News|Articles|April 16, 2026

Patients With Scarring Alopecia Value Expertise of Specialist Dermatologists

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Key Takeaways

Diagnostic ambiguity and shifting clinical features in scarring alopecia increase misdiagnosis risk, delaying effective intervention and necessitating careful clinicopathologic correlation in the absence of FDA-approved therapies.
CAPAIR respondents rated hair specialist dermatologists far higher than generalists for “excellent” disease knowledge (56.3% vs 10.5%) and treatment knowledge (51.7% vs 8.4%).
Patient experience measures favored specialists, including “excellent” explanations (47.8% vs 12.4%) and time answering questions (49.4% vs 8.4%), alongside greater perceived empathy and collaboration.
Care by hair specialists correlated with higher medication counts (2.36 vs 1.95) and more frequent topical minoxidil prescribing, with a trend toward increased oral minoxidil use.
Management should integrate multidisciplinary support and structured, patient-centered counseling to address substantial psychosocial burden and improve outcomes in a therapeutically off-label landscape.

Patients who saw hair specialist dermatologists tended to be prescribed more therapies for their scarring alopecia.

Many patients with scarring alopecia say they feel more confident in their care when they see a dermatologist who is a hair specialist, as opposed to a generalist, according to a new report. The findings were presented in a poster at the American Academy of Dermatology’s 2026 Annual Meeting.¹

The authors noted that scarring alopecia can be a challenging condition for physicians. Diagnosing scarring alopecia can be difficult for both dermatologists and pathologists, as clinical signs can change and overlap with other potential diagnoses. A misdiagnosis can lead to an inappropriate and ineffective therapy choice and delay effective treatment.²

Once the condition is correctly diagnosed, clinicians must rely on off-label therapies, since there are no FDA-approved therapies for the condition. In addition, patients with scarring alopecia often face a significant psychosocial burden, a fact that the authors noted should inform patient care.¹

Due to the particularity of the disease and the difficulty of its treatment, the authors aimed to better understand how the experiences of patients differed when they saw a hair specialist dermatologist (HSD) compared to a general dermatologist (GD). They decided to use data from the Cicatricial Alopecia Patient Assessment and Impact Report (CAPAIR), which was conducted by the Scarring Alopecia Foundation. The survey included 1047 patients with scarring alopecia, the vast majority of whom were female (97.4%). The patients’ mean age was 57.8 years.

Approximately half of participants (52.4%) reported having seen an HSD, and 81.8% said they had seen a GD. Approximately one-third of patients said their most recent visit was with an HSD, compared to 63.9% who said their most recent visit was with a GD.

The patients tended to feel that HSDs were more knowledgeable about scarring alopecia than GDs. For instance, 56.3% of respondents who saw an HSD rated their doctor’s knowledge of scarring alopecia as “excellent,” compared with 10.5% of respondents who saw a GD. Similarly, 51.7% of participants who saw an HSD said their clinician’s knowledge of treatments for scarring alopecia was “excellent,” compared with 8.4% of those who saw a GD.

Participants also said HSDs were more empathetic, more willing to collaborate, and had better knowledge of scarring alopecia support groups.

Nearly half of respondents who saw an HSD (47.8%) said their doctor gave “excellent” explanations, and 49.4% said their doctor spent an “excellent” amount of time answering questions. Among patients seeing GDs, the rates of “excellent” scores were 12.4% and 8.4%, respectively.

The authors also found that patients seeing HSDs tended to have higher numbers of medications. On average, patients seeing an HSD had 2.36 medications prescribed, compared to 1.95 among people seeing a GD. HSDs were more likely to prescribe topical minoxidil, and there was a trend toward an increased likelihood of prescribing oral minoxidil, the authors said.

Though the investigators said their findings are on some level intuitive, they highlight the importance of a multidisciplinary approach to scarring alopecia management and the need for dermatologists to remain well-informed and integrate patient-centered alopecia counseling into alopecia care.

References

1. Zappi I, Maas D, Spindler A, et al. Impact of hair specialist dermatologists in optimizing treatment and patient experience in scarring alopecia. Poster presented at: American Academy of Dermatology Annual Meeting; March 27-31, 2026; Denver, CO. Poster 75983.

2. Cummins DM, Chaudhry IH, Harries M. Scarring alopecias: pathology and an update on digital developments. Biomedicines. 2021;9(12):1755. doi:10.3390/biomedicines9121755