January 28, 2026
IN THIS ISSUE / Jan. 28, 2026
Topical estrogens for skin aging
Authors of a Brief Report published in JAAD evaluated the efficacy and safety of topical estrogens for skin aging. Estradiol (E2) showed improvements most consistently seen in skin thickness and collagen, but study designs varied widely. Estriol (E3) was evaluated in one double-blind randomized control trial (DB-RCT) and two open-label trials, all with E2 comparators, limited sample sizes, and ≤6-month durations. Across studies, improvements in wrinkles, firmness, and hydration were largely comparable to E2.
[Dermatologists discuss dermatologic changes before and during menopause and the dermatoses that may occur. Read more.]
Phytoestrogens increased skin thickness, collagen, and hyaluronic acid across three small DB-RCTs but were less effective than E2 controls. Methyl-estradiol-propanoate (MEP) and conjugated equine estrogen (CEE) both improved various markers of skin aging. Estrone (1%) failed to improve wrinkles or elasticity in a DB-RCT and significantly increased matrix metalloproteinase-1 expression, potentially promoting collagen degradation in photoaged facial skin.
[Learn about the most popular (and effective) applications of red-light therapies. Read more.]
The authors warned that patients should be cautioned that use of estrogens for skin aging expands overall estrogen exposure, and no trials have evaluated endometrial safety with combined facial and vaginal use. Given the significant heterogeneity across studies, confident conclusions about efficacy cannot yet be drawn, they noted.
Share anti-aging skin care resources with your patients.
DermWorld What’s Hot: Driver of psoriatic itch
A new study by Zhang et al. in the Journal of Investigative Dermatology pinpoints a neural IL-17 pathway as the driver of psoriatic itch, reshaping how we think about itch in psoriasis. Read more from Chirag Vasavda, MD, PhD.
Outcomes across JAK inhibitors in prurigo nodularis
Authors of an article in Clinical and Experimental Dermatology investigated clinical findings and treatment outcomes among patients diagnosed with prurigo nodularis (PN) and treated with JAK inhibitors in a real-world setting. Patients with PN were eligible if at least 18 years of age and had received a JAKi with a minimum follow-up of 12 weeks. The primary outcome was defined as the proportion of patients achieving a reduction of four points or greater from baseline in the Peak Pruritus Numerical Rating Scale score.
[Prurigo nodularis: 9 dermatologists’ tips for relieving the itch. Read more.]
At week 16, the proportion of patients achieving the primary outcome was 94% for upadacitinib, 83% for abrocitinib, and 100% for baricitinib, with results sustained at week 24. Improvements were observed across all other secondary outcomes assessed, with no safety concerns reported.
What are the effects of nemolizumab treatment in prurigo nodularis patients? Read more.
Anticholinergic treatments for hyperhidrosis
Authors of a clinical review published in JAAD Reviews investigated the impact of commonly prescribed anticholinergics for the treatment of hyperhidrosis. They reviewed glycopyrrolate, oxybutynin, sofpironium bromide, umeclidinium, propantheline bromide, and benztropine. Oxybutynin remains the most commonly prescribed treatment despite its off-label use and was shown to be more effective than glycopyrrolate with the lowest rate of adverse effects. However, the authors noted more recent studies showing a significantly increased risk of the development of dementia, emphasizing the need for more randomized controlled trials.
Read about the latest FDA-approved topical agent for hyperhidrosis.
Radiofrequency microneedling for hyperhidrosis – DermWorld Weekly (July 2025)
Coding and documentation for hyperhidrosis – DermWorld (November 2024)
Assessment of GPT-4 vision in dermoscopic image analysis
Authors of a Brief Report in JAAD assessed the capabilities of GPT-4 vision (GPT-4V) in analyzing dermoscopic images of common skin disorders. The biopsy-proven digital images were compared against five dermatologists’ assessments. The 273 images included 25.3% basal cell carcinomas, 17.2% melanomas, 7.0% squamous cell carcinomas, 5.5% seborrheic keratoses, 3.3% dermatofibroma, 2.9% verruca vulgaris, and 2.9% intradermal nevi.
[Can we chat? Read more about ChatGPT in DermWorld Insights and Inquiries.]
GPT-4V was diagnostically correct in 50.7% of images compared to 81.8% for human graders. While a subgroup analysis showed GPT-4V better identified melanoma (96% vs. 79% for the top diagnosis), this was offset by GPT-4V’s frequent misclassification of benign lesions as melanoma. While GPT-4V shows some diagnostic capabilities, it is not reliable for independent clinical use, the authors concluded.
Where do things currently stand with machine learning — and what does the future hold? Read more.
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