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Top Black Hair Loss Videos and Black Hair Loss Treatment Videos on YouTube

By | Aesthetic Dermatology, Media Coverage, Medical Dermatology, Sessions, Skin of Color Update Agenda | No Comments
Thin on Top Abstract Image

Next Steps in Derm recently published a highlight from the Skin of Color Update Virtual 2020 poster session.

Thin on Top: A Cross-Sectional Analysis of the Top Black Hair Loss Videos and Black Hair Loss Treatment Videos on YouTube

Esther B. Henebeng BS¹, Uzoamaka Okoro MD, MSc², Ogechi Ezemma BA¹, Kristina Monteiro PhD¹, Afiya M. Mbilishaka PhD³, Chesahna Kindred MD, MBA4
¹The Warren Alpert Medical School, Brown University, Providence, RI, ²Dwight D. Eisenhower Army Medical Center, Fort Gordon, GA, ³University of the District of Columbia, Washington, DC,4Howard University College of Medicine, Washington, DC

Introduction

Alopecia, or hair loss, is a prevalent concern for both men and women, that has substantial impact on quality of life.¹ Many forms of alopecia in Black women are associated with or worsened by traumatic styling practices such as braiding, weaving, thermal or chemical hair straightening. Therapy is tailored to the specific diagnosis and can include altering haircare practices, topical or oral medications (ex. minoxidil), and in-office treatments (ex. intralesional injections, hair transplant).² However, studies have shown a considerable amount of Black women are concerned physicians may not understand their hair and fail to engage in discussions about hair issues for this reason.³ More than 50% of Black women experience hair loss, with a majority of women searching for treatment options from online resources instead of seeking care from a primary care physician or dermatologist.4 YouTube is one of the most frequently used websites, with 77% of Black adults using the social media platform.5 Although dermatologists have established an online presence, approximately 75% of the top dermatology-related videos on YouTube are from non-dermatologist sources.6 This is particularly concerning because videos from third parties have been found to suffer from incomplete information, overall poor quality, and can contribute to potential harm or delay in appropriate diagnosis.6,7

Behbahani et al showed that YouTube is a highly utilized resource for hair loss treatment information, but found no significant difference between the overall quality of board certified dermatologist and non-physician videos.7 However, videos from lay media or individuals have been shown to have lower accuracy in comparison to videos from health care sources.8 Examination of top YouTube videos regarding “hair” and “hair loss” demonstrated very few videos displaying more textured or tightly coiled hair types associated with Black hair. Consequently, our project will evaluate the accuracy, quality, viewer engagement, and viewer experience of “Black hair loss” and “Black hair loss treatment” videos on YouTube.

Objectives

    • Evaluate the accuracy of Black hair loss and Black hair loss treatment videos on YouTube in comparison to published, peer-reviewed articles found via PubMed literature review
    • Compare the quality, viewer engagement, and viewer experience of non-health care and health care sources

Methods

YouTube was searched for the following: “Black hair loss” and “Black hair loss treatment” on June 18, 2020. The first 60 videos per search term were examined and categorized into health care or non-health care sources. Two independent raters evaluated each video with four validated instruments: 1) Accuracy in Digital Health, 2) Accuracy Scale, 3) Armstrong Viewer Assessment, and 4) Global Quality Scale.8 Viewer engagement ratio was defined as (number of likes + dislikes + comments) / total views. Discrepancies between coders were resolved through discussion. Duplicate and non-English videos were excluded. Significant differences between health care and non-health care sources were determined using Mann- Whitney U test.

Results

Our search yielded a total of seventy-eight unique YouTube videos. Three videos made no claims to assess accuracy and were excluded from analysis (*).

Twenty-two (28.2%) of the videos were from health care sources and fifty-six (71.8%) from non-health care sources. Health care sources were made up of dermatologists, nondermatologist medical doctors, and university/professional organizations. Non-health care sources included individuals, hairstylists, companies, and lay media. Speakers in 45 of the YouTube videos (57.7%) self-identified as Black based on video content or a publicly accessible social media post. Of the 45, there were only 2 videos categorized as health-care sources that had a self-identified Black speaker.

Discussion

There are over 20 million total views for the top 78 videos on Black hair loss and Black hair loss treatment. These videos typically range from 1 minute to 10 minutes long, with varying levels of engagement. Videos by Black speakers were found to have higher levels of engagement (0.02 ± 0.02, P = <0.001). Many of the videos by non-health care sources were inaccurate or made claims with no evidence supported by PubMed literature review. A few speakers encouraged viewers to try potentially harmful practices to stimulate hair growth (ex. Vicks VapoRub to scalp, prolonged protective styles, intermittent fasting or detoxing). When compared to non-health care sources, health care sources had lower mean numbers of views (81,965 vs 330,113, P = 0.008). Furthermore, health care sources were less engaging than non-health care sources (0.01±0.01 vs 0.02 ±0.02, P = 0.012), but more accurate (Accuracy in Digital Health: 3.77 ±0.43 vs 2.00 ±1.57, P = <0.001; Accuracy Scale: 3.91 ±0.30 vs 2.15 ±1.25, P = <0.001). Most inaccuracies from health care sources were primarily associated with the promotion of a product or treatment that does not have proven efficacy. Fewer inaccuracies were related to incorrect comments regarding hair physiology and causes of hair loss. Nevertheless, health care sources provided a superior viewer experience (Armstrong Viewer Assessment: 3.09 ±0.53 vs 2.55 ±1.01, P = 0.023) and were of higher quality (Global Quality Scale: 3.64 ±0.85 vs 2.47 ±1.09, P = <0.001) in comparison to non-health care sources.

Conclusion

    • Social media platforms can improve a patient’s access to care and serve as an inclusive environment to share educational content.
    • Our findings suggest that many of the top YouTube videos on “Black hair loss” and “Black hair loss treatment” are inaccurate.
    • Health care sources should be cautious when suggesting products or treatments that are not evidence-based.
    • Even though health care sources were more accurate, they had less viewer engagement when compared to non-health care sources.
    • The data supports the need for further diversity in dermatology as Black speakers were found to have greater levels of engagement and participation.
    • Lastly, our results also underscore the need for dermatologists to work in tandem with non-health care sources (ex. hairstylists) who may have a larger following on social media in order to dispel misinformation online.

Click here to view the full summary and images

Challenging Cases in Skin of Color Dermatology Patients

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Skin of Color patient dermatology cases

Source: Next Steps in Derm

This year at the 17th Annual ODAC Dermatology, Aesthetic & Surgical Conference (ODAC), Dr Amy McMichael presented the audience with new pearls of advice on how to approach and diagnose complex medical dermatology cases in patients with skin of color. During her session, she addressed the important need for providers to be able to recognize disease in patients of all races. The majority of the global population consists of people with skin of color and the US population is changing to include a higher percentage of patients with diverse backgrounds. She covered a wide range of diagnoses from psoriasis to melasma and how these may present differently is darker skin types. As she walked the audience through each case it became apparent that being able to recognize and treat certain conditions in patients with skin of color is not only essential but also complex in nature.

First, Dr McMichael summarized the top conditions that African American patients were evaluated for during a dermatologist visit. The top 6 conditions included:

This helped to set the scene for the first case involving a 40-year-old African American female with hidradenitis suppurativa presenting with draining gluteal plaques. Even though the biopsy showed granulomatous dermatitis, the patient was not improving with multiple treatments and developed worsening pain and drainage from gluteal plaques. On a second biopsy the pathology showed psoriasis with granulomatous changes. The patient eventually improved with the systemic treatment Humira, a TNF-a inhibitor. Her major takeaways from this case included:

  • Do a second biopsy if the patient’s skin is not responding as expected to the treatment you have prescribed
  • Psoriasis can have a unique presentation similar to existing hidradenitis
  • Use systemic treatments early to help control symptoms

Second, she tackled the challenge of treating melasma with combination therapies. In melasma, there is too much melanin being created by melanocytes and it is then carried by keratinocytes. These cells then release melanin into the dermis, causing blotchy pigmentation often on the face. Topical therapies are usually directed towards preventing increased creation of melanin by melanocytes. People often use hydroquinone 2% or 4% along with encouragement of consistent daily sunscreen use. If used at too high of a concentration, then hydroquinone may cause ochronosis (skin becomes bluish – grey).

Dr McMichael suggested adding a novel treatment called cysteamine to the regimen for melasma treatment for more effective results. Cysteamine is an aminothiol that is made in our cells from the amino acid cysteine. Although more interest is arising now for its use in treating melasma, cysteamine was actually researched in 1966 when scientist Dr Chavin injected it into black goldfish skin and observed partial depigmentation. Cysteamine 5% cream may be a more effect treatment for melasma with less side effects.

Another novel treatment Dr McMichael discussed was the use of tranexamic acid for resistant melasma. This is another derivative of an amino acid, lysine, and it works as an anti-fibrinolytic. It has the ability to block UV-induced plasmin activity within keratinocytes. Patients would need to be screened out by their providers for a past medical history of DVT, pulmonary embolism, heart disease, and stroke before starting the oral medication. She emphasized the importance of getting a good medical history related to these conditions since tranexamic acid could increase the risk of these conditions. For patients who are able to take the medication they are expected to experience a few side effects such as mild GI upset and palpitations. This medication could provide improvement for many patients with chronic melasma who have had to struggle with this condition.

Third, in the next case we were reminded by Dr McMichael that keloids can be very disfiguring and distressful to patients. She talked about using intralesional Kenalog with contact cryotherapy as effective treatments of keloids. Other options for treatment included combining cryosurgery, intralesional Kenalog, and doxycycline. It was eye opening for the audience to hear her say we should be thinking about keloids not just as scars but tumors representing overgrowth of tissue. This paradigm shift of how we think about keloids can further shape how we think about treatment modalities for keloids as well.

Read More….

Skin of Color Update Skin Lightening

Skin Lightening in Skin of Color: What You Need to Know

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The following is an excerpt from Next Steps in Dermatology based on a Pearl Grimes, MD lecture at Skin of Color Update 2019.

The topic of skin lightening can be very controversial, but the reality is that there is a large market for skin lightening and learning to treat patients in the safest way is the priority. At the 2019 Skin of Color Update, a lecture on skin lightening included panelists: Dr. Eliot Battle, Dr. Pearl Grimes, and Dr. Cheryl Burgess and featured their approaches to skin lightening.

  1. Skin lightening is still very common.
  2. Hydroquinone is still the gold standard.
  3. New therapies are on the horizon.
  4. More research needs to be done on glutathione.

Check out the full article on Next Steps in Derm for a more in-depth look.

Aesthetic Skin of Color

Consensus and Misconceptions Regarding the Aesthetic Skin of Color Consumer

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Each month the Journal of Drugs in Dermatology JDD Podcast discusses a current issue in dermatology. During the month of September, podcast host Dr. Adam Friedman sat down with Skin of Color Update 2019 co-chair and co-founder,  Dr. Andrew Alexis, Chair of Dermatology at Mt. Sinai St. Lukes and Mount Sinai West to discuss misconceptions regarding the aesthetic skin of color consumer.

Dr. Angela Hou, PGY-3 dermatology resident at George Washington University School of Medicine and Health Sciences, shares key takeaways from Dr. Alexis’ JDD podcast titled ‘Capturing Consensus and Cutting Out misconceptions regarding the Aesthetic Skin of Color Consumer’.

Here is an excerpt recently published on our media partner, Next Steps in Dermatology.

Key Takeaways

  • There has been a rapid increase in the past 10 years in Fitzpatrick Skin Type IV-VI patient’s seeking aesthetic skin care, however the guidelines for skin of color is limited and more clarification and guidance is needed
  • This article helps reduce the gap in knowledge in regard to skin of color. This was difficult given the lack of evidence-based studies, therefore expert consensus was necessary for deciding on recommendations.
  • A common myth is that darker-skinned patients of African descent do not seek or need injectable fillers of the lips. Although lip enhancement is less common than in other populations, restoration of lip volume is still an important aesthetic concern, albeit at an older age than among Caucasian patients
  • Another knowledge gap is regarding skin of color patients with a history of keloids and the risks of developing keloids after filler injections. However, per the expert consensus, there are no known cases of keloids induced by soft tissue filler injections. Therefore, keloids should not be an absolute contraindication to fillers and should be evaluated on a case-by-case basis.
  • To read more of the key takeaways and words from the investigator, read the full article here.

To hear the JDD podcast, click here.

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Hair and scalp at skin of color

Hair and Scalp Disorders at the 2019 Skin of Color Update

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Heather Woolery-Lloyd, MD lectured on hair and scalp disorders at Skin of Color Update 2019.  Kimberly Huerth, MD, M Ed, provided top tips and salient pearls from the lecture in the Next Steps in Derm article.  Missed this lecture? Purchase it on-demand

Treatment Strategies for Hair and Scalp Disorders: Biotin & Beyond

By: Kimberly Huerth, MD, M Ed

A full head of hair. This is how I came away from Dr. Heather Woolery-Lloyd’s lecture on hair and scalp disorders at the 2019 Skin of Color Update. There were many aspects of her talk that challenged me to rethink how I approach the management of hair loss in my patients. In this post we will cover biotin’s role in treating alopecia, and important considerations in the treatment of central centrifugal cicatricial alopecia (CCCA)—two topics that Dr. Woolery-Lloyd took a deep dive into during her lecture.

So I have a potentially hair raising confession to make…I might start recommending biotin again to my alopecia patients! I have previously written about the use of biotin in the treatment hair loss, the gist of it being—don’t. The don’t is because most individuals are not biotin deficient, there are potential risks associated with supplementation (such as effects on the results of thyroid function and troponin testing), and scientific data supporting the use of biotin to promote hair growth are weak unless there is a proven biotin deficiency. But Dr. Woolery-Lloyd discussed the results of a recent study out of Switzerland that lead me to question whether I might want to rethink my previous stance on biotin—Bad hair day for me!

Biotin is a coenzyme that plays a role in protein synthesis, including the production of keratin (which explains its contribution to healthy nail and hair growth). Primary and secondary biotin deficiencies are both considered very rare. Secondary biotin deficiency is thought to be rare because our intestinal flora produce more than our daily requirement. However, there are certain risk factors that may predispose an individual to a secondary biotin deficiency, including gastrointestinal disease, certain medications (isotretinoin, antibiotics, anti-epileptics), smoking, alcoholism, advanced age, extreme athleticism, pregnancy, and lactation. Moreover, serum biotin levels can demonstrate daily fluctuations of up to 100%, which is important to keep in mind when trying to identify which patients have suboptimal or deficient levels of biotin.

Let’s examine this study with a fine toothed comb. Read more on NextStepsinDerm.com 

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Skin of Color update Medical Student scholarship for diversity

Skin of Color Update Offers Medical Student Scholarships

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By Lola Adenkule, MD and Skin of Color Update staff

Skin color comes in all shades. Similarly, dermatologists should reflect the diversity that is apparent in our patients. However, in the US, African-Americans make up 12.8% of the population while there are only 3% of Black dermatologists. Addressing this gap is beneficial because studies have shown race-concordant visits are longer and have higher levels of patient satisfaction and patient engagement.

Closing this gap could likely increase access to care for minority patients, greater interest and attention to diseases that disproportionately affect minorities, and create a more diverse work force of dermatologists. The challenge becomes how do we turn the tide. Expert faculty members from the Skin of Color Update have weighed in to offer their solutions to identifying barriers and the ways to overcome them. To read these solutions from the experts, visit this Next Steps in Derm article by Lola Adenkule, MD.

To help address this gap in dermatology, Skin of Color Update 2019 increased their scholarship program for medical students, fellows and dermatology residents. Scholarship awards were provided to 7 medical students, residents and fellows with an interest in dermatology or currently enrolled in dermatology training.

SOCU Experts

Susan Taylor, MD, Andrew Alexis, MD,MPH,  Heather Woolery-Lloyd, MD and Maritza Perez, MD were among the Skin of Color Update 2019 faculty experts to spend time with the scholarship awardees.

Apply for 2020

If you are currently a medical student or dermatology resident interested in applying for Skin of Color Update 2020 scholarships please continue to check back for additional information. When information is available, here are the items you may need to be considered.

  1. Letter of recommendation
  2. C.V.
  3. Letter describing why you want to come to Skin of Color Update

 

 

 

Eliot Battle discusses Skin of Color Updates in 2019

Skin of Color Update 2019 Press Coverage

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NEW YORK (Oct. 16, 2019) Skin of Color Update 2019 continues to receive media coverage from various publications after producing a sold out event.  Skin of Color Update, Sept. 7 & 8, 2019, held at the Crowne Plaza Times Square, hosted an expert faculty with 2 days education, networking and discovery.  This 2-day event attracted over 300 dermatology providers from all over the US. Purchase Skin of Color Update On-demand here.

See what the media has to say about the event and register for Skin of Color Update 2020 before it sells out.

  • The Dermatologist covered Wendy Roberts, MD session on Hair and Scalp Disorders: A Review of Alternative Therapies
  • In an interview with The Dermatologist, Skin of Color Update presenter Cheryl M. Burgess, MD, discusses her lecture on common cosmetic concerns among patients with skin of color and the importance of recognizing adverse reactions. Read more.
  • Sun protection in Skin of Color patients still matters. Find out what Henry Lim, MD had to say in an interview with The Dermatologist regarding his lecture at Skin of Color Update 2019.  Read more.
  • Skin of Color Update speaker Theodore Rosen, MD presented on hidradenitis suppurativa in the black community and the improvement of disease control.  Read an overview of his session here.
  • Andrew Alexis, MD presented clinical findings on new drugs that particularly benefit skin of color patients with acne. Read the overview on Dermatology News.
  • Skin of color poses some unique challenges when it comes to diagnosing atopic dermatitis (AD). In a recent interview, co-founder and co-chair Andrew Alexis, MD discusses his challenges and pearls for treating AD in skin of color.  Read more.
  • Dermatology News recently covered Wendy Roberts, MD Skin of Color Update 2019 presentation on combination treatments for pseudofolliculitis barbae.  Read the interview and more here.
  • Whitening of skin remained charged topic at the recent Skin of Color Update, co-founder and co-chair Eliot F. Battle, Jr. MD lead the discussion with an interesting expert opinion on the topic.  Read more.

Register for Skin of Color Update at the Sheridan Times Square, September 12 and 13, 2020.

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Andrew Alexis atopic dermatitis skin of color lecture

Treating Atopic Dermatitis in Patients With Skin of Color

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The Dermatologist recently featured an interview with Dr. Andrew Alexis, Skin of Color Update co-founder and co-chair, regarding his lecture on challenges and pearls of treating atopic dermatitis (AD) inpatients with skin of color.

Associate Editor, Melissa Weiss posed the following questions:

  • What are some of the challenges for diagnosing AD in patients with skin of color?
  • What are your recommendations for clinically assessing AD in patients with skin of color?
  • What are your recommendations and treatment considerations for AD?
  • Do you discuss options for a patient who want to treat AD-associated pigmentary changes?
  • Are there any other key takeaways you would like dermatologists to leave our audience with?

 

Visit The Dermatologist to read Dr. Alexis’s answers and more.

Missed Skin of Color Update 2019? Purchase this lecture and more on-demand.

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Skin Lightening at Skin of Color Update Eliot Battle

Skin Lightening in Skin of Color Remains Charged Topic

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We recently hosted an expert panel discussion on the topic of skin lightening in skin of color at the 2019 Skin of Color Update.  Skin of Color Update co-chair and co-founder, Eliot F. Battle, MD took an informal audience poll and the results will surprise you.

“How many of you think total body skin whitening is wrong?” Dr. Battle asked the audience for a show of hands.  The majority of the audience raised their hand.

“How many think breast augmentation is wrong?” he asked. “How many think changing your hair color is wrong? Before we cast judgment, let’s think a little about how our patients feel.”

Should physicians provide total body skin whitening for cosmetic purposes or should skin lightening be provided only for clinical indications, like melasma?

Dr. Pearl Grimes and Dr. Cheryl Burgess weighed in on this charged topic to provide compelling commentary.  Read their insights and more here. Coverage provided by MDedge |Dermatology.

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