Patient perspectives on topical minoxidil for hair loss: a survey-based study from the University of Michigan Alopecia Clinic.

Topical minoxidil is a widely used therapy for alopecia. Its availability over the counter in the United States makes it easily accessible. Various factors impact whether an individual decides to pursue treatment and/or continue long-term use. Our study aimed to investigate patient awareness, opinions, and hesitations regarding topical minoxidil use for hair loss treatment. The study also aimed to identify information sources influencing these viewpoints. A survey was administered to new patients seeking evaluation for alopecia aged 18 and above at the University of Michigan Alopecia Clinic. Data collection occurred between August 2022 and August 2023. Demographics, patient-reported hair loss diagnosis, history of minoxidil use, opinions on minoxidil, influential information sources, and concerns about minoxidil were collected. A total of 47 surveys were completed, primarily by females (78.7%) ages 18-40 years (44.7%). Respondents were aware of minoxidil (97.9%), with 63.8% reporting they had heard of minoxidil, but had not used it. Medical professionals were the most influential information source (34%), followed by close contacts (17%), internet searches (10.6%), and television (10.6%). Overall, positive opinions on minoxidil were expressed by 51.1%, negative opinions by 31.9%, and neutral opinions by 17%. Most common concerns included the need for continuous use (46.8%), required regular application (31.9%), skepticism about hair regrowth (29.8%), and expense (25.5%). Addressing personalized concerns and tailoring communication based on hair loss type and information sources may lead to more informed decisions and improved adherence. Gauging the opinions of this population provides valuable insights, aiding dermatologists in patient education and counseling strategies.

Ocular side effects of systemic isotretinoin - a systematic review and summary of case reports.

Background: Isotretinoin is frequently used for treatment of severe nodulocystic and papulopustular acne, however use is limited by mucocutaneous, ocular, and systemic side effects.Objective: (1) provide a systematic meta-analysis of ocular side effects during isotretinoin use and their corresponding incidences; (2) provide a narrative summary of ocular side effects during isotretinoin use reported in case reports.Methods: A systematic database search using predefined search terms was performed in PubMed, EMBASE, and Scopus from inception to 5 March, 2021. Predetermined inclusion and exclusion criteria were used to select included studies. In total, 53 original studies qualified for meta-analysis, and 41 case reports/series qualified for narrative results.Results: The studies included in the meta-analysis reported incidences of various ocular side effects including dry eye, eye sensitivity, vision changes, and ocular inflammatory conditions. Incidences across studies did vary, leading to considerable heterogeneity. The narrative results summarize more uncommon, but equally important, ocular side effects.Conclusions: Dry eye is the most commonly reported ocular side effect. Other less common, but more serious, ocular side effects including vision changes can occur. We recommend that isotretinoin prescribers monitor for dry eye. Limitations include the heterogeneity of reported incidences of ocular side effects between studies.

Skin cancer prevention: knowledge and perceptions of a nationwide sample of youth.

Context: Skin cancer is the most common type of cancer in the United States and incidence continues to rise. The leading risk factor for skin cancer is sun exposure in adolescence. Given this, sun protection in young adults is an effective way to reduce the occurrence of skin cancer. The goal of this study is to identify knowledge, behaviors, and barriers among young adults toward the use of sunscreen. Primary care physicians interact with a large number of young adults and have the ideal opportunity to counsel this population. Objective: To identify youths' knowledge and experiences with sun protection and elicit recommendations to increase protection usage. Study Design: Data was obtained using MyVoice, a national poll of youth (www.hearmyvoicenow.org). Five open-ended questions were sent via text message to 1,151 youth on April 9, 2021. Responses were analyzed by two independent investigators after using a modified grounded theory approach to iteratively develop codes based on salient themes. Setting: Participants are youth from the United States aged 14-24 years old who were recruited from social media to meet national benchmarks based on weighted samples of the American Community Survey. Results: Of 1,151 youth, 977 responded to at least one question (response rate= 84.9%). Respondents' mean age was 19.3 years (SD=2.4), 48.1% identified as male, and 62.2% as non-Hispanic white. Nearly all respondents stated "It is very important" or "It's important!" (62.1%, 25.5% respectively) to protect your skin from the sun. The most frequently reported reason for using sun protection was to "reduce the risk of getting skin cancer" (51.7%). Nearly all (90.1%) youth reported use of sunscreen, but 81.1% of respondents have had at least one sunburn and 28.4% have had 5 or more "Many [sunburns], and yes some have blistered". Participants commonly recommended emphasizing the consequences of sun exposure to encourage sun protection use, "Inform people about the dangers of not wearing sun protection" (41.1%). Conclusions: Youth in our nationwide sample understand both the short and long term risks of sun exposure and believe that sun protection is important. Though nearly all reported sunscreen use, youth struggle with implementation of consistent sun protective behaviors with a large number reporting numerous sunburns. These youth reported insights can inform more effective strategies to improve the use of sun protection by youth.

Microbial Metabolite Signaling Is Required for Systemic Iron Homeostasis.

Iron is a central micronutrient needed by all living organisms. Competition for iron in the intestinal tract is essential for the maintenance of indigenous microbial populations and for host health. How symbiotic relationships between hosts and native microbes persist during times of iron limitation is unclear. Here, we demonstrate that indigenous bacteria possess an iron-dependent mechanism that inhibits host iron transport and storage. Using a high-throughput screen of microbial metabolites, we found that gut microbiota produce metabolites that suppress hypoxia-inducible factor 2α (HIF-2α) a master transcription factor of intestinal iron absorption and increase the iron-storage protein ferritin, resulting in decreased intestinal iron absorption by the host. We identified 1,3-diaminopropane (DAP) and reuterin as inhibitors of HIF-2α via inhibition of heterodimerization. DAP and reuterin effectively ameliorated systemic iron overload. This work provides evidence of intestine-microbiota metabolic crosstalk that is essential for systemic iron homeostasis.