Maria Hordinsky, MD: Early Clue in Scarring Alopecia May Change Clinical Approach

At the 2025 Society of Dermatology Physician Associates (SDPA) Annual Summer Dermatology Conference, Maria Hordinsky, MD, R.W. Goltz Professor in the Department of Dermatology at the University of Minnesota, led a session titled “Spotting Scarring Alopecia Early: Clues, Challenges, and Clinical Pearls.”

In a post-session interview, Hordinsky shared a clinical insight that she says can change how dermatology clinicians approach patients with scarring alopecia in day-to-day practice.

“I think it’s really important to recognize that when you’re working with a patient that has a scarring alopecia, and you are doing all the right things, all the things that are in the algorithm for the treatment of a scarring alopecia, and your patient does not get better, then you have to think about allergic contact dermatitis,” said Hordinsky.

She emphasized that even when clinicians follow established treatment pathways, improvement may stall due to undiagnosed allergies to components of prescribed medications or injection preparations.

“Sometimes the treatments that we prescribe or the injections that we do have chemicals in them your patient might be allergic to,” she explained. “It’s very important to recognize if you’re doing everything you can, the patient’s not getting better, then it’s time to investigate with testing to figure out if there’s something the patient’s coming in contact with that’s driving this process.”

In addition to her clinical pearl, Hordinsky commented on the momentum in hair loss research, particularly for scarring alopecias.

“The wrap up is really that hair is hot, and there’s a lot of research that’s going on right now in hair diseases,” she noted.

However, she also emphasized the need for further clinical trials.

“There needs to be more research in the scarring hair diseases in the sense that we need really good, standardized clinical trials to really prove that certain treatments work or don’t work,” she concluded.

Considering allergic triggers may not only improve outcomes but prevent unnecessary treatment escalation.

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