Alopecia is associated with significant psychological burden. There is limited evidence on the use of psychological interventions in conditions of hair loss. This manuscript systematically reviews the current state of literature on psychological treatments for quality of life, mental health, and hair growth in various forms of alopecia. PubMed and Embase were searched with predefined inclusion and exclusion criteria. Reference lists were also examined for relevant studies. Nine articles met our criteria and are included in this review. Eight of the articles related to alopecia areata and one related to scarring alopecia. Mindfulness-based stress reduction (MBSR) was found to improve quality of life-related subjective symptoms, relationship impacts, anxiety, phobia, distress, and psychological symptom intensity. Alopecia-specific collocated behavioral health (CLBH) treatment showed a trend for psychosocial improvement in areas such as appearance shame, activity avoidance, negative emotions, and coping. Hypnotherapy was found to improve anxiety and depression, quality of life measures, and alexithymia. There was also some evidence for significant hair growth with hypnosis, but the data are mixed. Psychotherapy combined with immunotherapy led to more hair growth, and supported self-confidence. Finally, coping strategies modulated the subjective burden of alopecia, and were associated with disease improvement. Further research will be necessary to better establish the efficacy and optimal administration of these interventions in alopecia.
Background: Although skin cancer is less common, minorities present with more advanced stages at diagnosis and have worse outcomes. Literature on this disparity is limited.Objective: To evaluate attitudes influencing sun protective behaviors, skin cancer risk perception, and dermatologist access among an underserved, racially/ethnically diverse community.Methods: A cross-sectional survey of patients at 5 ethnically diverse student-run, free primary care clinics in Sacramento, California.Results: 390 surveys were collected with a response rate: 86.4%. Overall, respondents did not use sunscreen, rarely sunburned, were unsure or perceived themselves at low risk for skin cancer and reported limited access to dermatologists. Compared to Whites, Latinos were likely to believe it was not worth getting sunburned to be tan (OR = 24.43, 95% CI: 9.37 to 63.3, P < 0.0001). Whites were more likely than Asians (OR = 3.69, 95% CI: 1.50 to 9. 11, P = 0.004) and Latinos (OR = 4.83, 95% CI: 1.83 to 12.8, P = 0.001) to perceive access to dermatology care.Limitations: Response bias, sampling bias, generalizabilityConclusions: Ethnic groups differ in knowledge of sun protection and self-perceived skin cancer risk. The Latino community showed discrepancies between sun protection knowledge and practices, serving as an interventional target.
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