Dermatologist Matthew J. Zirwas, M.D., says it would be shocking if a day went by when he didn’t use one of these therapeutic approaches in practice. After all, each meets his criteria for being cheap, safe and making sense. The following treatments are so cheap that they don’t need prior authorizations and patients can afford them. They’re safe, with no significant risks. And they make sense, meaning there is either a good study showing they work or there is a good rationale behind them.
Even if they’re not efficacious, they are cheap and safe and patients at least get a placebo effect, according to his presentation “Therapeutic Approaches You Probably Haven’t Heard of but May Actually Use,” which Dr. Zirwas gave at the 2020 Congress of Clinical Dermatology in Sandestin, Ga., in August. Yet, most dermatologists don’t know the options exist.
Dr. Zirwas, director of the Ohio Contact Dermatitis Center in Columbus, said he has been using these therapeutic approaches for years—sometimes decades. They are his go-to treatments where better options don’t exist.
“I probably read a few hundred articles in the literature each week. Based on those, I make hypotheses and try them in practice,” he said. “I’m constantly trying new things for conditions where there are no good treatment options. I can’t emphasize that enough. If I already have good treatments for something that are supported by data and evidence in trials, I’m going to use those treatments. I’m not trying to reinvent the wheel.”
Minoxidil for chronic telogen effluvium Chronic telogen effluvium is among the more challenging conditions that dermatologists treat. It’s distressing for patients, but oral minoxidil has helped to change that, according to Dr. Zirwas.
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It’s dirt cheap, completely safe and there’s good rationale. The skin is supposed to be a pH of 5 to 6. Inflamed skin has a higher pH, so restoring that natural acidity makes sense.”