In this feature video, Dr Glynis Ablon shares what she’ll be covering during her session, “Treating AGA II: Nutraceuticals and Light,” to be presented at the 2023 Fall Clinical Dermatology Conference, including the mechanism of action behind light therapy and nutraceuticals utilized to treat androgenetic alopecia and more.

Glynis Ablon, MD, is a board-certified dermatologist at the Ablon Skin Institute (ASI) Research Center in Manhattan Beach, CA. She is also an associate clinical professor at the University of California, Los Angeles (UCLA) in Los Angeles, CA.

Transcript:

Can you describe the mechanism of action behind light therapy and nutraceuticals utilized to treat androgenetic alopecia (AGA)?

Dr Glynis Ablon: I'm Dr Glynis Ablon. I'm a board certified dermatologist from Manhattan Beach, California, and I'd like to talk to you about nutraceuticals and supplements and light therapy. I review all the mechanisms of actions with my patients. It's really important to discuss both the importance of nutrition when it comes to all skin disorders, all medical disorders, not just hair. I love the old adage you are what you eat. We talk about what can be missing from their diet and that's where I think really nutraceuticals and supplements are beneficial. And then, replacing what's missing from that attritional status. As far as light therapy goes, both lasers and light emitting diodes provide a decrease in inflammation around the hair follicle. They also provide an increase in nitrous oxide, which increases the growth factors, superoxide dismutase, and then, of course, decreased inflammatory cytokines.

What other options are available to treat AGA? Can these be combined with light therapy and nutraceuticals?

Dr Glynis Ablon: When it comes to other treatment options, it's really important to understand, again, there is a multifactorial etiology when it comes to androgenic alopecia and, thereby, you understand that armamentarium of the multiple treatment options that we have. Once we've established an actual diagnosis, I think that it's important to discuss all treatment options with your patients. That includes cost, the frequency of procedures, success rates, and we work out a plan with the patient themselves that's best for them and their personal lifestyle and what they can do and afford. All treatments can be combined. I remind patients that treatment is lifelong because androgenic alopecia is not a curable condition, so it really is something that we have a continuum of, finding the perfect working relationship and working products, and treatments, and procedures that work for that patient.

How can physicians determine if light therapy and/or nutraceuticals are the best treatment option for patients with AGA?

Dr Glynis Ablon: Not all treatment options are successful for all patients and I explain that to every one of my patients, and so the idea is that you kind of want to go over what is best for them. Again, with their lifestyle, their cost, where they live, can they get into the office for the treatment, so there are multiple things that affect which treatment options they choose. Again, important to understand the risks and the benefits, success rates, so they're really making an informed decision on what they want to do for their androgenic alopecia. I like to take hair metrics photos and global photography before any treatments, and then typically once they've started whatever plan we put in place, then I'll repeat those pictures about six months after to really see how they're responding. Because again, the hair does grow and it takes a while so you really want to see that true growth change. The nice thing with the hair matrix is I can actually tell the number of terminal hairs, vellus hairs, then of course the diameters as well from before and after my treatment options.

And then, I do say that, depending on how they're doing, I may add or take away certain options from the chosen therapies that they've decided on based on my results at that point. And then, it's really ... When you're dealing with supplements or nutraceuticals and when you're dealing with light therapy, other than cost there are really no side effects so the question just is, if a patient can't tolerate a supplement, hurts their stomach or something like that, but again, there's no negative to it. And then, the light therapy, again, there's no negative to light therapy. A group of us did an article that was published back in September of 2021 in the Journal of Cosmetic Dermatology comparing all the treatment options that are available and the success rate. I think it's really important, again, to be very honest with your patients and let them know what they're dealing with.

What additional tips and insights would you like to share with your colleagues regarding your session for Fall Clinical on nutraceuticals and light?

Dr Glynis Ablon: I think it's critical to make a plan, have a clear plan in your discussion with your patients and the evaluation of the patient in for the hair consultation. I do a step-by-step approach and I think it's really important that you start with a great questionnaire, a hair loss questionnaire that you can give to the patient and they can fill out for you, and then we review that. Once again, we've established the diagnosis, and sometimes that means pull tests, sometimes that means biopsies, sometimes that means TrichoScans of the hairs themselves. Whatever it is, we want to get a good diagnosis and once we have that then we can, again, review all the treatment options that we have for our patient. I give lots of handouts. I send patients home with a ton of work. They get to read it all over and then, of course, we call them the next day to make sure they have no questions on all the stuff that we've given them.

I think it's really important that you, again, find something that works for the patient. The nice thing, of course, is that supplements are easy. They can just do it at home, they don't have to come in to see you. They can order it, we can ship it, they can get it online, so I think that the nice thing about nutraceuticals and supplements is it's something very easy to add to your regimen. When it comes to light, I discuss in office laser therapies. I also discuss home units. I think it's really important to, again, understand all the risks and benefits and what works for the patient. The technology of light therapy really has changed. I think we always had this idea that if it doesn't hurt it can't work. We now know with CT scans and with documentation and scientific data, it really does work. It is not a no pay, no gain, you can truly get amazing results with this technology and the patients, again, have no complications, no side effects.

I think the research is there and I think that you need to always keep in mind, nutraceuticals and light therapy are just a couple of the options when it comes to treating androgenic alopecia and do what's best for your patients.