Dermatologist discusses emerging treatments in LGBTQ+ healthcare
“LGBTQ+ individuals are at higher risk for STIs than the general public, and it’s important for patients to know that there are new treatments available that can improve their health and quality of life,” said board-certified dermatologist John Zampella, MD, FAAD, an associate professor of dermatology at New York University School of Medicine in New York, speaking at the American Academy of Dermatology’s 2024 Annual Meeting. “Dermatologists are the experts in the diagnosis and treatment of many sexually transmitted infections like syphilis, HPV, and herpes that often have skin related symptoms.”
New treatments include an FDA-approved injectable medication that individuals can take prior to HIV exposure that can provide protection from contracting HIV for up to two months—a potential advantage for patients who may not like taking a daily pill. Additionally, the CDC has approved guidelines suggesting doxycycline, an oral antibiotic which is often used to treat other dermatologic conditions, may be useful for preventing bacterial sexually transmitted diseases like syphilis, chlamydia, and gonorrhea, and can be taken after potential STI exposure. Both medications, Dr. Zampella remarked, are important breakthroughs to help minimize exposure to HIV and other STIs.
Recent reports are highlighting new types of fungal infections, such as ringworm, that are spreading among gay and bisexual men and may be sexually transmitted. These new types of fungi are resistant to some commonly used antifungal treatments and patients may require a longer period of treatment, noted Dr. Zampella. If patients experience a spreading rash in the groin or on the buttocks that is not responding to treatments, patients should consider seeing a board-certified dermatologist for evaluation.
One of the most common dermatologic conditions the New York board-certified dermatologist sees in his clinic among his LGBTQ+ patients? Acne — a skin condition that affects more than 80% of people at some point in their lives.
“Acne in transgender individuals can be challenging to treat on your own because the cause is often a result of hormone therapy,” said Dr. Zampella. “In these patients, the acne can be severe and the hormones life-long, so these individuals often need the support of a dermatologist.”
To effectively treat acne caused by hormone replacement therapy, Dr. Zampella often recommends isotretinoin, an acne medication used for severe cases, to help clear his patients’ skin.
Another key aspect of transgender patient care is aligning appearance with gender identity, with hair growth and removal being a frequent priority for transgender and gender diverse (TGD) patients going through hormonal changes and medication side effects. To assist TGD individuals in aligning their gender identity with their gender expression, dermatologists provide a variety of gender affirming hair removal (GAHR) procedures, including electrolysis and laser hair reduction. Hair removal can also be an essential step in the gender reassignment process.
“Hair growth is often a goal in transgender men and can be challenging to address,” the New York board-certified dermatologist stated. “While numerous hair loss treatments are available, dermatologists are finding that using therapies like oral minoxidil, a common blood pressure medication, are showing potential for improving hair growth.”
He added, “Similarly, in many transgender women, hair on the face does not align with their gender identity and laser hair reduction is often sought.”
Dermatologists use lasers to remove unwanted facial and body hair safely and effectively with results appearing in 6 or more sessions.
“As with any patient population, the ability to engage patients in an understanding and culturally competent way helps improve their quality of care,” said Dr. Zampella. “A board-certified dermatologist is not only able to develop individualized treatment plans that work for each patient but is also an effective partner who can help those seeking to align their gender identities.”
To find a board-certified dermatologist in your area, visit aad.org/findaderm.
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About the AAD
Headquartered in Rosemont, Ill., the American Academy of Dermatology, founded in 1938, is the largest, most influential and most representative of all dermatologic associations. With a membership of more than 20,800 physicians worldwide, the AAD is committed to advancing the diagnosis and medical, surgical, and cosmetic treatment of the skin, hair, and nails; advocating high standards in clinical practice, education and research in dermatology; and supporting and enhancing patient care because skin, hair, and nail conditions can have a serious impact on your health and well-being. For more information, contact the AAD at (888) 462-DERM (3376) or aad.org. Follow @AADskin on Facebook, TikTok, Pinterest and YouTube and @AADskin1 on Instagram.
Editor’s note: The AAD does not promote or endorse any products or services. This content is intended as editorial content and should not be embedded with any paid, sponsored or advertorial content as it could be perceived as an AAD endorsement.
