ethnic hair types. Conclusion: Marketing of adolescent hair products on social media is dominated by influencers with minimal dermatologist oversight. Many promoted products contain allergens or irritants that may contribute to contact dermatitis. Dermatologists should inquire about hair-care practices during adolescent visits and advocate for improved oversight of influencer marketing.

Introduction: Many conditions, such as malnutrition, radiation exposure, drugs, trauma, and systemic and metabolic disorders, can lead to nail pigmentation. Many other dermatological and systemic conditions, mycologic and bacterial infections, and repetitive trauma can be associated with non-melanoma-related Hutchinson’s sign. Case Presentation: We report a 68-year-old woman with the complaint of darkening of her existing nail bands and development of a newly pigmented lesion on the edge of her left thumb after taking chemotherapy. Lateral longitudinal biopsy, including Hutchinson’s sign, was performed. Melanocytes in normal number and localization in the nail matrix on histopathological evaluation. The patient was diagnosed with frictional hypermelanosis. Conclusion: It is very important to exclude subungual melanoma and to find out the etiology of Hutchinson’s sign. Repetitive trauma can be a cause of non-melanoma Hutchinson’s sign.

Introduction: Patients suffering from androgenetic alopecia may experience obsessive behaviors on observing their own scalp. Case Presentation: This article describes a series of three cases of young men presenting with an unusual, seemingly compulsive behavior related to mild scalp psoriasis and a family history of androgenetic alopecia. Contrary to the typical goal of psoriasis treatment, these patients exhibit an intense fixation on scalp scales containing embedded hairs. They actively avoid dislodging these scales during routine hygiene or therapeutic efforts, fearing that their removal might accelerate hair loss. The cases involve young men (aged 24, 19, and 22) with significant anxiety about hair loss, which manifests as a meticulous and repetitive manipulation of their scalps to preserve these specific scales. Conclusion: This behavior may fall within the spectrum of body-focused repetitive behaviors. This observation underscores the importance for dermatologists to thoroughly question patients about underlying anxieties and specific scalp manipulation behaviors, especially in young men with a familial history of alopecia, to facilitate more effective clinical management.

Introduction: We aimed to evaluate the recent trends in public interest regarding various alopecia-related treatments using Google Trends (GT). Method: Data generated through GT for the relative search volumes (RSVs) of the treatments-related terms were analysed: “hair loss treatment”; “minoxidil”; “oral minoxidil”; “finasteride”; “dutasteride”; “hair transplant.” Analysis has been performed worldwide from July 29, 2018, to July 16, 2023. Results: Mean RSVs for “hair loss treatment” have increased since 2021 (23 ± 2.8 in 2018 to 70 ± 7.5 in 2023). Interest in “minoxidil” has been growing since 2018, with “minoxidil oral treatment” gaining attention since 2021. “Finasteride” saw a rise in 2021; “dutasteride” experienced consistent growth. RSVs for “hair transplant” have remained stable. Geographically, public interest in “hair loss treatment” was concentrated in Middle Eastern countries and Japan. Interest in oral treatments was prominent in Latin American and Spanish-speaking countries; Ireland and the UK showed strong focus on hair transplants. Conclusion: GT is not a real epidemiological tool and can be only used by individuals who have access to the Internet. We observed temporal and geographical variations in public interest in hair loss treatments. COVID-19 pandemic, differences in the prevalence of alopecia-related conditions, cultural, social influences impact search trends across countries.

Introduction: Although platelet-rich plasma (PRP) is a widely used treatment for androgenetic alopecia (AGA), the impact of patient age on treatment efficacy remains underexplored. Method: This retrospective study evaluated PRP outcomes in 57 AGA patients treated at NYU Langone Health, stratified into four age cohorts. Changes in trichometric hair density and width were measured from initial to final follow-up visits. Statistical significance and linear regression testing were determined using ANOVA and Rank-Based ANCOVA, respectively. Results: While overall changes in density and width did not differ significantly across age groups, younger patients trended toward greater density gains. Furthermore, greater baseline hair width was predictive of smaller improvements in width, and significant interactions between age and the number of PRP sessions suggested that older individuals may require a greater number of treatments to attain results comparable to those seen in younger cohorts. Additionally, improvements in hair density were positively associated with the number of adjunctive therapies, as patients who received more concurrent treatments experienced greater gains. PRP was well tolerated across all age groups. Conclusion: These findings highlight the potential impact of patient age on PRP efficacy, informing counseling and treatment planning.

Plain Language SummaryAlopecia areata (AA) is an autoimmune disease that causes unpredictable hair loss in 2% of people worldwide. It can be challenging to live with AA because of its emotional impacts, with negative effects on self-confidence and quality of life being common. People with AA also often experience stigma, which becomes more severe as hair loss becomes more severe. To explore how stigma affects how often people with AA interact with healthcare system, we analyzed responses from a survey completed by 500 participants. Participants who experienced the most stigma were twice less likely to seek medical care. They were also more likely to have severe AA, anxiety, and depression. This relationship was seen across different races and economic backgrounds. These results suggest that stigma plays a large role in the care-seeking behaviors of people with AA, which may prevent them from accessing the medications and support needed to treat and manage the condition. This study highlights the need for interventions that address stigma as a barrier to care and support patients with AA in accessing comprehensive healthcare.

Plain Language SummarySurgery with digit preservation is the recommended treatment for early forms of nail melanoma (a type of skin cancer that affects the nails). When the melanoma is very thin or limited to the surface of the nail, allowing the wound to heal on its own (known as secondary intention healing or SIH) can be a good alternative to closing the wound after surgery. This method has shown good cosmetic and functional results, fewer complications, and high patient satisfaction. In this study, we evaluated 6 patients who underwent this type of surgery with SIH. We focused on how long it took for their wounds to heal, how much pain they experienced, cosmetic results, finger function, complications, and overall satisfaction. The wounds took around 8.5 weeks to heal completely. Patients reported good functional and cosmetic results. Their quality of life was minimally affected, with high satisfaction scores (9.8 out of 10). Importantly, no recurrences of melanoma or skin discoloration were observed. In conclusion, healing with SIH is a safe and effective option. It also allows flexibility if more tissue needs to be removed later while still providing excellent cosmetic and functional results.

Introduction: There is scarce evidence in the literature regarding the association of JAK inhibitors and keratitis. Case Presentation: We present the case of a 33-year-old woman with alopecia areata who developed 3 episodes of keratitis within 2 months of treatment with baricitinib, a JAK1/JAK2 inhibitor, and had to therefore stop treatment with baricitinib. Conclusion: On review of the literature regarding ocular side effects with JAK inhibitors, these seem rare but not exceptional. At this time, a casual link cannot be established. To exercise caution, clinicians should be aware of possible ocular adverse events in patients using JAK inhibitors and should also report these cases to the relevant drug safety agencies. Discontinuing the drug and switching to an alternative agent may also be necessary.