LGBT people can face unique skin health challenges

Gay and bisexual people, as well as those undergoing gender transition, could face unique dermatological issues, an expert says.

Board-certified dermatologist Dr. John Zampella, who runs a clinic in New York City that caters to many LGBTQ+ patients, said the risk for sexually transmitted infections is higher among this group and can sometimes lead to skin complications.

"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," Zampella explained at the American Academy of Dermatology annual meeting in San Diego.

There are recent reports on the emergence of fungal infections, such as ringworm, that could also be sexually transmitted among gay and bisexual men.

These typically appear as a spreading rash in the groin or buttocks area, and should be examined by a physician such as a dermatologist, Zampella said. Strains of these infections often prove resistant to traditional antifungal meds and may take longer to treat.

The best way to stop many STIs is prevention, of course. As Zampella noted, pre-exposure prophylaxis (PrEP) antivirals are now available as injections that can provide users with two months of protection against HIV.

The U.S. Centers for Disease Control and Prevention has also approved the antibiotic doxycycline, taken within 72 hours of having sex, as a preventive measure against syphilis, chlamydia and gonorrhea.

Apart from STIs, transgender people often face the dermatological issues of acne and unwanted hair growth, Zampella noted.

"Acne in transgender individuals can be challenging to treat on your own because the cause is often a result of hormone therapy," Zampella noted in a meeting news release. "In these patients, the acne can be severe and the hormones lifelong, so these individuals often need the support of a dermatologist."

He said that in many cases isotretinoin (Accutane), can help clear patients of problem acne.

Hormonal and medication side effects can also bring on unwanted hair growth in transgender people, as well. According to Zampella, many dermatologists now include laser hair removal or electrolysis to help these patients.

"In many transgender women, hair on the face does not align with their gender identity and laser hair reduction is often sought," he explained. Results are often seen within six sessions.

In other cases, hair growth is desired.

"Hair growth is often a goal in transgender men and can be challenging to address," Zampella said. "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."

"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," Zampella said.

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