Abnormalities of hair growth carry a great psychosocial impact, and are intimately related to self-image for both men and women. Although associations with systemic disease are less common, evaluation and management of hair disorders are an essential part of patient care within dermatology.

Hair growth abnormalities include disorders of hair loss, termed alopecia, and excess hair growth, known as hypertrichosis.

Alopecias may be further subdivided into diffuse alopecias, in which hair loss occurs throughout the scalp, and focal alopecia, with distinct areas of localized hair loss or bald spots. Another important distinction to be made is whether a scarring or non-scarring process has occurred. In scarring alopecias, inflammation within the scalp has lead to destruction of hair follicles. In these situations, therapy is directed towards preventing further hair loss, as areas of the scalp already affected are not likely to show significant re-growth. In patients with non-scarring alopecias, hair follicles are still present, and therapy is geared towards re-growth of lost hair.

Hypertrichosis may also be localized or diffuse, and may be congenital (present at birth) or acquired at any time. An important form of hypertrichosis, known as hirsutism, occurs in women and refers to excess hair growth on the body in a male distribution. In some cases this is a normal variant with a genetic predisposition. For many patients, however, this may be a clue to an underlying endocrine disturbance for which treatment may improve the appearance of hirsutism.

At Columbia University, we offer a comprehensive evaluation of patients suffering from hair growth abnormalities. Our goal is to determine whether the disturbance in hair growth is reversible, and to individualize therapy to meet our patients’ needs. Therapies directed at removal of excess hair are also available.

 

Nail Disease Therapy
Ravi Ubriani, M.D., F.A.A.D
Assistant Professor of Clinical Dermatology
Director, Section for Diagnosis and Treatment of Nail Disorders

The Department of Dermatology of Columbia University Medical Center is one of the few centers in the world for the diagnosis and treatment of nail disorders. Patients at CUMC have access to this unique and important service directed by Dr. Ravi Ubriani. Dr. Ubriani completed his residency training at the University of Pennsylvania, where he led a nail clinic, prior to joining Columbia University.

Nails are often a window to a patient’s general health, and nail changes may signal a systemic disease. Additionally, primary diseases of the nail unit can be quite serious. Even simple nail problems can take a variety of forms and affect a person’s ability to walk, wear shoes, pick up objects, or fasten buttons.

Approximately fifty million Americans suffer from fungal infections of the nail. Some forty percent of the elderly have toenail fungus. More than twenty percent of all American women suffer from brittle nails.

The Nail Therapy Service of the Department of Dermatology evaluates and treats patients of all ages with any type of nail abnormality that may include:

• Fungal, bacterial and viral nail infections
• Effects of nail cosmetics, including nail product allergy
• Nail psoriasis
• Tumor of the nail unit such as melanoma and others
• General diseases of the nail

The Nail Therapy Service works closely with the Clinical Trials Unit of the Department of Dermatology, which participates in the development of new nail therapies, including topical and oral anti-fungals, psoriasis medications, nail growth enhancers, and nail conditioners.  To discover new nail therapies and to participate in a clinical trial, visit the Department’s Clinical Trials Unit for more information.

Preparation for Your Appointment

• Remove all nail polish and acrylic nails prior to your visit.
• Bring all nail products and tools that you use regularly to your appointment
• If you suspect that you have a fungal infection of the nail, do not clip the nail for at least one month prior to your visit – this will allow us to do the appropriate diagnostic procedure.
• If you have a single dark streak in the nail, please let the schedulers know so that we can schedule you appropriately. If this is in your toenail, please wear comfortable wide-toed shoes to the visit in case we need to do a biopsy.
• Wear loose-fitting clothing – nail diseases can reflect other skin disease, and Dr. Ubriani will need to examine your knees and elbows during the visit.