Explore every episode of the podcast Derms on Drugs

Dr. Jason Hawkes makes the case for putting speed first when choosing an advanced treatment for CSU. Remibrutinib works fast—but can he convince the Derms that fast is reason enough to put it first?

The Derms size up high-dose vitamin D, a head-to-head lichen planus trial, and whether contact dermatitis testing is overcalling the culprit.

The Derms question treatment monogamy: a personalized melanoma vaccine joins forces with immunotherapy, while dual therapy takes on refractory HS and AD.

In Utah, AI is getting its hands on the prescription pad—starting with topical acne treatment. The Derms grill Nolla’s CEO on the big questions: Who catches the misses, and is this better access or the beginning of the robot takeover?

Dr. Steve Daveluy makes the case that Cosentyx is the “just right” first biologic for HS—but not every Derm is ready to move past TNFs. Durability, infection risk, IBD, and insurance all enter the argument.

Exosomes may be real science, but the marketing has sprinted miles ahead of the data. The Derms dig into their promise for burns and epidermolysis bullosa—and why that pricey cosmetic vial may not contain what it claims.

Three papers, three practical questions: Who really needs antibiotics before derm surgery? What comes after an AD drug fails? And does taking oral minoxidil in the morning actually grow more hair—or just raise more eyebrows?

Dr. Marc Serota makes the case for targeted lab testing in CSU—but the Derms worry it may open a can of worms. The Chronic Urticaria Index gets a closer look, shotgun allergy panels get nowhere—but does he convince the Derms?

After 70,000 virtual consults, Dr. Joe English knows what a photo can—and can’t—tell you. He joins the Derms to talk diagnostic curveballs, hospital saves, and bringing dermatology where there’s no dermatologist in sight.

Three papers, three very different reactions: a Treg-boosting AD drug that may be too clever for its own good, a Steri-Strip trick you can use tomorrow, and Rinvoq alopecia data that have the Derms calling game changer.

Convince the Derms on Drugs makes its debut with Dr. Christopher Sayed making the case for earlier systemic treatment in HS. Can he convince the Derms to act before recurring lesions become tunnels, scars, and damage no medication can undo?

Patch first or treat first? The Hamann brothers join the Derms to tackle mystery dermatitis, questionable allergens, wet wraps, hand eczema—and why the answer may be hiding in your patient’s shampoo.

Three papers, three plot twists: new HS data that underwhelm on paper, a transected melanoma that may not need a sentinel node, and a possible explanation for why JAK clot risk may depend on the disease.

Male genital disease expert Dr. Christopher Bunker joins the Derms for the penis episode no one else was brave enough to make. Lichen sclerosus, circumcision, penile cancer—and one diagnosis he says doesn’t exist—are all on the table.

The Derms debut a shorter format with three papers and one newly dirt-cheap drug: generic tofacitinib. The safety, the risks, and the practicalities—right down to getting it for just $25 a month.

Pediatric dermatology legend Dr. Sheila Fallon Friedlander joins the Derms to sort through the new topical “Goldilocks” problem, take the sting out of Dupixent injections, and make the case for treating molluscum sooner. Plus, how to recognize measles—and why its most frightening complication may not appear for years.

The CSU rulebook is getting a rewrite, and the Derms on Drugs crew has thoughts. Dr. Jason Hawkes joins the conversation to talk new guidelines, new therapies, and why it may be time to stop sending these patients somewhere else.

This week, the DoD tackle studies that leave plenty of room for debate—from skin cancer treatment costs and melanoma risk to HS, alopecia areata, and the real-world decisions that don't always come with straightforward answers.

The DOD tackle longitudinal melanonychia, retronychia, nail biopsies, and other everyday nail problems—with enough practical pearls to make you rethink your next nail patient.

One paper questions melanoma screening. Another challenges patch testing. By the end, the conversation has wandered into studies on physician burnout and more, sparking exactly the kind of debate you'd expect from DoD.

Dermatologist William Damsky, MD, joins the DoD crew to explore immune biomarkers, treatment prediction, and whether precision dermatology is finally ready for prime time.

Burnout isn't just about long hours. From moral distress to prior authorizations and system barriers, this week's conversation with Dr. Lisa Swanson explores what's really wearing physicians down—and why resilience alone won't fix it.

Thin melanomas that behave badly, a surprisingly intriguing role for oxybutynin in HS, and a reminder that some of dermatology’s most trusted assumptions deserve a second look. This week’s 6-pack is all about the exceptions that force us to rethink the rules.

The diagnoses get messy, the treatment decisions get interesting, and the DoD crew has opinions. From a major scabies study to a practical overlap-disease pearl, this week's episode is full of reminders that dermatology is rarely as straightforward as it seems.

An emerging infection out of France, a surprisingly clever vitiligo combo, and a spirited debate about whether medicine has ever actually cured anything. Just another normal week on Derms on Drugs.

Melanoma, Anxiety, and Depression Links; Biosimilars vs Humira; Air Pollution and Atopic Dermatitis – Have We Finally Figured Out Why Eczema Is So Common and much, much more… 

• Which patients are the most affected by anxiety and depression after a melanoma diagnosis and what can we do about it?
• Patients who are switched onto a biosimilar do “worse” than patients who start one as their first therapy – why?
• We finally got eczema answers.  Turns out that air pollution, both indoor and outdoor, is the cause of the atopic dermatitis epidemic that started in the 1970s and is why eczema is more common in urban areas.
• Ian Myles explains how he proved that air pollution is the driving force behind atopic dermatitis and helps our team understand what it all means  
• Plus: Predictors of acne relapse after isotretinoin, dupilumab prevents cancer, how well does tralokinumab work in dupilumab "failures," ferulic acid for rosacea, cysteamine vs hydroquinone for melasma, and the best way to treat digital mucous cysts

Guest: Ian A. Myles, MD, Mph 

Dr. Myles,  Principal Investigator, Epithelial Therapeutics Unit, graduated with a B.S. in biology from Colorado State University in 2001 and then obtained an M.D. from the University of Colorado in 2005. He completed an internal medicine residency at The Ohio State University prior to beginning fellowship training in allergy and clinical immunology at NIH. He worked under the mentorship of Dr. Sandip Datta investigating the mechanistic details of susceptibility to S. aureus skin infections. In 2011, Dr. Myles became a commissioned officer in the United States Public Health Service Commissioned Corps. LCDR Myles has supported several USPHS missions, from the Ebola virus vaccine trial in West Africa to congressional Gold Medal Ceremonies at the U.S. Capitol. In 2013, he was awarded a position as an assistant clinical investigator in the NIAID Transition Program in Clinical Research. Dr. Myles received his M.P.H. from George Washington University in 2016. In 2018, Dr. Myles became the head of the newly formed Epithelial Therapeutics Unit to evaluate the efficacy and safety of a topical, live bacterial treatment for atopic dermatitis (eczema). He is currently a participant in the Lasker Clinical Research Scholars and Distinguished Scholars programs.

Psoriatic arthritis usually gets explained in a way that makes derms want to leave the room. Not this episode. Drs. Zirwas, Ferris, and Patton are joined by double-boarded rheum-derm expert Dr. Saakshi Khattri for a practical, entertaining deep dive into recognizing PsA and making smarter treatment decisions — without the rheumatology overload.

This week’s Derms on Drugs is a classic six-pack episode. From cutting-edge CTCL therapies to biologic safety data and the growing world of oral photoprotection, the group covers the studies worth knowing—plus a few opinions spicy enough to start a conference hallway argument. 

This week on Derms on Drugs, the gang goes deep into vulvar dermatology with double-boarded derm/OB-GYN expert Dr. Kelly Tyler. From lichen sclerosus and recurrent candidiasis to estrogen, lasers, PRP, and the wildly overmarketed “Mona Lisa” treatments, they they break down what helps, what doesn’t, and what’s probably paying for someone’s boat. Equal parts practical pearls and inappropriate laughter — exactly how medical education should be.

This week’s Derms on Drugs is a 6-pack that covers a little bit of everything and somehow lands on: just do what you want. From a randomized trial showing eczema doesn’t care how often you shower to wild dupilumab data—plus a heating pad “treatment” that might actually work and a new JAK/TYK2 raising eyebrows—this one is equal parts useful, questionable, and predictably unpredictable.

Feeling a little worn down by Friday? A bit… degenerated, perhaps? This week’s Derms on Drugs goes off the beaten path and into the world of regenerative dermatology, where the line between legit science and “sounds like a scam” gets… blurry. With guest Dr. Amanda Hill, the team tackles hormones, skin aging, and whether we’re actually regenerating tissue—or just getting better at marketing it. From estrogen myths (and what we got very wrong) to PRP, exosomes, and the truth about “bioidentical” everything, this one separates hype from what might actually matter—and calls out a lot of nonsense along the way.

This week’s Derms on Drugs 6-pack moves past theory and into real decisions—what actually helps you pick the rightdrug for the patient in front of you. From gene expression profiling that predicts JAK vs Th2 response to the growing concern around dupilumab and CTCL, and more, this episode separates signal from noise—and gives you a few things you won’t forget (looking at you, abscopal effect).

Couldn’t make it to Denver for AAD—or made it to Part 1 but still hungry for the rest? Derms on Drugs is back with Part 2, finishing the job with more of the hottest late-breaking data in dermatology. Join Drs. Zirwas, Ferris, and Patton as they dive into the remaining abstracts, breaking down what actually matters (and what doesn’t) with the same unfiltered, practical take you expect from the DoD crew.

Couldn't make it to Denver for the AAD conference?  Made it to Denver but maybe had one too many Old Fashions to make it to the late breaking abstract presentations?  DoD may have had too many Old Fashions (it was really only Dr. Zirwas), but we still made it to the session with all the hottest data in the world of dermatology.  Join Drs. Zirwas, Ferris, and Patton for the first episode of this pair that'll keep you ahead of the curve.  

Some studies make you rethink everything. Others… not so much. This week, it’s a classic Derms on Drugs 6-pack that sorts through what’s actually useful, what’s overhyped, and what might quietly change how you practice. Can Castle testing spare sentinel node biopsies—or not yet? And why U.S. derms (and Patton) disagree with Europe on BP guidance. Plus more!

The Derms on Drugs get schooled on Hidradenitis Suppurativa by Dr. Chris Sayed from the University of North Carolina.  This will be one of the most practically useful sessions you've ever heard as we go way beyond the basics - we go way beyond basics like the biologics that don't work all that well.
We'll get into a bunch of questions you probably haven't hear discussed with HS before:
- What's the window of opportunity in HS and how do you keep it open?
- Is there any such thing as mild HS?
- What antibiotics actually work for HS and how do you use them?
- Do ancillary treatments like spironolactone, metronidazole and oral roflumilast actually move the needle in a meaningful way?
- If you're going to learn one surgical technique to really help your HS patients which procedure should you pick and how should you learn it?
- What will be the likely role of JAK Inhibitors in HS?
- Is it actually possible to get patients with long term, scarring severe HS better?

Melanoma, extramammary paget's and a prostate cancer drug walk into a bar... well, it may sound like a joke, but this week's episode is no laughing matter!  Join the Derms on Drugs as we get into some deep topics:
New data on Castle Gene Expression Profiling for thin melanomas - does it finally answer the age old question question:  To send or not to send?
Did you know that as we get older, our lymphatics get leaky and it is actually pretty important when it comes to melanoma?
Extramammary Paget's Disease (EMPD) is a bad actor - when you see it, what should you do about it? Wide local excision vs Mohs vs Mohs plus radiation?
You know Dr. Patton's a nerd.  But this week is off the charts.  You'll learn more about pathological staining of EMPD that you ever wanted.
Bicaludamide?  Better than spironolactone for female pattern hair loss?  What do you need to know to start prescribing it?
Pruritus in renal failure patients is the WORST, turns out that medications can be a big driving factor and stopping them might be all you need to do.

Matt, Laura, and Tim are joined by Dr. Lauren Graham (UAB) for a deep dive into cutaneous connective tissue disease. They cover the latest in lupus treatment — including the game-changing anifrolumab and its emerging sub-Q formulation — plus dermatomyositis workup, malignancy screening, the buzz around brepocitinib, and whether roflumilast deserves a spot as first-line therapy. 

The Derms on Drugs are back it, answering the burning questions you didn't know you had.  This week's hot topics:
Aviclear laser new data just dropped. Realistic alternative to Accutane or just another device that sits in the corner and gathers dust?
Does mycophenolate actually do anything in pemphigus?
More data about Dupixent, CTCL and cancer.  Does it help, hurt or it's a wash?
What happens if you get scabies while you're on Dupixent?  Turns out Zirwas has been wrong about this for years.
Who is at risk for hyperkalemia on spironolactone and is it bad enough that we should care?
Our goal in early hidradenitis is to prevent progression to scarring - what factors that predict who is likely to progress and what can prevent it?
There's a new side effect to worry about with JAK inhibitors and we promise you won't forget about it.
Finally, what do you say when a patient says "What would you do?"

Big news on TB Tests for psoriasis patients on biologics! New official recommendations say not necessary for IL-17s and IL-23s.  Literally zero cases.  Ever.  
Think nicotinamide prevents skin cancer?  Think again.  Not saying it doesn't, but turns out data isn't really there and the jury is still out. 
How safe are topical steroids?  Depends.  Depends what else you're taking, especially NSAIDS - turns out it may increase your risk of an upper GI pretty substantially.
If somebody doesn't respond adequately to Dupixent, what happens if you switch them to Rinvoq?  Abbvie kind of answered the question, but not really.
Just how well does Rhapsido work in CSU?  And does it actually cause bleeding? No, no it does not.  But we're understanding more and more about why it causes petechiae.  
Are PDE4 inhibitors like apremilast and roflumilast effective for bullous pemphigoid?  Maybe.  
Do Sotyktu (and the new TYK2 inhibitors coming soon) work for atopic dermatitis?  We got our first data and it looks like they are pretty great. 

The Derms on Drugs are back at it, answering the burning derm questions you didn't even know you had.  Join us this week as we dive into more "outside the box" therapies that you can use next week in the office.
-Is low dose naltrexone a lifeline in difficult dermatoses or a false hope?
-There's been some chatter around metformin for hidradenitis suppurativa.  Is it hype or hope?
-Diet and chronic spontaneous urticaria - Patients always ask and while we know it isn't food allergy, new data says that diet does play a role and gives us a simple intervention that's worth trying.
-Everybody hates warts and we're always looking for pain free treatment options - could a heating pad and hydrogen peroxide be the answer?
-Can we knock out psoriasis long term with a few months of high dose IL-23 inhibition?
-We love tranexamic acid for melasma, but does oral or topical work better?
-Once a vitiligo patient gets better, can you stop the Opzelura?
-Fact or Fiction:  Compared to PLEVA, PLC lasts longer and happens in adults more than kids?

The Derms on Drugs are joined by Dr. Peter Lio to take a dive into the "root causes" of atopic dermatitis and what we can do to address them.  Maybe you've heard about the "NICE" Axis - the Neuro-Immuno-Cutaneo-Endocrine Axis and thought you were on the cutting edge.  Well, you're not.  The new and updated model is the "SINGE" Network - the Skin-Immuno-Neuro-Gastro-Endocrine Network.  Join us this week to get the answers to more of the questions you didn't know you should have!

• New data confirms again that elimination diets don't help with atopic dermatitis and data shows that avoiding foods makes you more likely so how do you talk to patients who are convinced food allergy is driving their atopic dermatitis?
• Should you be recommending probiotics to you atopic dermatitis patients (and which one)?
• How (and why) do probiotics work for atopic dermatitis?
• What does a lion in your basement have to do with atopic dermatitis?
• How do you handle patients who say that all moisturizers sting when you put them on?
• How do you deal with people in whom Staph aureus is playing a major role in their atopic dermatitis?
• What's coming for atopic dermatitis in 2026?

This week's episode will help you not get sued, talk to psoriasis patients about diet, manage transplant patients with skin cancer and more.  Join us again this week to get the answers to burning dermatology questions you didn't know you had.   
Can the Mediterranean diet help with psoriasis?  And why do people get 'gluten sensitivity' from US wheat but not Mediterranean wheat?

When do you recommend changing immunosuppression in transplant patients with skin cancer?

Are people with atopic dermatitis more or less likely to have contact derm than other people?

Hailey Hailey is an awful disease that's hard to treat - can dupilumab help?  What other 'off the beaten path' therapies are there?

Cosibelimab is the new kid on the block for bad squamous cell carcinoma - is it any better than existing treatments?

When do you need to be worried about underlying malignancy in dermatomyositis patients?

Oral minoxidil causes hairy arms in men.  But do they care?

You know Bactrim can cause SJS and TEN, but do you know about the other life threatening side effect that specifically affects young healthy people with acne?

The Derms on Drugs bring in a heavy hitter straight out of silicon valley to talk AI and the future of dermatology.  Dr. Faranak Kamangar is a Board Certified Dermatologist who founded, built and continues to improve DermGPT - a derm specific LLM that just outperformed ChatGPT in a head-to-head contest judged by dermatologists!  As usual, we'll answer the questions you didn't know you had (well, maybe you knew you had some of these):

• Is AI going to make our lives easier or is it going to replace us?
• How good is AI at answering patient questions?
• Will patients accept "AI Providers"?
• How can you start levering AI now to make your life better?
• What AI tools are out there to start using right now?
• Are AI scribes all that great?

The Derms on Drugs give the definitive answer to the age old question:  What came first, the chicken or the egg?  You'll have to listen to find out.  

• What's a Mazotti Reaction and why do you care?

• How do JAK inhibitors compare to dupilumab for treating prurigo nodularis?
• What's a cheap, easy, safe, effective treatment for palmoplantar pustulosis?
• Can a steroid nasal spray help for Chronic Spontaneous Urticaria?
• Do biologics reduce infection risk in AD more than JAK Inhibitors and why?
• How does superficial radiation therapy compare to Mohs for skin cancer?
• Dermal hyperpigmentation is impossible to treat - can isotretinoin help?
• Cheilitis drives derms and patients nuts - what's the new, cheap, easy way to help?

Get ready for a no-nonsense tour-de-force of practical application in the latest derm literature. Pipeline drugs, new approvals, brand names, generics—and HS data you’re better off ignoring (we’ll tell you why).

In this episode:

·       Leqselvi: the newest JAK for alopecia areata—actually different, or more of the same?

·       HS & spondyloarthritis: are you screening… should you be?

·       JAKs and the heart: are all cardiovascular risks created equal?

·       “2/3 HS remission” headlines: why this data shouldn’t change your practice

·       Tirbanibulin + cryo for AKs: combo win or marketing math?

·       Hydrochlorothiazide & skin cancer: do you really need that conversation?

·       Oral minoxidil + Olumiant: synergy or wishful thinking in AA?

·       OX40/OX40L blockers: exciting pathway—new hope or new hype?

Fast. Practical. Slightly skeptical (for good reason).

If you prescribe, counsel, or roll your eyes at bad data—this one’s for you.

Listening this week could save your life (well, at least your kidneys).  Find out what common ingredient in keratin treatments you (and your friends, family and patients) NEED to avoid.  But there's a lot more than that packed into this week's episode.  As always, the Derms on Drugs bring the goods on the latest questions that the literature is answering:
-Is isotretinoin making kids short?  
-Is Dupixent making them tall?  
-What is "transcutaneous auricular vagus nerve stimulation" and which common but difficult derm disease does it help with?  
-What OTC supplement makes NBUVB work better for vitiligo?  
-What oral drug can you add to isotretinoin to make it work even better?  
-Does oral tranexamic acid increase the risk of blood clots when used in dermatology?
-How well does Opzelura work for hidradenitis suppurativa?
-Do Humira biosimilars work as well as Humira in hidradenitis suppurativa?
-What common statistical technique used by pharma is total BS?
-Which ingredient in 'keratin treatments" is causing kidney failure and kidney stones? 

Admit it—bad hair days are the worst. Now imagine every day is one. Alopecia’s psychological impact is way deeper (and more surprising) than most people think. This week, the Derms on Drugs sit down with Harvard’s Dr. Maryanne Makredes Senna to unpack the mental side of AA—and then dive into what to do when a JAK inhibitor just… doesn’t JAK. As always, we’re answering the questions you didn’t even know you had.

Here’s what we’re tackling:

• What hits harder on anxiety and depression—scarring or non-scarring alopecia?

• How tightly does AA severity track with psychological burden?

• How should you approach the mental health effects of AA?
  (Yes, you should ask. No, you shouldn’t be the one treating—here’s how to bridge patients to the right therapists.)

• And what do you do when a JAK Inhibitor isn’t giving you the results you hoped for?

This week, the Derms on Drugs are back with another literature speed-run—think 3D chess meets derm nerd nirvana. We’re answering questions you didn’t even know you had (and a few you wish you didn’t).

Here’s what we’re tackling:

• Do herbal supplements turn up dermatomyositis?

• Can biologics cut down on blood clots in HS?

• Wait… does Claritin supercharge isotretinoin?

• Is Sotyktu stirring up rosacea?

• How good is the new oral IL-23 inhibitor icotrokinra for psoriasis?

• Any fresh weapons against demodex?

• Anything new for those stubborn pemphigus oral lesions?

• What to do when your patient is resistant to multiple botulinum toxins?

• And—holy grail alert—can we actually prevent chemo-induced alopecia in breast cancer?

The Derms on Drugs are joined by Dr. Crystal Aguh from Johns Hopkins for an AMAZING discussion on central centrifugal scarring alopecia.  From uber practical, cheap, safe, effective treatment approaches to deep science on what is happening in this disease, listen this week and you'll be an expert - how to talk to these patients, the baseline treatments everybody should be on, when to get more aggressive, when to step therapy back - the whole enchilada.  We even throw in a little frontal fibrosing alopecia.  Quite honestly one of the best episodes we've ever done.  The Derms on Drugs learned new approaches to this disease and we promise, you will too!